Project ‘Post-acute health consequences of COVID-19 - Follow-up project’ (Post-COVID-19-II)

In September 2024, the project ‘Post-acute health consequences of COVID-19 - follow-up project’ (Post-COVID-19-II), funded by the Federal Ministry of Health, was launched as a continuation of the previous project ‘Post-acute health consequences of COVID-19’ (Post-COVID-19) with the following objectives:

1. Continuation of the systematic review of epidemiological data and the public health impact of Long COVID to support scientific communication with the professional public (e.g., FAQ on Long COVID on the homepage of the Robert Koch Institute) and the Long COVID Initiative of the Federal Ministry of Health.
2. Expansion of the public health research network on Long COVID to improve the epidemiological data situation in Germany and to harmonise case definitions and survey instruments as a basis for the continuous consolidation of epidemiological measures of Long COVID from various primary and secondary existing data sources.
3. Analysis and publication of a pilot study for ongoing population-based data collection and assessment of prevalence and determinants of selected common health complaints associated with Long COVID in adults in Germany.

Project Funding: Federal Ministry of Health
Funding number: 2524FSB422 
Duration: 01.09.2024 – 31.08.2026

Project leader: Giselle Sarganas
Deputy project leader: Julia Nübel 

Project ‘Post-acute health consequences of COVID-19’ (Post-COVID-19)

The completed project ‘Post-acute health consequences of COVID-19’ (Post-COVID-19, funding number: ZMI1-2521NIK705, duration: 01.12.2021 - 31.12.2023) had the following objectives:

1. Expansion of public health research on Long COVID with analyses of statutory health insurance (SHI) data in cooperation with health insurance funds and scientific institutes for health services research within the framework of the research initiative ‘Post-COVID-19 Monitoring in Routine Health Insurance Data’ (POINTED), under the coordination of the Center for Evidence-based Health Care (ZEGV) at the University Hospital of Dresden and the Robert Koch Institute (RKI).
2. Expansion of scientific communication on Long COVID for research and health care. In this context, the Institute of General Medicine of the Charité – Universitätsmedizin Berlin, together with the RKI and the Clinic and Polyclinic of Pediatrics and Adolescent Medicine of the Carl Gustav Carus University Hospital, Dresden, conducted a survey on the information needs of general practitioners and outpatient pediatricians in the context of care for people with long-term health consequences of a SARS-CoV-2 infection. In addition, there has been and continues to be close cooperation with the Bundesinstitut für Öffentliche Gesundheit (BIÖG) and the Federal Ministry of Health.
3. Expansion of cooperation between the RKI and partners in research and practice at the national and international level, in particular the scientific medical societies, professional associations, networks of practicing physicians as well as the public health sector.

Further activities:

In addition, the scientific evidence on Long COVID was continuously summarised as part of a systematic evidence synthesis. This information should help to inform science and practice and to identify research gaps. Furthermore, the RKI has developed together with ZB MED and PubPharm extended options for literature research on Long COVID.

Subproject 1: ‘Post-COVID-19 Monitoring in Routine Health Insurance Data’ (POINTED)

This subproject examined possible long-term health consequences of a SARS-CoV-2 infection through the evaluation of routine data from the statutory health insurance (SHI).

Although a variety of clinical symptoms are associated with post-COVID syndrome, there is still no uniform understanding of the underlying mechanisms of the disease. In addition to the acute illness, some of those infected may suffer from organ damage and lasting impairments of physical and mental health, functionality and quality of life. The need for care services for outpatient or inpatient follow-up care, treatment and rehabilitation measures is currently estimated to be high. In connection with this, there is an increased need for information on post-COVID, especially in general practitioner, pneumological and infectious disease care.

In order to assess the long-term health consequences of a SARS-CoV-2 infection, an evaluation of routine data from the statutory health insurance funds is taking place in the POINTED consortium as part of the German Ministry of Health-funded project ‘Post-acute health consequences of COVID-19’. The analyses are harmonised at the participating institutions and converge in aggregated form at the Center for Evidence-based Health Care (ZEGV) at the TU Dresden.

The results were presented at the symposium ‘SHI-insured persons in the dynamic context of COVID-19’ as part of the fourteenth annual conference of the German Society for Health Economics on 29.3.2022.

