Incidence of Post-Covid Syndrome and Associated Symptoms in Outpatient Care in Bavaria, Germany, 2022, Donnachie et al

Abstract
Objectives: To estimate the treatment incidence of Post-Covid Syndrome in the context of office-based care in Bavaria, Germany, and to establish whether related diagnoses occur more frequently than in patients with no known history of COVID-19. Design: Retrospective analysis of routinely collected claims data.

Setting: Office-based care in Bavaria, Germany. Participants: 391,990 patients with confirmed COVID-19 diagnosis, 62,659 patients with other respiratory infection, and a control group of 659,579 patients with no confirmed or suspected diagnosis COVID-19.

Primary and Secondary Outcome Measures:
Primary outcome is diagnosis of a Post-COVID Syndrome by an office-based physician. Secondary outcomes are: Chronic Fatigue Syndrome (CFS), psychological disorder, fatigue, mild cognitive impairment, disturbances of taste and smell, dyspnea, pulmonary embolism and myalgia.

Results: Among all patients with confirmed COVID-19 infection, 14.2% (95% CI: 14.0-14.5) received a diagnosis of a Post-COVID Syndrome, and 6.7% (6.5-6.9) received the diagnosis in at least two quarterly periods during a two-year follow-up. Compared with patients with other respiratory infections and with controls, patients with COVID-19 more frequently received a variety of diagnoses including CFS (1.6% vs. 0.6% and 0.3%, respectively), fatigue (13.3% vs. 9.2% and 6.0%), dyspnea (9.9% vs. 5.1% and 3.2%) and disturbances of taste and smell (3.2% vs. 1.2% and 0.5%). The treatment incidence of Post-COVID Syndrome was highest among adults aged 40-59 (19.0%) and lowest among children aged below 12 years (2.6%).

Conclusions: Our results demonstrate a moderately high incidence of Post-COVID Syndrome two years after infection with COVID-19. There is an urgent need to find efficient and effective solutions to help patients with mental disorders, dyspnea, fatigue and loss of smell. Guidelines and treatment algorithms, including referral criteria, occupational and physical therapy, require promptly and coherent implementation. Further research is required both to find new therapeutic options and to assess the implications of Post-COVID Syndrome for health services.

https://www.medrxiv.org/content/10.1101/2022.05.29.22275262v1

 

Now published in BMJ Open:
https://bmjopen.bmj.com/content/12/9/e064979.long

The data is based on insurance records and CFS diagnosis were recorded using the ICD-10-GM, so there might have been underdiagnosis as many doctors do not recognize the illness or make the diagnosis.

 

The authors write:

"Of particular note is a cumulative treatment incidence of 1.6% for chronic fatigue syndrome in the COVID-19 group, with 0.6% of all patients with COVID-19 receiving the diagnosis in multiple quarterly periods. Among patients with other respiratory infection and in controls without COVID-19- related contact, the proportions with a single diagnosis were 0.6% and 0.3%, respectively."​