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Open Access 01-12-2021 | Vaccination | Research

Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

Authors: Jakob Holstiege, Manas K. Akmatov, Claudia Kohring, Lotte Dammertz, Frank Ng, Thomas Czihal, Dominik von Stillfried, Jörg Bätzing

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Research has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data.

Methods

We used nationwide outpatient claims data from the years 2010 to 2019 collected according to § 295 of the Code of Social Law V, covering data for all statutory health insurees (SHI) which is nearly 87% of the entire German population. We considered 15 chronic disorders based on the current state of knowledge about clinically relevant risk factors. Three risk groups for a severe COVID-19 course were defined: 1. individuals in the age group 15 to 59 years with at least two comorbid disorders; 2. individuals aged 60 to 79 years with at least one disorder and 3. all individuals 80 years and older irrespective of the presence of chronic conditions. Regional analysis was conducted at the level of administrative districts (n = 401).

Results

Overall, 26% of individuals over 15 years were at high risk for a severe COVID-19 course in 2019 amounting to a total number of nearly 18.5 million individuals in Germany. This included 3.8 million individuals in risk group 1, 9.2 million in risk group 2, and 5.4 million in risk group 3, corresponding to 8, 50 and 100% of German inhabitants in the respective age groups. On the level of the 17 administrative regions formed by the Association of SHI Physicians (ASHIP regions), the proportion of individuals at high risk ranged between 21% in Hamburg and 35% in Saxony-Anhalt. Small-area estimates varied between 18% in Freiburg (Baden-Württemberg) and 39% in the district Elbe-Elster (Brandenburg).

Conclusions

The present study provides small-area estimates of populations at high risk for a severe COVID-19 course. These data are of particular importance for planning of preventive measures such as vaccination.

Trial registration

not applicable.

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Title: Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany
Authors: Jakob Holstiege
Manas K. Akmatov
Claudia Kohring
Lotte Dammertz
Frank Ng
Thomas Czihal
Dominik von Stillfried
Jörg Bätzing
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Vaccination
COVID-19
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11735-3

At a glance: The STEP trials

Springer Medicine

Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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