Immunity against SARS-CoV-2 in the German population

Schulze-Wundling, Kai; Ottensmeyer, Patrick Frank; Meyer-Schlinkmann, Kristin Maria; Deckena, Marek; Krüger, Stefan; Schlinkert, Simon; Budde, A.; Münstermann, Dieter; Töpfner, Nicole; Petersmann, Astrid; Nauck, Matthias; Karch, André; Lange, Berit; Blaschke, Sabine; Tiemann, Carsten; Streeck, Hendrik

doi:10.3238/arztebl.m2023.0072

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…This was confirmed by a recent study that analysed blood samples from 15,932 adult German participants for the presence of antibodies against the S-antigen and N-antigen of the SARS-CoV-2 virus: 95.7% and 44.4% had antibodies against the S-antigen and N-antigen, respectively. 38 Amongst the most vulnerable age groups (those aged >65 years and >80 years), the presence of anti-S-antibodies was 97.4% and 98.8%, respectively, and the presence of anti-N-antibodies in those aged >80 years was 28.5%. Consequently, the risk for developing severe COVID-19 has decreased, though the RKI has not modified its criteria for high risk of severe COVID-19.…”

Section: Discussionmentioning

confidence: 94%

“…A recent study based on a sample of 15,932 participants reported a similar frequency of risk factors for severe COVID-19 (46.0%). 38 …”

Section: Discussionmentioning

confidence: 99%

“…A recent study based on a sample of 15,932 participants reported a similar frequency of risk factors for severe COVID-19 (46.0%). 38 At the time of writing, two oral treatments for COVID-19 were available in Germany -nirmatrelvir/ritonavir, which is authorized for use in the EU, 25 and molnupiravir, for which a marketing authorization application has been submitted. 39 According to the approved label, nirmatrelvir/ritonavir has several contraindications and numerous pDDIs due to inhibition of CYP3A4, 25 which may limit its use in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Individuals at risk for severe COVID-19 in whom ritonavir-containing therapies are contraindicated or may lead to interactions with concomitant medications: a retrospective analysis of German health insurance claims data

Lübbert,

Dykukha,

Pelz

et al. 2023

DIC

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Background Nirmatrelvir/ritonavir is authorized for the treatment of COVID-19 but has several contraindications and potential drug–drug interactions (pDDIs) due to ritonavir-induced irreversible inhibition of cytochrome P450 3A4. We aimed to assess the prevalence of individuals with one or more risk factors for severe COVID-19 along with contraindications and pDDIs due to ritonavir-containing COVID-19 therapy. Methods Retrospective observational study of individuals with one or more risk factors according to Robert Koch Institute criteria for severe COVID-19 according to German statutory health insurance (SHI) claims data from the pre-pandemic years 2018–2019 based on the German Analysis Database for Evaluation and Health Services Research. Prevalence was extrapolated to the entire SHI population using age-adjusted and sex-adjusted multiplication factors. Results Nearly 2.5 million fully insured adults, representing 61 million people in the German SHI population, were included in the analysis. In 2019, prevalence of individuals that would have been at risk of severe COVID-19 was 56.4%. Amongst them, the prevalence of contraindications for treatment with ritonavir-containing COVID-19 therapy was approximately 2% according to presence of somatic comorbidities (severe liver or kidney disease). Prevalence of intake of medicines contraindicated for their potential interactions with ritonavir-containing COVID-19 therapy was 16.5% according to Summary of Product Characteristics and 31.8% according to previously published data. The prevalence of individuals at risk of pDDIs during ritonavir-containing COVID-19 therapy without adjustment of their concomitant therapy was 56.0% and 44.3%, respectively. Prevalence data for 2018 were similar. Conclusion Administering ritonavir-containing COVID-19 therapy can be challenging as thorough medical record review and close monitoring are required. In some cases, ritonavir-containing treatment may not be appropriate due to contraindications, risk of pDDIs, or both. For those individuals, an alternative ritonavir-free treatment should be considered.

