German nationwide inpatient data on the post-COVID-19 syndrome: an update

Post-COVID syndrome (PCS) continues to pose a serious public health issue, with persistent symptoms requiring ongoing medical care after the acute phase of infection. Despite its clinical significance, data on its burden on hospital systems and healthcare costs have been limited. This study updates the national analysis of PCS-related hospitalizations in Germany for the year 2023, focusing on patient demographics, primary diagnoses, procedures, and inpatient costs.

Using nationwide data from the Institute for the Hospital Remuneration System (InEK) and the German Diagnosis-Related Groups (G-DRG), the study identified patients with PCS via the diagnosis code "U09.9!" as a secondary diagnosis. Parameters included age, sex, diagnoses, procedures, length of stay (LOS), and direct cost estimates. Incidence rates were calculated using official population data.

There were 17,209 PCS-related hospital admissions, translating to 48.9 cases per 100,000 people. Women represented 60% of cases, with peak prevalence in the 55-60 age group. Common diagnoses were chronic fatigue, dyspnea, and general malaise; procedures mainly involved respiratory and neurological evaluations. Only 4% required care dependency assessments. The average LOS was 8.3 days (SD 11.6 days). LOS showed a right-skewed distribution. The median LOS was 7.1 days [interquartile range (IQR): 3.9-7.9 days]. Total inpatient costs reached €67.9 million. Compared to early-pandemic data, the number of PCS-related hospitalizations decreased substantially in 2023, while diagnostic complexity and inpatient resource utilization remained high.

PCS continues to challenge healthcare systems, underlining the need for ongoing research, policy adjustments, and resource planning.