Long-term health consequences in persons with and without SARS-CoV-2 infection in Germany

Abstract

Abstract Background So far, few population-based studies comprehensively examined health consequences of COVID-19 including a control group not exposed to SARS-CoV-2 infection and a long-term follow-up. This cohort study of 4817 adults from four municipalities in Germany examined health consequences among individuals more than one year after SARS-CoV-2 infection compared with non-infected individuals. Methods Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (04/2020 to 12/2020). Outcomes assessed at follow-up (10/2021 to 01/2022) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health and subjective memory impairment. Regression models were adjusted for socio-demographic and lifestyle characteristics, pre-existing health conditions and follow-up time. Results Overall, 350 participants had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Individuals with an infection reported more often 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (OR 4.1, 95%−CI 2.8-6.0), shortness of breath (3.5, 2.6-4.7), pain when breathing (2.4, 1.3-4.2), fatigue (1.8, 1.4-2.2), weakness in legs (1.9, 1.3-2.8), myalgia/joint pain (1.5, 1.2-2.0) and cough (1.3, 1.0-1.7) and 3 out of 6 groups of incident diseases: liver/kidney (3.7, 1.7-8.1), lung (3.5, 1.7-7.1) and cardiovascular/metabolic (1.7, 1.0-2.7) diseases. Participants with an infection were significantly more likely to report poor subjective health, memory impairment and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected. Conclusions Results of this population-based controlled study point to a considerable impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection even more than one year after infection. Key messages • After one year, individuals with SARS-CoV-2 infection showed increased risks of various health complaints, functional limitations and worse subjective health compared to those without an infection. • Long-term health consequences after a SARS-CoV-2 infection is a relevant public health concern.