Abstract
BackgroundResearch has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data.MethodsWe used nationwide outpatient claims data from the years 2010 to 2019 collected according to § 295 of the Code of Social Law V, covering data for all statutory health insurees (SHI) which is nearly 87% of the entire German population. We considered 15 chronic disorders based on the current state of knowledge about clinically relevant risk factors. Three risk groups for a severe COVID-19 course were defined: 1. individuals in the age group 15 to 59 years with at least two comorbid disorders; 2. individuals aged 60 to 79 years with at least one disorder and 3. all individuals 80 years and older irrespective of the presence of chronic conditions. Regional analysis was conducted at the level of administrative districts (n = 401).ResultsOverall, 26% of individuals over 15 years were at high risk for a severe COVID-19 course in 2019 amounting to a total number of nearly 18.5 million individuals in Germany. This included 3.8 million individuals in risk group 1, 9.2 million in risk group 2, and 5.4 million in risk group 3, corresponding to 8, 50 and 100% of German inhabitants in the respective age groups. On the level of the 17 administrative regions formed by the Association of SHI Physicians (ASHIP regions), the proportion of individuals at high risk ranged between 21% in Hamburg and 35% in Saxony-Anhalt. Small-area estimates varied between 18% in Freiburg (Baden-Württemberg) and 39% in the district Elbe-Elster (Brandenburg).ConclusionsThe present study provides small-area estimates of populations at high risk for a severe COVID-19 course. These data are of particular importance for planning of preventive measures such as vaccination.Trial registrationnot applicable.
Highlights
Research has shown that the risk for a severe course of coronavirus disease (COVID)-19 is increased in the elderly population and among patients with chronic conditions
First recommendations for the prioritization of risk groups were already published in a position paper by the German Standing Committee on Vaccination (STIKO) in cooperation with the German National Academy of Sciences Leopoldina and the German ethics council back in November 2020 [7]
On the national level, an overall number of about 18.5 million people showed a high risk for a severe course of COVID-19
Summary
Research has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data. Patients with cancer, diabetes mellitus, chronic diseases of heart, liver, lungs or kidneys, neurological and immunological diseases including organ transplantations as well as individuals with obesity should be prioritized for vaccination. This selection of chronic conditions was supported by several other studies [5] and reviews [4, 6]. Current clinical data from the Italian Istituto Superiore di Sanitá confirm an almost identical profile [10]
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