Model-Based Analysis of SARS-CoV-2 Infections, Hospitalization and Outcome in Germany, the Federal States and Districts

Abstract

The coronavirus disease 2019 (COVID-19) pandemic challenged many national health care systems, with hospitals reaching capacity limits of intensive care units (ICU). Thus, the estimation of acute local burden of ICUs is critical for appropriate management of health care resources. In this work, we applied non-linear mixed effects modeling to develop an epidemiological SARS-CoV-2 infection model for Germany, with its 16 federal states and 400 districts, that describes infections as well as COVID-19 inpatients, ICU patients with and without mechanical ventilation, recoveries, and fatalities during the first two waves of the pandemic until April 2021. Based on model analyses, covariates influencing the relation between infections and outcomes were explored. Non-pharmaceutical interventions imposed by governments were found to have a major impact on the spreading of SARS-CoV-2. Patient age and sex, the spread of variant B.1.1.7, and the testing strategy (number of tests performed weekly, rate of positive tests) affected the severity and outcome of recorded cases and could reduce the observed unexplained variability between the states. Modeling could reasonably link the discrepancies between fine-grained model simulations of the 400 German districts and the reported number of available ICU beds to coarse-grained COVID-19 patient distribution patterns within German regions.

Motivations for Adolescent COVID-19 Vaccination: A Comparative Study of Adolescent and Caregiver Perspectives in Germany

“…To analyze the conducted study in the context of local and nationwide incident and vaccination rates, incidence data was fetched from the RKI (https://survstat.rki.de) via a work ow derived from Dings and coworkers [23] and vaccination rates were gathered from the RKI vaccination repository (https://github.com/robert-koch-institut/COVID-19-Impfungen_in_Deutschland).…”

Post-COVID-19 pandemic organ donation activities in Germany: a multicenter retrospective analysis

“…Interestingly, this correlation was weak negative in 2022, suggesting that the numbers of monthly treated DsBD was independent of ICU treatment capacities, albeit at an overall lower level in terms of numbers. A possible explanation is the decreasing number of COVID-19 admissions to the ICU, which may have resulted in a shift toward admission of patients with a severe brain damage in 2022 ( 17 , 39 ), although their absolute numbers were still lower than 2021. University hospitals were thus capable to treat those patients despite decreasing ICU treatment capacities.…”

“…University hospitals were thus capable to treat those patients despite decreasing ICU treatment capacities. Or, to put it in other words, for many patients with a severe brain damage, ICU beds could probably only be found in hospitals of a higher level of care in view of the overall reduced ICU capacity in Germany ( 39 ).…”

“…Level C hospitals experienced a dramatic decline of DsBD, pDBD and uDBD from 2020 to 2022, probably because of an ongoing referrals of DsBD to hospitals with a higher level of care in times of reduced ICU capacities ( 39 ). Additionally, prepandemic studies could show, that level C hospitals had a significantly higher number of cases with an indicated but not performed diagnostic of braindeath in pDBD compared to university hospitals ( 33 ).…”

Redefining pandemic preparedness: Multidisciplinary insights from the CERP modelling workshop in infectious diseases, workshop report

“…Thorsten Lehr (Saarland University, Germany) presented on a compartmental model ( Dings et al., 2022 ), implemented with a stepwise approach, going from infection to hospitalization to outcome, that was applied at different levels: Germany-wide, the federal state (Bundesland, or NUTS -1), the government region (Regierungsbezirk, NUTS-2) and the county (Landkreis, NUTS-3). The objective from the beginning was to make the results publicly available.…”