INCIDENCE PATTERNS OF POST-COVID SYNDROME IN GERMANY BETWEEN 2021 AND 2024: EVIDENCE FROM STATUTORY HEALTH INSURANCE CLAIMS DATA
Author(s)
Daniel Gensorowsky, PhD1, Emma Fröling, RPh2, Jana Diekmannshemke, MSc1, Agnes Kisser, PhD3, Philipp Reuken, MD4, Julia Blaurock, MSc3, Jessica Noll, PhD2, Eveline Otte im Kampe, MSc3.
1Vandage GmbH, Bielefeld, Germany, 2Medical Affairs Primary Care, Pfizer Pharma GmbH, Berlin, Germany, 3Access and Value, Pfizer Pharma GmbH, Berlin, Germany, 4Internal Medicine IV, University Hospital Jena, Jena, Germany.
1Vandage GmbH, Bielefeld, Germany, 2Medical Affairs Primary Care, Pfizer Pharma GmbH, Berlin, Germany, 3Access and Value, Pfizer Pharma GmbH, Berlin, Germany, 4Internal Medicine IV, University Hospital Jena, Jena, Germany.
OBJECTIVES: Post-COVID syndrome has emerged as a relevant long-term consequence of SARS-CoV-2 infection, yet population-based evidence on its incidence and determinants remains limited. We estimated the incidence of post-COVID among post-acute COVID-19 patients within the statutory health insurance (SHI) in Germany.
METHODS: This retrospective cohort study analyzed anonymized SHI claims data from GWQ ServicePlus AG. Individuals with an incident COVID-19 diagnosis (ICD-10-GM U07.1!) during seasons 2021/22-2023/24 were followed from start of the post-acute phase (90 days after diagnosis) until post-COVID diagnosis (ICD-10-GM U07.4! or U09.9!), death, disenrollment, or 31 December 2024. Incidence rates (IR) per 1,000 person-years (PY) with 95% confidence intervals (CI) were estimated overall and stratified by age, sex, COVID-19 severity, and Elixhauser Comorbidity Index (ECI). Exploratory analyses further assessed associations using Poisson regression with covariate sets informed by directed acyclic graphs.
RESULTS: Among 1,254,747 COVID-19 patients entering the post-acute phase, 1.96% received a post-COVID diagnosis (IR 9.2 per 1,000 PY; 95% CI 9.1-9.4). Post-COVID incidence increased steadily with age, from 1.1 per 1,000 PY (95% CI 0.8-1.4) among children aged 0-5 years to 13.0 per 1,000 PY (95% CI 12.7-13.3) among those ≥60 years. Women had nearly 50% higher incidence than men (10.9 vs. 7.5 per 1,000 PY). Incidence also rose with acute COVID-19 severity, from 8.9 per 1,000 PY (95% CI 8.8-9.0) in non-hospitalized patients to 59.8 per 1,000 PY (95% CI 53.3-66.9) among ICU-treated patients. Individuals with ≥5 ECI comorbidities had 3.6-fold higher incidence than those without ECI comorbidities (19.1 vs. 5.3 per 1,000 PY). Regression analyses suggested increasing age, more severe COVID-19, female sex, and higher baseline comorbidity level as risk factors.
CONCLUSIONS: Post-COVID risk varies by demographic factors, comorbidity level and COVID-19 severity. Thus, targeted prevention and early interventions in risk groups may reduce long-term health impacts and healthcare burden.
METHODS: This retrospective cohort study analyzed anonymized SHI claims data from GWQ ServicePlus AG. Individuals with an incident COVID-19 diagnosis (ICD-10-GM U07.1!) during seasons 2021/22-2023/24 were followed from start of the post-acute phase (90 days after diagnosis) until post-COVID diagnosis (ICD-10-GM U07.4! or U09.9!), death, disenrollment, or 31 December 2024. Incidence rates (IR) per 1,000 person-years (PY) with 95% confidence intervals (CI) were estimated overall and stratified by age, sex, COVID-19 severity, and Elixhauser Comorbidity Index (ECI). Exploratory analyses further assessed associations using Poisson regression with covariate sets informed by directed acyclic graphs.
RESULTS: Among 1,254,747 COVID-19 patients entering the post-acute phase, 1.96% received a post-COVID diagnosis (IR 9.2 per 1,000 PY; 95% CI 9.1-9.4). Post-COVID incidence increased steadily with age, from 1.1 per 1,000 PY (95% CI 0.8-1.4) among children aged 0-5 years to 13.0 per 1,000 PY (95% CI 12.7-13.3) among those ≥60 years. Women had nearly 50% higher incidence than men (10.9 vs. 7.5 per 1,000 PY). Incidence also rose with acute COVID-19 severity, from 8.9 per 1,000 PY (95% CI 8.8-9.0) in non-hospitalized patients to 59.8 per 1,000 PY (95% CI 53.3-66.9) among ICU-treated patients. Individuals with ≥5 ECI comorbidities had 3.6-fold higher incidence than those without ECI comorbidities (19.1 vs. 5.3 per 1,000 PY). Regression analyses suggested increasing age, more severe COVID-19, female sex, and higher baseline comorbidity level as risk factors.
CONCLUSIONS: Post-COVID risk varies by demographic factors, comorbidity level and COVID-19 severity. Thus, targeted prevention and early interventions in risk groups may reduce long-term health impacts and healthcare burden.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH118
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Public Health
Disease
Infectious Disease (non-vaccine)