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Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis

BACKGROUND: Congenital cytomegalovirus (cCMV) infection can have a broad range of manifestations. This study aimed to assess cCMV-associated sequelae and healthcare resource utilization (HCRU) in infants during the first year of life in Germany. METHODS: A retrospective, controlled cohort study usin...

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Autores principales: de Lepper, Marion, Stephan, Anna-Janina, Wölle, Regine, Wang, Wei, Jacob, Christian, Schneider, Kim Maren, Buxmann, Horst, Goelz, Rangmar, Hamprecht, Klaus, Kummer, Peter, Modrow, Susanne, Greiner, Wolfgang, Luzak, Agnes, Reuschenbach, Miriam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653416/
https://www.ncbi.nlm.nih.gov/pubmed/37972113
http://dx.doi.org/10.1371/journal.pone.0293869
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author de Lepper, Marion
Stephan, Anna-Janina
Wölle, Regine
Wang, Wei
Jacob, Christian
Schneider, Kim Maren
Buxmann, Horst
Goelz, Rangmar
Hamprecht, Klaus
Kummer, Peter
Modrow, Susanne
Greiner, Wolfgang
Luzak, Agnes
Reuschenbach, Miriam
author_facet de Lepper, Marion
Stephan, Anna-Janina
Wölle, Regine
Wang, Wei
Jacob, Christian
Schneider, Kim Maren
Buxmann, Horst
Goelz, Rangmar
Hamprecht, Klaus
Kummer, Peter
Modrow, Susanne
Greiner, Wolfgang
Luzak, Agnes
Reuschenbach, Miriam
author_sort de Lepper, Marion
collection PubMed
description BACKGROUND: Congenital cytomegalovirus (cCMV) infection can have a broad range of manifestations. This study aimed to assess cCMV-associated sequelae and healthcare resource utilization (HCRU) in infants during the first year of life in Germany. METHODS: A retrospective, controlled cohort study using German claims data from the Institute for Applied Health Research Berlin (InGef) database was conducted. cCMV-associated sequelae and HCRU during the first year of life were assessed by matching (1:60) infants with at least one inpatient/outpatient cCMV diagnosis (ICD-10-GM: P35.1) ≤90 days after birth (cCMV(90) cohort) and infants with at least one inpatient cCMV diagnosis plus specific sequelae ≤21 days after birth (cCMV(21-S)) to infants without cCMV or CMV (ICD-10-GM: B25) diagnosis (control group), respectively. Outcomes were analyzed during the first 365 days of life. RESULTS: Between 2014–2018, we identified 54 newborns for cCMV(90) and 24 newborns for cCMV(21-S) cohort. Compared to the 3,240 and 1,440 controls, respectively, more cCMV(90) infants (83.3% vs. 41.9%, p<0.01) presented with at least one sequela during the first year of life, including intrauterine growth retardation (42.6% vs. 5.3%, p<0.01), sensorineural hearing loss (SNHL) to deafness (38.9% vs. 2.2%, p<0.01), and motor development disorders (33.3% vs. 10.9%, p<0.01). Further, 13.0% of cCMV(90) infants (vs. 2.3%, p<0.01) suffered from visual impairment. In cCMV(21-S) cohort, intrauterine growth retardation (79.2% vs. 6.0%, p<0.01), prematurity (54.2% vs. 7.3%, p<0.01), and motor development disorders (50.0% vs. 11.0%, p<0.01) were the most frequent sequelae. Infants in the cCMV(90) and cCMV(21-S) cohort had, on average, 7.3 times and 9.5 times more hospitalizations and 2.0 times and 2.1 times more outpatient physician visits than their respective controls (p<0.01). Hospitalized infants with cCMV stayed, on average, significantly longer in hospital compared to their controls (cCMV(90) cohort: 30.3 days vs. 9.0 days, p<0.01; cCMV(21-S) cohort: 46.5 days vs. 9.3 days, p<0.01). CONCLUSIONS: cCMV-infection shows a considerable disease and healthcare burden during the first year of life. More than 80% of the identified newborns with cCMV suffered from at least one associated sequela during the first year of life, including long-term sequelae such as SNHL (40%) and visual impairment (13%). Additional steps for prevention of cCMV infection and associated sequelae as well as a comprehensive monitoring of disease burden are needed.
