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. 2023 Feb 10;23(1):89.
doi: 10.1186/s12879-023-08035-z.

Disease severity in hospitalized COVID-19 patients: comparing routine surveillance with cohort data from the LEOSS study in 2020 in Germany

Uwe Koppe  1 , Julia Schilling  2 , Melanie Stecher  3   4 , Maria Madeleine Rüthrich  5 , Adine Marquis  2 , Michaela Diercke  2 , Martina Haselberger  6 , Carolin E M Koll  3   4 , Michaela Niebank  7 , Bettina Ruehe  7 , Stefan Borgmann  8 , Linus Grabenhenrich  9 , Kerstin Hellwig  10 , Lisa Pilgram  11   12 , Christoph D Spinner #  13 , Thomas Paerisch #  7 ; LEOSS study group
Collaborators, Affiliations

Disease severity in hospitalized COVID-19 patients: comparing routine surveillance with cohort data from the LEOSS study in 2020 in Germany

Uwe Koppe et al. BMC Infect Dis. .

Abstract

Introduction: Studies investigating risk factors for severe COVID-19 often lack information on the representativeness of the study population. Here, we investigate factors associated with severe COVID-19 and compare the representativeness of the dataset to the general population.

Methods: We used data from the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) of hospitalized COVID-19 patients diagnosed in 2020 in Germany to identify associated factors for severe COVID-19, defined as progressing to a critical disease stage or death. To assess the representativeness, we compared the LEOSS cohort to cases of hospitalized patients in the German statutory notification data of the same time period. Descriptive methods and Poisson regression models were used.

Results: Overall, 6672 hospitalized patients from LEOSS and 132,943 hospitalized cases from the German statutory notification data were included. In LEOSS, patients above 76 years were less likely represented (34.3% vs. 44.1%). Moreover, mortality was lower (14.3% vs. 21.5%) especially among age groups above 66 years. Factors associated with a severe COVID-19 disease course in LEOSS included increasing age, male sex (adjusted risk ratio (aRR) 1.69, 95% confidence interval (CI) 1.53-1.86), prior stem cell transplantation (aRR 2.27, 95% CI 1.53-3.38), and an elevated C-reactive protein at day of diagnosis (aRR 2.30, 95% CI 2.03-2.62).

Conclusion: We identified a broad range of factors associated with severe COVID-19 progression. However, the results may be less applicable for persons above 66 years since they experienced lower mortality in the LEOSS dataset compared to the statutory notification data.

Keywords: COVID-19; LEOSS; SARS-CoV-2; Severe COVID; Statutory notification.

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Conflict of interest statement

CDS reports grants, personal fees from AstraZeneca, personal fees and non-financial support from BBraun Melsungen, personal fees from BioNtech, grants, personal fees and non-financial support from Gilead Sciences, grants and personal fees from Janssen-Cilag, personal fees from Eli Lilly, personal fees from Formycon, personal fees from Roche, other from Apeiron, grants and personal fees from MSD, grants from Cepheid, personal fees from GSK, personal fees from Molecular partners, other from Eli Lilly, personal fees from SOBI during the conduct of the study; personal fees from AbbVie, personal fees from MSD, personal fees from Synairgen, grants and personal fees from ViiV Healthcare, outside the submitted work. The other authors report no conflict of interest.

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