Prevalence of and factors associated with COVID-19 diagnosis in symptomatic patients followed in general practices in Germany between March 2020 and March 2021

Louis Jacob,Ai Koyanagi,Lee Smith,Josep Maria Haro,Anna M Rohe,Karel Kostev

doi:10.1016/j.ijid.2021.08.010

Abstract

AimsThis study aimed to investigate the prevalence of and the factors associated with the diagnosis of coronavirus disease 2019 (COVID-19) in symptomatic patients followed in general practices in Germany between March 2020 and March 2021. MethodsSymptomatic patients tested for COVID-19 and followed in one of 962 general practices in Germany from March 2020 to March 2021 were included in this study. Covariates included sex, age, and comorbidities present in at least 3% of the population. The association between these factors and the diagnosis of COVID-19 was analyzed using an adjusted logistic regression model. ResultsA total of 301,290 patients tested for COVID-19 were included in this study (54.7% women; mean [SD] age 44.6 [18.5] years). The prevalence of COVID-19 was 13.8% in this sample. Male sex and older age were positively and significantly associated with COVID-19. In terms of comorbidities, the strongest positive associations with COVID-19 were observed for cardiac arrhythmias, depression, and obesity. There was also a negative relationship between the odds of being diagnosed with COVID-19 and several conditions such as chronic sinusitis, asthma, and anxiety disorders. ConclusionsApproximately 14% of symptomatic patients tested for COVID-19 were diagnosed with COVID-19 in German general practices from March 2020 to March 2021.

Highlights

Coronavirus disease 2019 (COVID-19) refers to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a singlestranded RNA virus with predominant respiratory transmission (Baloch et al, 2020; Meyerowitz et al, 2020), which has triggered a worldwide and ongoing pandemic
This study included 301,290 symptomatic patients tested for COVID-19 and followed in 962 general practices
COVID-19 diagnosis was positively and significantly associated with male sex and older age

Summary

Introduction

Coronavirus disease 2019 (COVID-19) refers to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a singlestranded RNA virus with predominant respiratory transmission (Baloch et al, 2020; Meyerowitz et al, 2020), which has triggered a worldwide and ongoing pandemic. A retrospective study, including 24,081 healthcare workers who had nasopharyngeal swabs taken in an academic medical center in the United States between March and June 2020, showed that the prevalence of COVID-19 was around 0.59% (Shepard et al, 2021) By contrast, another cross-sectional study of 3,802 patients followed in primary care practices in the United Kingdom in January– April 2020 revealed that more than 15% of the sample had tested positive for SARS-CoV-2 (Lusignan et al, 2020). One study has found people with diabetes to be at an increased risk of COVID-19 compared to their counterparts without diabetes (Fan et al, 2020), while another has found that this is not the case (Lusignan et al, 2020) Taking these discrepancies into consideration, more data are needed on the rate of COVID-19 diagnosis among individuals with common COVID-19 symptoms, and on the sociodemographic and clinical characteristics of this population

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