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Background: The COVID-19 pandemic has been on a downward trend since May, 2022, but it continues to cause substantial numbers of hospital admissions and deaths. We describe this burden in the 2 years since May, 2022, and compare it with the burden of influenza in Denmark., Methods: This observational cohort study included residents in Denmark from May 16, 2022, to June 7, 2024. Data were obtained from national registries, including admissions with COVID-19 or influenza (ie, having a positive PCR test for either virus from 14 days before and up to 2 days after the hospital admission date), deaths, sex, age, COVID-19 and influenza vaccination status, comorbidities, and residence in long-term care facilities. Negative binomial regression was used to estimate adjusted incidence rate ratios (aIRRs) to compare rates of hospital admissions between COVID-19 and influenza. To compare the severity of COVID-19 versus influenza among patients admitted to hospital, we used the Kaplan-Meier estimator to produce weighted cumulative incidence curves and adjusted risk ratios (aRRs) of mortality at 30 days between COVID-19 and influenza admissions., Findings: Among 5 899 170 individuals, COVID-19 admissions (n=24 400) were more frequent than influenza admissions (n=8385; aIRR 2·04 [95% CI 1·38-3·02]), particularly during the first year (May, 2022, to May, 2023) versus the second year (May, 2023, to June, 2024; p=0·0096), in the summer versus the winter (p<0·0001), and among people aged 65 years or older versus younger than 65 years (p<0·0001). The number of deaths was also higher for patients with COVID-19 (n=2361) than patients with influenza (n=489, aIRR 3·19 [95% CI 2·24-4·53]). Among patients admitted in the winter (n=19 286), the risk of mortality from COVID-19 was higher than for influenza (aRR 1·23 [95% CI 1·08-1·37]), particularly among those without COVID-19 and influenza vaccination (1·36 [1·05-1·67]), with comorbidities (1·27 [1·11-1·43]), and who were male (1·36 [1·14-1·59])., Interpretation: COVID-19 represented a greater disease burden than influenza, with more hospital admissions and deaths, and more severe disease (primarily among non-vaccinated people, those with comorbidities, and male patients). These results highlight the continued need for attention and public health efforts to mitigate the impact of SARS-CoV-2., Funding: Danish Government., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Background: Zoonotic transmission of livestock-associated methicillin-resistant Staphylococcus aureus clonal complex 398 (LA-MRSA CC398) from industrial pig farms to farm workers and their household members and secondary transmission to elderly and immunocompromised persons has led to a growing number of serious infections and even death., Objective: We tested the hypothesis that conventional pig farms confer a higher risk for LA-MRSA CC398 carriage among farm workers and their household members than specific pathogen-free (SPF) farms, which follow a set of stringent rules concerning biosecurity, health control and transportation of pigs between herds., Methods: We conducted a cross-sectional study of farm workers and their household members from 25 Danish pig farms positive for LA-MRSA CC398. Questionnaires were designed to obtain information about each farm and participant. Nasal samples from pigs and human volunteers were screened for LA-MRSA CC398. Multivariate logistic regression analyses were used to calculate adjusted ORs (aORs) and 95% CIs., Results: The study included 25 pig farms, 154 farm workers screened at the farm (93 of whom were also screened at home) and 173 household members. The risk of LA-MRSA CC398 carriage among farm workers at the farm (aOR=5.40, 95% CI 1.05 to 27.80) and household members (aOR=8.32; 95% CI 2.81 to 24.63) was significantly higher in conventional pig farms than in SPF farms., Conclusions: This study shows that strict biosecurity measures reduce the risk of LA-MRSA CC398 carriage among farm workers and their household members and thereby the disease burden in the general population., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Competing Interests: S.Brunak has ownerships in Intomics A/S, Hoba Therapeutics Aps, Novo Nordisk A/S, Lundbeck A/S, ALK abello A/S, Eli Lilly and Co and managing board memberships in Proscion A/S and Intomics A/S. C.E. has received unrestricted research grants from Novo Nordisk administered by Aarhus University and Abbott Diagnostics administered by Aarhus University Hospital. C.E. received no personal fees. K.G. received a Janssen Pharma research grant and is on the advisory board of Otsuka Pharma. L.B. currently works for MSD Denmark. All other authors report no competing interests.