The following publications of results have been produced in subproject 1:

• Roessler M, Tesch F, Batram M, et al. Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with covid-19 in Germany. PLOS Medicine. 2022;19(11). doi: 10.1371/journal.pmed.1004122
• Tesch F, Ehm F, Vivirito A, et. al.  Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clin Rheumatol 2023 Oct;42(10):2905-2914. doi: 10.1007/s10067-023-06670-0. Epub 2023 Jun 19. Erratum in: Clin Rheumatol 2023 Jul 5;: PMID: 37335408; PMCID: PMC10497688.
• Schmitt J, Ehm F, Vivirito A, et. al. Large cohort study shows increased risk of developing atopic dermatitis after COVID-19 disease. Allergy. 2023 Jul 20. doi: 10.1111/all.15827. Epub ahead of print. PMID: 37469301.
• Tesch F, Ehm F, Loser F, et al. Post-viral symptoms and conditions are more frequent in COVID-19 than influenza, but not more persistent. BMC Infect Dis. 2024 Oct 9;24(1):1126. doi: 10.1186/s12879-024-10059-y. PMID: 39385128; PMCID: PMC11465902.
• Ehm F, Tesch F, Menzer S, et al. Long/post-COVID in children and adolescents: symptom onset and recovery after one year based on healthcare records in Germany. Infection. 2024 Sep 16. doi: 10.1007/s15010-024-02394-8. Epub ahead of print. PMID: 39285063.

Project leader Subproject 1: Jochen Schmitt, Center for Evidence-based Health Care, TU Dresden

Subproject team:

Center for Evidence-based Health Care, Dresden University of Technology
Falko Tesch
Franz Ehm
Martin Seifert

InGef - Institute for Applied Health Research Berlin GmbH
Josephine Jacob
Oliver Nagel
Annika Vivirito

Techniker Krankenkasse
Christina König
Friedrich Loser

BARMER Institut für Gesundheitssystemforschung (bifg)
Claudia Schulte
Danny Wende

IKK classic
Simone Menzer

AOK PLUS
Tilo Buschmann

Vandage GmbH
Manuel Batram

Robert Koch Institute
Christin Heidemann
Lukas Reitzle

Subproject 2: Survey of general practitioners and outpatient paediatricians

Through this nation-wide online survey, information about the experiences of general practitioners and outpatient paediatricians in treating Long COVID has been collected and analysed.

The COVID-19 pandemic has posed major challenges to the health system. Due to the continuation of the pandemic and the emergence of new SARS-CoV-2 variants, it is to be expected that more and more people will become infected and that the number of patients with long-term health consequences (long COVID) will also increase. General practitioners and paediatricians working in outpatient settings are the primary contact persons for the care of people with long COVID.

In an anonymous online survey, GPs’ outpatient paediatricians’ information and support needs for providing long COVID care are investigated. The objective of this study is to gain first-hand knowledge from general practitioners’ and paediatricians’ offices about how often they see patients with long COVID, which challenges they experience in treating those patients, which information sources they rely on for their work and, more specifically, which information and support needs in working with long COVID patients are yet unmet.

The results of the survey will help to design information services that are tailored to their needs. Through cooperation with various responsible parties in the health system, e.g. from health policy and self-governing organisations, approaches to solutions are to be expanded.

The nationwide survey is being conducted by the Institute of General Practice and Family Medicine of the Charité – Universitätsmedizin Berlin in cooperation with the RKI and the Clinic and Polyclinic of Paediatrics and Adolescent Medicine of the Carl Gustav Carus University Hospital, Dresden. It is supported by the following organisations:

• National Association of Statutory Health Insurance Physicians (KBV)
• German College of General Practitioners and Family Physicians (DEGAM)
• German Society of Paediatrics and Adolescent Medicine (DGKJ)
• German Society for Paediatric Infectious Diseases (DGPI)
• Association of Professional Paediatrics and Adolescent Medicine (BVKJ)

Publications

• Gubernath J, Mekkes S, Sarganas G, et al. Herausforderungen in der Primärversorgung von Patientinnen und Patienten mit Long‑/Post-COVID. Z Allg Med (2024). https://doi.org/10.1007/s44266-024-00233-5

Project leader Subproject 2: Lorena Dini, Institute of General Practice and Family Medicine, Charité – Universitätsmedizin Berlin.

Subproject team:

Institute of General Practice and Family Medicine, Charité – Universitätsmedizin Berlin
Salma Mekkes

Robert Koch Institute
John Gubernath
Christina Leuker
Giselle Sarganas

Further publications from the Post-COVID-19 project:

• Scheidt-Nave C, Poethko-Müller C, Sarganas G, et al. Long COVID bei Kindern und Jugendlichen - ein kurzer Überblick. Blickpunkt Öffentliche Gesundheit. 2022;38(1):5.
• Nübel J, Sarganas G, Mikolajewska A, et al. Long COVID – eine Herausforderung für Public Health und Gesundheitsforschung. Epid Bull 2022; 44:3-9 | DOI 10.25646/10753