Prevalence of Long COVID-associated symptoms in adults with and without SARS-CoV-2 infection in Germany: Results of the population-based study “Corona Monitoring Nationwide 2021/22” (RKI-SOEP-2)

Background Controlled population-based studies on long-term health sequelae of SARS-CoV-2 can help to identify clinical signs specific to “Long COVID” and to evaluate this emerging public health challenge. Aim To examine prevalence differences of Long COVID-associated symptoms among adults with and without SARS-CoV-2 infection in Germany. Methods This population-based, retrospective study (11/2021-2/2022) included 7,683 working aged adults (18-65 years), a subset of the Corona Monitoring Nationwide study in Germany. Prior SARS-CoV-2 infection was defined based on self-reported PCR-confirmed infections and IgG-antibody dried blood spot testing. Participants answered a questionnaire including 19 common symptoms of Long COVID experienced in the six months preceding the survey. We estimated population-weighted prevalence of ([1][1]) individual symptoms, and ([2][2]) ≥1 symptom, with and without impact on work ability, by infection status within strata of sex, age group, income and comorbidity. We calculated model-adjusted prevalence differences and the probability that symptoms among infected are attributable to infection. Results 12 of 19 symptoms showed a significantly higher prevalence in infected than non-infected participants, including fatigue (27.5% versus 18.3%; p<0.001), concentration problems (22.2% vs. 13.1%; p<0.001), shortness of breath (15.6% vs. 7.5%; p<0.001), and smell and taste disorder (10% vs. 1.2%; p<0.001). ≥1 symptom with impact on work ability was more prevalent following infection (16.0% vs. 12.2%; p=0.06) with a model-adjusted prevalence difference of 3.8% (95%-CI -0.5-8.0). Conclusion We observed a rather small excess prevalence attributable to SARS-CoV-2 infection. However, the absolute number of persons places great demands on the health care system and may affect economic productivity. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The RKI-SOEP-2 study was funded by the German Federal Ministry of Health (project number ZMI1-2521COR305). The funders had no role in the design and conduct of the study, in the collection, management, analysis and interpretation of the data, in the preparation, review or approval of the manuscript, or in the decision to submit the manuscript for publication. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of the Berlin State Chamber of Physicians gave ethical approval for this work (reference ID Eth-33/20 as of September 21, 2021). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data cannot be made publicly available because informed consent from participants did not cover the public deposition of data. However, the data underlying the analysis in this article is archived in the SOEP Research Data Centre ([https://www.diw.de/en/diw\_01.c.601584.en/data\_access.html][3]) in Berlin and can be accessed on site upon reasonable request. [1]: #ref-1 [2]: #ref-2 [3]: https://www.diw.de/en/diw_01.c.601584.en/data_access.html