The contribution of SARS-CoV-2 to the burden of acute respiratory infections in winter season 2022/2023: Results from the DigiHero study

Objectives: In winter 2022/23 SARS-CoV-2 had developed into one of many seasonal respiratory pathogens, causing an additional burden of acute respiratory infections (ARI). While testing was still widely used, many positive tests were not reported for the official statistics. Using data from a population-based cohort, we aimed to investigate the contribution of SARS-CoV-2 to the burden of ARI.Methods: Over 70,000 participants of the German population-based DigiHero study were invited to a questionnaire about the number and time point of ARI, and SARS-CoV-2 test results in winter 2022/23. We calculated the incidence of non-SARS ARI, the additional contribution of SARS-CoV-2, and extrapolated the age-specific estimates to obtain the total burden of SARS-CoV-2 in Germany.Results: For the winter 2022/23, 37,708 participants reported 54,813 ARI, including 9,358 SARS-CoV-2 infections. This translated into a cumulative incidence of 145 infections/100 persons for all ARI, 120 infections/100 persons for non-SARS ARI and 25 infections/100 persons for SARS ARI (+21%).Conclusions: Our estimate for ARI related to SARS-CoV-2 is consistent with the difference in all ARI between pre-pandemic years and 2022/23. This additional burden should be considered, particularly with respect to the implications for the work force.