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spelling pubmed-106534162023-11-16 Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis de Lepper, Marion Stephan, Anna-Janina Wölle, Regine Wang, Wei Jacob, Christian Schneider, Kim Maren Buxmann, Horst Goelz, Rangmar Hamprecht, Klaus Kummer, Peter Modrow, Susanne Greiner, Wolfgang Luzak, Agnes Reuschenbach, Miriam PLoS One Research Article BACKGROUND: Congenital cytomegalovirus (cCMV) infection can have a broad range of manifestations. This study aimed to assess cCMV-associated sequelae and healthcare resource utilization (HCRU) in infants during the first year of life in Germany. METHODS: A retrospective, controlled cohort study using German claims data from the Institute for Applied Health Research Berlin (InGef) database was conducted. cCMV-associated sequelae and HCRU during the first year of life were assessed by matching (1:60) infants with at least one inpatient/outpatient cCMV diagnosis (ICD-10-GM: P35.1) ≤90 days after birth (cCMV(90) cohort) and infants with at least one inpatient cCMV diagnosis plus specific sequelae ≤21 days after birth (cCMV(21-S)) to infants without cCMV or CMV (ICD-10-GM: B25) diagnosis (control group), respectively. Outcomes were analyzed during the first 365 days of life. RESULTS: Between 2014–2018, we identified 54 newborns for cCMV(90) and 24 newborns for cCMV(21-S) cohort. Compared to the 3,240 and 1,440 controls, respectively, more cCMV(90) infants (83.3% vs. 41.9%, p<0.01) presented with at least one sequela during the first year of life, including intrauterine growth retardation (42.6% vs. 5.3%, p<0.01), sensorineural hearing loss (SNHL) to deafness (38.9% vs. 2.2%, p<0.01), and motor development disorders (33.3% vs. 10.9%, p<0.01). Further, 13.0% of cCMV(90) infants (vs. 2.3%, p<0.01) suffered from visual impairment. In cCMV(21-S) cohort, intrauterine growth retardation (79.2% vs. 6.0%, p<0.01), prematurity (54.2% vs. 7.3%, p<0.01), and motor development disorders (50.0% vs. 11.0%, p<0.01) were the most frequent sequelae. Infants in the cCMV(90) and cCMV(21-S) cohort had, on average, 7.3 times and 9.5 times more hospitalizations and 2.0 times and 2.1 times more outpatient physician visits than their respective controls (p<0.01). Hospitalized infants with cCMV stayed, on average, significantly longer in hospital compared to their controls (cCMV(90) cohort: 30.3 days vs. 9.0 days, p<0.01; cCMV(21-S) cohort: 46.5 days vs. 9.3 days, p<0.01). CONCLUSIONS: cCMV-infection shows a considerable disease and healthcare burden during the first year of life. More than 80% of the identified newborns with cCMV suffered from at least one associated sequela during the first year of life, including long-term sequelae such as SNHL (40%) and visual impairment (13%). Additional steps for prevention of cCMV infection and associated sequelae as well as a comprehensive monitoring of disease burden are needed. Public Library of Science 2023-11-16 /pmc/articles/PMC10653416/ /pubmed/37972113 http://dx.doi.org/10.1371/journal.pone.0293869 Text en © 2023 de Lepper et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
de Lepper, Marion
Stephan, Anna-Janina
Wölle, Regine
Wang, Wei
Jacob, Christian
Schneider, Kim Maren
Buxmann, Horst
Goelz, Rangmar
Hamprecht, Klaus
Kummer, Peter
Modrow, Susanne
Greiner, Wolfgang
Luzak, Agnes
Reuschenbach, Miriam
Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title_full Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title_fullStr Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title_full_unstemmed Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title_short Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis
title_sort burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (ccmv) infection in germany: a retrospective statutory health insurance claims database analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653416/
https://www.ncbi.nlm.nih.gov/pubmed/37972113
http://dx.doi.org/10.1371/journal.pone.0293869
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