Severity score-based study of predictors and clinical correlates of Post-COVID Syndrome (PCS) in Germany

Abstract

<b>Background:</b> Post-COVID Syndrome (PCS) is an important sequela of COVID-19, characterised by symptom persistence &gt;3 months, subacute symptom onset, and worsening of pre-existing comorbidities. The causes and public health impact of PCS are still unclear, not least for the lack of efficient means to assess the presence and severity of PCS. <b>Methods:</b> COVIDOM is a population-based cohort study of PCR-confirmed cases of SARS-CoV-2 infection, recruited through local public health authorities in three German regions. Standardised interviews and in-depth on-site examinations were scheduled 6-12 months post infection. Based upon 12 long-term symptom complexes, we developed a comprehensive PCS severity score in a training cohort and validated the score in two independent sub-cohorts. <b>Results:</b> In the training sub-cohort (n=667, 56% female), 90% of participants were treated as outpatients for&nbsp;acute COVID-19. Neurological ailments (61.5%) and fatigue (57.1%) persisted most frequently. Across all sub-cohorts, higher PCS scores were associated with lower health-related quality of life (EQ-5D-5L-VAS/−index, all p&lt;0.001). Similarly, participants with a higher PCS score consistently showed increased blood inflammatory markers and D-dimer as well as lower diffusing capacity in lung function (all p&lt;0.01). Significant early predictors of the PCS score included the number and intensity of acute symptoms, resilience, and general anxiousness. <b>Conclusion:</b> PCS severity can be quantified by an easy-to-use score summarising individual disease burden and reflecting pathological processes. The PCS score promises to facilitate diagnosis&nbsp;of PCS, studies of its natural course, and of therapeutic interventions.