BACKGROUND:Persistent symptoms after a respiratory infection can impair daily life, as has been shown, for example, for "long COVID." In this study, we determined the frequency and impact of symptoms that persisted for 12 weeks or more after a respiratory infection. A further endpoint was health care utilization for such symptoms in the general population. METHODS:A cross-sectional study was conducted within the population-based digital cohort DigiHero in Germany (DRKS00025600). 39.3% of invited participants responded by completing an online questionnaire. 46 915 adults were included in the analysis. Participants were asked about symptoms that persisted 12 weeks or longer after a respiratory infection between September 2024 and August 2025. RESULTS:48.3% of participants (95% confidence interval: [47.9; 48.8]) reported having had at least one respiratory infection during the study period. Among them, 18.8% [18.3; 19.3] stated that they still had symptoms 12 weeks or more afterward. The frequency of persistent symptoms was higher in older persons (13.1% for ages 20 to 29, 21.4% for ages 60 to 69). Most (86.8%) of those affected reported at least moderate functional impairment, and 57.9% consulted a physician. The pathogen causing the original infection was known for 24.3% of those reporting persistent symptoms: there were 483 cases of SARS-CoV-2 infection, 102 of influenza, and 36 of RSV. The symptom duration, functional impairment, and symptom pattern were similar after infection with SARS-CoV-2 and influenza. The most common symptoms in all pathogen groups were impaired physical performance, shortness of breath, rapid exhaustion, and fatigue. CONCLUSIONS:Persistent symptoms after respiratory infections are common and similar across pathogens in frequency and severity.
Background: Fever is one of the more common symptoms in children and adolescents, accounting for 20%-40% of all pediatric office visits and ca. 30% of all pediatric contacts with the emergency medical services. The present clinical practice guideline concerns the management of fever of acute onset in otherwise healthy children and adolescents in the outpatient setting. Methods: A systematic literature search was conducted, with evaluation according to SIGN and GRADE. Results: For neonates and infants under the age of 3 months, the body temperature should be measured rectally with a digital thermometer. From the age of 1 year onward, it can be measured with an infrared tympanic thermometer (sensitivity 77%, specificity 98%). For infants under the age of 3 months, temperatures above 40 degrees C are associated with an elevated risk of severe bacterial infection (OR 6.3, 95% confidence interval [4.44; 8.95]); in older children, the height of the fever has little prognostic significance (p = 0.11). The decision whether to lower the fever by medical means should be based exclusively on the degree of suffering and impairment of the child. Antipyretic agents should not be given routinely. Parents and other carers should be educated about fever as a normal defense reaction of the body and should be made acquainted with the warning signs (impaired consciousness, cutaneous hemorrhage, dehy dration, capillary refill time longer than 3 seconds). Children whose degree of suffering and impairment from fever calls for treatment can be given acetaminophen (10 to 15 mg/kg BW in each individual dose, no more than 4 times per day) or ibuprofen (10 mg/ kg BW in each individual dose, no more than 3 times per day). Conclusion: This evidence-based clinical practice guideline establishes a differentiated, symptom-oriented approach to the outpatient management of fever and emphasizes the education of parents and other carers so that the unnecessary administration of antipyretic drugs can be avoided.