Importance: Fatigue remains one of the most common and debilitating symptoms of post-COVID-19 condition; however, existing studies are limited to select populations and often lack noninfected controls. It also remains unclear to what extent severity of infection and psychiatric conditions, which are often linked to chronic fatigue, modify the risk of post-COVID-19 condition fatigue symptoms., Objective: To evaluate the impact of SARS-CoV-2 infection on self-reported fatigue and postexertional malaise over time and to explore possible risk factors, such as the impact of acute SARS-CoV-2 hospitalization and preexisting psychiatric conditions on postacute fatigue., Design, Setting, and Participants: In this cohort study, Danish residents aged 15 years and older were invited to participate in the EFTER-COVID survey, which used repeated, self-reported online questionnaires that collected information on fatigue (Fatigue Assessment Scale) and postexertional malaise scores (DePaul Symptom Questionnaire) after individuals' index SARS-CoV-2 polymerase chain reaction test. Participants were included if they completed a baseline and at least 1 follow-up questionnaire 2 to 18 months after testing for SARS-CoV-2., Exposure: Testing for SARS-CoV-2 infection., Main Outcomes and Measures: The primary outcomes were fatigue and postexertional malaise 2 to 18 months after testing. Mixed-effects models were used to compare scores between SARS-CoV-2 test-positive and test-negative individuals (testing period April 2021 to February 2023)., Results: Of a total of 50 115 participants (median [IQR] age at test date, 57 [46-67] years; 29 774 female [59.4%]), 25 249 were test positive and 24 866 were test negative. Most participants were vaccinated with at least 2 doses (21 164 test-negative participants [85.1%] and 22 120 test-positive participants [87.6%]) before their SARS-CoV-2 index test and fatigue reporting. In the period 2 to 18 months after testing, SARS-CoV-2 infection was associated with a small but significant 3% increase in self-reported fatigue scores (score ratio [SR], 1.03; 95% CI, 1.03-1.04) and higher odds of self-reported postexertional malaise (odds ratio, 2.04; 95% CI, 1.81-2.30), compared with test-negative participants. In the same period, hospitalization with SARS-CoV-2 increased fatigue scores by 23% (SR, 1.23; 95% CI, 1.20-1.26) compared with test-negative participants. Preexisting psychiatric conditions did not significantly modify postacute fatigue scores., Conclusions and Relevance: In this cohort study, SARS-CoV-2 infection was associated with a subtle increase in self-reported fatigue and postexertional malaise symptoms 2 to 18 months after mild infection. In contrast, individuals hospitalized with acute SARS-CoV-2 experienced a more substantial increase in postacute symptoms. Preexisting psychiatric conditions did not significantly modify the risk of postacute fatigue symptoms. The findings largely captured symptoms following first-time infections in a population where most had been vaccinated. Persons who experienced severe acute infection may benefit from clinical follow-up for fatigue.

Objectives: To investigate the associations of physical activity (PA) and sedentary behaviour in early childhood with asthma and reduced lung function in later childhood within a large collaborative study., Design: Pooling of longitudinal data from collaborating birth cohorts using meta-analysis of separate cohort-specific estimates and analysis of individual participant data of all cohorts combined., Setting: Children aged 0-18 years from 26 European birth cohorts., Participants: 136 071 individual children from 26 cohorts, with information on PA and/or sedentary behaviour in early childhood and asthma assessment in later childhood., Main Outcome Measure: Questionnaire-based current asthma and lung function measured by spirometry (forced expiratory volume in 1 s (FEV 1 ), FEV 1 /forced vital capacity) at age 6-18 years., Results: Questionnaire-based and accelerometry-based PA and sedentary behaviour at age 3-5 years was not associated with asthma at age 6-18 years (PA in hours/day adjusted OR 1.01, 95% CI 0.98 to 1.04; sedentary behaviour in hours/day adjusted OR 1.03, 95% CI 0.99 to 1.07). PA was not associated with lung function at any age. Analyses of sedentary behaviour and lung function showed inconsistent results., Conclusions: Reduced PA and increased sedentary behaviour before 6 years of age were not associated with the presence of asthma later in childhood., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To follow SARS-CoV-2-infected persons up to 18 months after a positive test in order to assess the burden and nature of post acute symptoms and health problems., Participants: Persons in Denmark above 15 years of age, who were tested positive for SARS-CoV-2 during 1 September 2020 to 21 February 2023 using a RT-PCR test. As a reference group, three test-negative individuals were selected for every two test-positive individuals by matching on test date., Findings to Date: In total, 2 427 913 invitations to baseline questionnaires have been sent out and 839 528 baseline questionnaires (34.5%) have been completed. Females, the age group 50-69 years, Danish-born and persons, who had received at least one SARS-CoV-2 vaccination booster dose were more likely to participate. Follow-up questionnaires were sent at 2, 4, 6, 9, 12 and 18 months after the test, with response rates at 42%-54%., Future Plans: New participants have been recruited on a daily basis from 1 August 2021 to 23 March 2023. Data collection will continue until the last follow-up questionnaires (at 18 months after test) have been distributed in August 2024., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Inflammation of the tonsils is a normal response to infection, but some individuals experience recurrent, severe tonsillitis and massive hypertrophy of the tonsils in which case surgical removal of the tonsils may be considered., Objective: To identify common genetic variants associated with tonsillectomy., Methods: We used tonsillectomy information from Danish health registers and carried out a genome-wide association study comprising 1464 patients and 12 019 controls of Northwestern European ancestry, with replication in an independent sample set of 1575 patients and 1367 controls., Results: The variant rs2412971, intronic in HORMAD2 at chromosome 22q12.2, was robustly associated with tonsillectomy (OR=1.22; p=1.48×10 -9 ) and is highly correlated with SNPs previously found to be associated with IgA nephropathy, Crohn's disease (CD) and early onset inflammatory bowel disease (IBD). The risk allele for tonsillectomy corresponded to increased risk of IgA nephropathy and decreased risk of CD and IBD. We further performed lookup analyses of the top SNP for outcomes related to tonsillectomy in the combined discovery and replication sample and found that rs2412971 was associated with acute tonsillitis (OR=1.19; p=7.82×10 -4 ), chronic disease of the tonsils (OR=1.19; p=2.32×10 -6 ) and appendectomy (OR=1.18; p=1.13×10 -3 )., Conclusions: We identified and replicated a genetic association at 22q12.2 with tonsillectomy. Further functional investigation is required to illuminate whether the molecular mechanisms underlying the genetic association involve general lymphoid hyper-reaction throughout the mucosa-associated lymphoid tissue system., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)