{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T14:42:43Z","timestamp":1784990563340,"version":"3.55.0"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BioNTech Europe GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The ROUTINE-COV19 study explores the burden of COVID-19 in Germany during the early endemic phase, assessing disease patterns and their impact on the healthcare system from 1 July 2022 to 30 June 2023. Using anonymized statutory health insurance data from over 3 million individuals in Thuringia and Saxony, COVID-19 cases were identified through diagnostic codes, with severe and critical cases defined by hospitalization and intensive care criteria. The study focused on high-risk populations as identified by the German Immunization Technical Advisory Group. During the study period, 414,648 new COVID-19 cases were documented, with peaks in October 2022 and March 2023. Severe cases occurred at a rate of 241.6 per 100,000 persons, with in-hospital mortality exceeding 12%. Critical cases requiring intensive care had an in-hospital mortality rate of 32.2%. COVID-19-related hospitalizations averaged 9.94 days, generating direct costs of EUR 64.9 million, while indirect costs from work absenteeism amounted to EUR 454.3 million, representing 7.5% of all-cause absenteeism costs. Despite entering an endemic phase, COVID-19 continues to pose a substantial burden, particularly among older adults and those with pre-existing cardiovascular conditions.<\/jats:p>","DOI":"10.3390\/v17030424","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T13:07:51Z","timestamp":1741957671000},"page":"424","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["COVID-19 Disease Burden in the Omicron Variant-Dominated Endemic Phase: Insights from the ROUTINE-COV19 Study Using Real-World German Statutory Health Insurance Data"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-3058","authenticated-orcid":false,"given":"Sabrina","family":"M\u00fcller","sequence":"first","affiliation":[{"name":"GIPAM GmbH, 23966 Wismar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-9382","authenticated-orcid":false,"given":"Andrea","family":"Schmetz","sequence":"additional","affiliation":[{"name":"BioNTech Europe GmbH, 10179 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia K.","family":"Knaul","sequence":"additional","affiliation":[{"name":"BioNTech Europe GmbH, 10179 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wilke","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pharmako\u00f6konomie und Arzneimittellogistik (IPAM), 23966 Wismar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-649X","authenticated-orcid":false,"given":"Jingyan","family":"Yang","sequence":"additional","affiliation":[{"name":"Pfizer Inc., New York, NY 10017, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Dornig","sequence":"additional","affiliation":[{"name":"AOK PLUS, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3875-5367","authenticated-orcid":false,"given":"Christoph D.","family":"Spinner","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e499","DOI":"10.1017\/dmp.2023.139","article-title":"The Effect of the COVID-19 Pandemic on Environmental Health (Two Sides of the Same Coin): A Systematic Review","volume":"17","author":"Farrokhi","year":"2023","journal-title":"Disaster Med. 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