Record linkage as a vital key player for the COVID-19 syndemic

Abstract Chronicity, comorbidities, and social context influence COVID-19 risk and prognosis, drawing attention to a syndemic dimension. We discuss how linking routinely collected data and data collected through observational population-based cohorts can contribute to advance knowledge on the association between COVID-19 and chronic diseases and social indicators. Record linkage as a multidimensional tool may ultimately enable defining and optimizing of integrated strategies, which may create multilevel public health measures to foster solidarity on health in all policies when ethical and legal barriers under prerequisite data protection and privacy can be overcome. Legal discrepancies have been proving detrimental to research in member states, including those which already had established a margin for research for the common good without explicit consent. We hence call for further harmonization of data protection requirements for scientific research activities in the EU/EEA, focusing in particular on health-related research. A proposed framework demonstrates the role of record linkage as a trailblazing key player in research optimization due to its multidimensional possibilities calling for harmonization. Key messages • Further harmonization of data protection requirements for scientific research may create multilevel public health measures. • As a multidimensional tool, it optimizes integrated strategies and fosters solidarity on Health in All Policies (HiAP).