Presentation (CTI)

OBJECTIVES: Herpes zoster (HZ), a painful rash caused by reactivation of varicella zoster virus, can lead to severe complications requiring hospitalisation. HZ hospitalisation rates in Germany are understudied, but previous data indicate they increase with age. This study evaluated HZ-related hospitalisation rates in Germany.
METHODS: A descriptive, retrospective database analysis was conducted using data from the Federal Statistical Office (GENESIS-Online, 2000-2023) and Institute for the Hospital Remuneration System (InEK, 2019-2024). Annual hospitalisation rates for primary (main discharge diagnosis) and primary/secondary HZ diagnoses, mean length of stay (LOS) and intensive care unit (ICU) admission rates were estimated for three age groups (18-49 years [y], 50-59y, ≥60y).
RESULTS: Primary HZ hospitalisation rates increased from 2000-2019, reaching 13.3, 25.1 and 81.6 (per 100,000 population) for the 18-49y, 50-59y and ≥60y groups in 2019, respectively, with a drop in 2020, particularly for the ≥60y group. For the 18-49y and 50-59y groups, rates increased in 2021, reaching pre-2020 levels in the following years, whereas rates in the ≥60y group declined and plateaued in 2023. Rates were 14.3 (18-49y), 25.8 (50-59y) and 60.8 (≥60y) in 2023. InEK data, including primary and secondary HZ hospitalisations, confirmed this trend, with a further decline in ≥60y rates in 2024 due to decreased secondary HZ diagnoses. In 2024, InEK estimated hospitalisation rates were 20.2, 38.7 and 112.8, mean LOS of primary HZ diagnosis hospitalisations was 7.0, 7.2 and 8.5 days and ICU admission rates were 3.08%, 3.84% and 4.04% for the 18-49y, 50-59y and ≥60y groups, respectively.
CONCLUSIONS: HZ hospitalisations pose a substantial burden across age groups, with mostly increasing trends. The post-pandemic decline in hospitalisation rates in the ≥60y group may be due to implementation of national HZ vaccination recommendations. Further studies are needed to better understand these observed trends.