{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:22:04Z","timestamp":1786972924821,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 \u201cU09.9!\u201d 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u201360 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\u202fdays (SD 11.6\u202fdays). LOS showed a right-skewed distribution. The median LOS was 7.1\u202fdays [interquartile range (IQR): 3.9\u20137.9\u202fdays]. Total inpatient costs reached \u20ac67.9 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PCS continues to challenge healthcare systems, underlining the need for ongoing research, policy adjustments, and resource planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1774115","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:33:34Z","timestamp":1771310014000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["German nationwide inpatient data on the post-COVID-19 syndrome: an update"],"prefix":"10.3389","volume":"14","author":[{"given":"Nike","family":"Walter","sequence":"first","affiliation":[{"name":"Department for Psychosomatic Medicine, University Hospital Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Giessen","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Hinterberger","sequence":"additional","affiliation":[{"name":"Department for Psychosomatic Medicine, University Hospital Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H.","family":"Loew","sequence":"additional","affiliation":[{"name":"Department for Psychosomatic Medicine, University Hospital Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Rittmann","sequence":"additional","affiliation":[{"name":"Department for Psychosomatic Medicine, University Hospital Regensburg","place":["Regensburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/S0140-6736(22)01214-4","article-title":"Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study","volume":"400","author":"Ballering","year":"2022","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.bbi.2021.12.020","article-title":"Fatigue and cognitive impairment in post-COVID-19 syndrome: a systematic review and meta-analysis","volume":"101","author":"Ceban","year":"2022","journal-title":"Brain Behav 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Analysis of clinical features in a Swedish COVID-19 cohort with 18 months\u2019 follow-up: a national observational cohort and matched cohort study","volume":"2","author":"Ollila","year":"2024","journal-title":"BMJ Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1002\/pmrj.13397","article-title":"Multidisciplinary collaborative guidance on the assessment and treatment of patients with long COVID: a compendium statement","volume":"17","author":"Cheng","year":"2025","journal-title":"PM&R"},{"key":"ref20","first-page":"e59478","article-title":"Multidisciplinary management strategies for long COVID: a narrative review","volume":"16","author":"Prusinski","year":"2024","journal-title":"Cureus"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1097\/MS9.0000000000003066","article-title":"A multidisciplinary review of long COVID to address the challenges in diagnosis and updated management guidelines","volume":"87","author":"Abbas","year":"2025","journal-title":"Ann Med Surg (Lond)"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"16144","DOI":"10.1038\/s41598-021-95565-8","article-title":"More than 50 long-term effects of COVID-19: a systematic review and meta-analysis","volume":"11","author":"Lopez-Leon","year":"2021","journal-title":"Sci Rep"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1085988","DOI":"10.3389\/fmed.2023.1085988","article-title":"Biomarkers in long COVID-19: a systematic review","volume":"10","author":"Lai","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1007\/s40291-024-00731-z","article-title":"Blood biomarkers of long COVID: a systematic review","volume":"28","author":"Thomas","year":"2024","journal-title":"Mol Diagn Ther"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"e0316335","DOI":"10.1371\/journal.pone.0316335","article-title":"Care for post-COVID-19 condition in Germany from the perspectives of patients, informal caregivers and general practitioners: study protocol for a mixed methods study","volume":"19","author":"Brinkmann","year":"2024","journal-title":"PLoS ONE"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1186\/s12913-023-09601-6","article-title":"Long COVID: costs for the German economy and health care and pension system","volume":"23","author":"Gandjour","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"ref27","volume-title":"Deskription von Post-COVID-Patient:innen (Bundesweit, Q2 2024)","year":"2025"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1774115\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:33:36Z","timestamp":1771310016000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1774115\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":27,"alternative-id":["10.3389\/fpubh.2026.1774115"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1774115","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]},"article-number":"1774115"}}