The number of infections in Germany is increasing and with it the number of people affected by long-Covid. An evaluation of data from statutory health insurance physicians now indicates that most of those affected by long-Covid were probably already ill beforehand. We asked Long Covid experts.

The new, even more infectious omicron subline BA.5 continues to increase the number of infections in Germany. According to the Robert Koch Institute, there are currently over 1.6 million active cases in Germany. The consequences of this new wave cannot yet be precisely assessed. But many experts, including Health Minister Karl Lauterbauch, fear that there will also be a flood of long-Covid sufferers. People with Long-Covid continue to experience symptoms such as weeks or months after they are infected

But heart problems, kidney and metabolic disorders can also occur as a result of an infection – the list of possible symptoms is long: In various studies, those affected have given up to 200 different symptoms for Long-Covid.

The treacherous thing about Long-Covid: It can affect anyone and also occurs regardless of the severity of the course of the infection. Thus, people who have only mild Covid symptoms or who were even asymptomatic can also suffer from severe long-Covid symptoms as a result of the infection.

A new evaluation by the Central Institute for Statutory Health Insurance Physicians (ZI) now shows, based on billing data from statutory health insurance physicians for the year 2021, that many long-Covid patients were already ill before their corona infection. According to the analysis, almost 96 percent of around 170,000 long-Covid patients were already treated by a panel doctor in the previous year.

According to the report, conspicuously frequent treatment occasions in the run-up to Corona were, for example

According to ZI boss Dominik Stillfried, the study indicates that people with previous illnesses have a higher risk of long-Covid. “The billing data from the health insurance companies show that people with long-Covid were usually not completely healthy before,” Stillfried told FOCUS Online.

“It does happen that someone was perfectly healthy beforehand and is severely affected by long-Covid after their corona infection, but it is not the rule,” says Stillfried. At least that was reflected in the data from the health insurance companies. Because four percent of long-Covid patients had not previously seen a doctor. The data showed that younger and healthier people were less likely to be affected by post-Covid than people with pre-existing conditions.

One problem, however, is the diagnosis of Long-Covid. “Post-Covid is not precisely defined, it is a multitude of symptoms that are also observed in other diseases. Therefore, it can be difficult to identify specific post-Covid symptoms in patients with pre-existing conditions,” he continues.

The long-Covid specialist Jördis Frommhold, who has already treated over 5000 patients in the Median Klinik in Heiligendamm, is critical of the results. “Long-Covid is very difficult to diagnose and many doctors have little experience with it.” To say that most long-Covid patients therefore have a previous illness is too one-sided. Because she doubts that all the diagnoses that were included in the survey were always correct.

Since the symptoms are so varied and the clinical picture so diffuse, it could be that many were wrongly diagnosed with long-Covid and maybe have something else. This also applies to the reverse case. “I also saw many young people who had no previous illness and were therefore not taken seriously by the doctors,” says Frommhold.

For example, if a young, healthy person comes to the doctor with massive concentration problems, they may receive a psychosomatic diagnosis, even though it is a result of a corona infection. “To say that most Long-Covid patients have pre-existing conditions means that many patients who are young, now suffering from Long-Covid and who were healthy before their Covid-19 infection, are no longer seen.” That is problematic.

This is also how the physicians Kristina Adjoran and Hans Christian Stubbe from the post-Covid outpatient clinic of the LMU Klinikum Munich see it: “Of course we have many patients with previous illnesses, but we also see young patients without previous illnesses who are significantly affected”. , the two explain when asked by FOCUS Online.

In principle, however, the observations of the study coincided with their experiences, that people with previous illnesses are more severely affected by Long-Covid than others. Nevertheless, the two doctors also point out the difficult diagnosis of Long-Covid. Not every illness that was previously treated by a doctor is also relevant for Long-Covid.