ArticleInfectious diseases and therapy2026
Clinical and Economic Inpatient Burden of Influenza and Influenza-Like Illness in Germany 2019-2025: Analysis of Nationwide Hospital Data.
Article in Infectious diseases and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
introductionData on the influenza burden in Germany during and after the global COVID-19 pandemic are limited. This study presents nationwide trends in the clinical and economic inpatient burden of influenza and influenza-like illness (ILI) in the German population from 2019 to 2025.
methodsWe conducted a descriptive, retrospective analysis of nationwide hospital data from the German Institute for Hospital Reimbursement covering six consecutive influenza seasons (2019-2020 to 2024-2025). Influenza/ILI hospitalizations were identified using the International Classification of Diseases version 10 (ICD-10) codes J09-J11 recorded as primary diagnosis. Outcomes included hospitalization counts, incidence rates, mean length of stay, ICU admissions, in-hospital mortality, and estimated costs, and were reported for three age groups (0-17 years, 18-59 years, ≥ 60 years). Regional variation across federal states was assessed using directly age-standardized rates.
resultsWe identified 240,646 influenza/ILI hospitalizations, with the highest burden observed in the 2024-2025 season (87,745 cases; incidence: 105.0/100,000 population). Less than 5000 cases were observed in both the 2020-2021 and 2021-2022 seasons. Across all seasons, adults aged ≥ 60 years accounted for 48% of hospitalizations and 92% of 10,054 in-hospital deaths. In this age group, in-hospital mortality ranged between 5.8% and 12.3% per season. Mean hospitalization costs per case increased during the study period and were highest in older adults, reaching €5430 in 2023-2024 and €5421 in 2024-2025. Total inpatient costs of influenza/ILI were highest in 2024-2025 and estimated at €390 million. Regional hospitalization rates varied considerably, but patterns were inconsistent across seasons.
conclusionsInfluenza/ILI causes a substantial and re-emergent inpatient burden in Germany, disproportionately affecting older adults. These findings highlight the need for sustained prevention efforts to reduce the burden of influenza/ILI in Germany. Further research is needed to understand the substantial regional disparities between federal states.
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