Determinants of self-reported long COVID: findings from the German Health Update 2023 (GEDA 2023)

Abstract Background Long COVID comprises manifold persistent or newly emerging symptoms following a SARS-CoV-2 infection, lasting at least four weeks. Its diverse and poorly understood manifestations pose significant public health challenges. This study aims to estimate the prevalence of self-reported medically diagnosed Long COVID among adults in Germany and identify sociodemographic and health-related correlates. Methods Data basis was the GEDA 2023 survey (March 2023-February 2024), a nationwide cross-sectional telephone survey in Germany. Long COVID was defined as self-report of ever having been diagnosed by a doctor with “long COVID” or a “post-COVID condition.” Analyses were based on complete cases aged 18 years or older reporting previous SARS-CoV-2 infection (N = 6,060) and included weighted prevalence estimates and Poisson regression, with sex, age, education level, partnership status, chronic conditions, social support and number of SARS-CoV-2 infections as determinants. Results 6.2% (95% CI: 5.1-7.2) of participants reported having ever received a Long COVID diagnosis. Prevalence was higher among females (7.6% [6.0-9.2]) compared to males (4.5% [3.2-5.9]). Individuals with self-reported Long COVID reported poorer self-rated health, more frequent sleep problems, subjective memory impairment, and greater restrictions in daily activities compared to those without Long COVID (all p-values < 0.001). In multivariable regression, female sex (adjusted relative risk [aRR] 1.58), older age (aRR 1.01), low educational level (aRR 1.68), presence of chronic conditions (aRR 3.04), and having more than three previous COVID-19 infections (aRR 2.62) were significantly associated with Long COVID. Conclusions Long COVID affects a significant share of those with prior infection and is linked to female sex, older age, low education, chronic conditions, and reinfections. These findings highlight the need for targeted prevention, early diagnosis, and support for vulnerable groups. Key messages • Self-reported medically diagnosed LC affects 6.2% of previously infected adults in Germany and is more common in women, older adults, those with low education, chronic conditions or reinfections. • Long COVID is associated with poorer health, sleep problems, memory impairment, and activity limitations, highlighting the need for targeted support for vulnerable groups.