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. 2025 Jul 16;15(1):25830.
doi: 10.1038/s41598-025-07894-7.

Cross-sectional study of health impairment related to post COVID-19 condition among participants of a large population-based cohort in Germany

Sophie Diexer  1 , Jonas Frost  1 , Peter Ahnert  2 , Till W Baernighausen  3   4   5 , Hermann Brenner  6 , Julia Fricke  7   8 , Sabine Gabrysch  3   9   10 , Karin Halina Greiser  11 , Volker Harth  12 , Jana-Kristin Heise  13 , Rudolf Kaaks  11 , André Karch  14 , Thomas Keil  7   15   16 , Bianca Klee  1 , Carolina J Klett-Tammen  13 , Lilian Krist  7 , Benedikt M J Lampl  17   18 , Michael F Leitzmann  18 , Wolfgang Lieb  19 , Claudia Meinke-Franze  20 , Karin B Michels  21 , Ilais Moreno Velásquez  22 , Nadia Obi  12 , Annette Peters  23   24   25   26   27 , Laura R Pfrommer  1 , Tobias Pischon  22 , Oliver Purschke  1 , Nicole Rübsamen  14 , Tamara Schikowski  28 , Börge Schmidt  29 , Sigrid Thierry  23   30 , Henry Völzke  20 , Marvin N Wright  31   32   33 , Hajo Zeeb  31   34 , Rafael Mikolajczyk  35
Affiliations

Cross-sectional study of health impairment related to post COVID-19 condition among participants of a large population-based cohort in Germany

Sophie Diexer et al. Sci Rep. .

Abstract

Post COVID-19 condition (PCC) is a substantial burden for patients, society, and the healthcare system. Participants of the German National Cohort (NAKO) were asked in an online survey about their self-perceived health, symptoms related to PCC, and infection status. PCC was defined as reporting symptoms for the time window 4-12 months after infection. Of 110,375 respondents (73% response), 86,833 were included in this analysis. Of these, 44,451 (51%) did not report a SARS-CoV-2 infection (no infection), 26,726 (31%) reported an infection but no symptoms 4-12 months after infection (infection/no PCC), and 15,656 (18%) reported an infection and symptoms (PCC). The median number of current symptoms at the time of the survey was two for the "no infection" and the "infection/no PCC" group, and five for the "PCC" group. Participants with PCC had a substantially higher probability of having worse self-perceived health (OR 1.84, 95% CI [1.75; 1.93] compared to the "no infection" group, adjusting for sex, age, education and chronic diseases with elevated risk for developing PCC. After adjusting for the number of current symptoms related to PCC, this difference disappeared, suggesting that the symptoms collected explain the impairment of self-perceived health in the PCC group.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: The NAKO was approved by the ethical review committees of all 18 participating NAKO study centers using their own reference number: Augsburg, Regensburg, Mannheim, Freiburg, Saarbrücken, Essen, Münster, Düsseldorf, Halle/Saale, Leipzig, Berlin North, Berlin Centre, Berlin South, Hannover, Hamburg, Bremen, Kiel, Neubrandenburg. Informed consent was obtained from all participants.

Figures

Fig. 1
Fig. 1
(a) Health status by infection/PCC group and (b) Mean number of current symptoms by infection/PCC group.
Fig. 2
Fig. 2
Proportion of participants reporting specific individual symptoms at the time of the survey by infection/PCC group sorted by overall frequency.
See this image and copyright information in PMC

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