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Section: Discussionmentioning

confidence: 94%

“…A recent study based on a sample of 15,932 participants reported a similar frequency of risk factors for severe COVID-19 (46.0%). 38 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Individuals at risk for severe COVID-19 in whom ritonavir-containing therapies are contraindicated or may lead to interactions with concomitant medications: a retrospective analysis of German health insurance claims data

Lübbert,

Dykukha,

Pelz

et al. 2023

DIC

View full text Add to dashboard Cite

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“…Further limitations of the study are the possible recall and interviewer bias. A reliable antibody status for SARS-CoV-2 infections could not be used for the study, as a clinical marker for SARS-CoV2-immunity has not been established at the time of the study [ 28 ]. Asymptomatic infections may be underreported, and the proportion of undetected infections can be estimated 1.5–4 times higher than the number of confirmed cases [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…A reliable antibody status for SARS-CoV-2 infections could not be used for the study, as a clinical marker for SARS-CoV2-immunity has not been established at the time of the study [ 28 ]. Asymptomatic infections may be underreported, and the proportion of undetected infections can be estimated 1.5–4 times higher than the number of confirmed cases [ 28 ]. Regarding infections < 3 months before ART treatment, the small numbers in this study in each group limited the statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

Assisted reproduction after SARS-CoV-2-infection: results of a single-center cohort-study

Eckstein,

Glaß,

Leßmann

et al. 2023

Arch Gynecol Obstet

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Purpose The effects of SARS-CoV-2 infections on the outcome of assisted reproduction techniques (ART) were studied in a retrospective cohort study. Methods The outcome of 1581 treatment cycles with embryo transfer at a university fertility center in Germany was compared in years before and during the COVID-19 pandemic. For 335 treatment cycles in 2022 a detailed analysis was carried out depending on infection and immunization status of both partners. Results ART cycles did not differ in most of the parameters examined between 2018–2022. In spite of comparable clinical pregnancy rates, there was a significantly higher miscarriage rate at 34.6% (27/78) in 2022, compared to 19.7% (29/147) in the pre-pandemic years of 2018–2019 (p = 0.014). In 37.0% of the treatment cycles (124/335) 2022 at least one partner reported a SARS-CoV-2-Infection 6 months before ART, mostly with the virus variant Omicron. Clinical pregnancy rates were lower in cycles without infection. Comparing women with confirmed infection to no infection, a significantly higher risk of miscarriage was seen (62.5% vs. 26.2%, p = 0.009). In treatment cycles of partners with basic immunization against SARS-CoV-2 a statistically significant increase of pregnancy rates was seen comparing to cycles with both unvaccinated partners (p = 0.011). Conclusion The results indicate a negative impact of SARS-CoV-2-infections up to 6 months on ART treatment, in particular an increased risk of miscarriage. Vaccination was associated with a better outcome of ART treatment.

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Estimates of protection levels against SARS-CoV-2 infection and severe COVID-19 in Germany before the 2022/2023 winter season: the IMMUNEBRIDGE project

Lange,

Jaeger,

Harries

et al. 2023

Infection

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Purpose Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. Methods In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n = 33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses (“confirmed exposures”). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest. Results Most participants were seropositive against the spike antigen; 37% of the participants ≥ 79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46–56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4–28% of participants having less than three confirmed exposures. Conclusion Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups.

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Immunity against SARS-CoV-2 in the German population

Cited by 3 publications

References 6 publications

Individuals at risk for severe COVID-19 in whom ritonavir-containing therapies are contraindicated or may lead to interactions with concomitant medications: a retrospective analysis of German health insurance claims data

Individuals at risk for severe COVID-19 in whom ritonavir-containing therapies are contraindicated or may lead to interactions with concomitant medications: a retrospective analysis of German health insurance claims data

Assisted reproduction after SARS-CoV-2-infection: results of a single-center cohort-study

Estimates of protection levels against SARS-CoV-2 infection and severe COVID-19 in Germany before the 2022/2023 winter season: the IMMUNEBRIDGE project

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