Regarding the BMG Long COVID Initiative

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Researchers at Charité Berlin have examined a link between the hand grip strength and severity of symptoms in persons suffering from post COVID and ME/CFS. The measurement of individual hand grip strength is used for the medical diagnosis of a physical decline in performance.&nbsp;
The study by Charité Berlin included 144 female patients with post COVID, 78 of whom are affected by ME/CFS. The hand grip strength was impaired in all study participants, but only in participants with ME/CFS was the degree of impairment associated with severity of symptoms. This suggests a common mechanism for muscle weakness and other symptoms experienced by persons suffering from ME/CFS, but not found in other forms of post COVID. According to the study, impaired hand grip strength is an objective marker of physical function in post COVID patients.&nbsp;

A study conducted by Charité examines hand grip strength as an objective measure of muscle fatigue in persons with post COVID

The Charité - Universitätsmedizin Berlin is a world-renowned institution for medical research, education and high-performance medicine and one of the largest hospitals in Europe. It combines, both, university research and teaching in its medical faculty and care of patients in its university hospital. In the process, both, basic research and application-oriented research contiguous to the hospital are further developed through interdisciplinary networking. The Charité is responsible for the university education of the next generation of human and dental doctors and provides further education offers in the field of health sciences.

Charité University Medicine Berlin National Clinical Study Group

On 16 April 2024, the third Long COVID round table was held in Berlin, continuing the dialogue on the improvement of care for those affected by Long COVID. Once again, Federal Minister of Health Prof. Dr Karl Lauterbach invited experts from the fields of medicine, science, industry and politics as well as patient advocacy groups to discuss current developments. This time, the focus was on the Federal Joint Committee’s (G-BA) new Long COVID directive, the promotion of patient-oriented research by the BMG, the planned measures to improve care for children and adolescents with Long COVID as well as the work of the expert group on Long COVID Off-Label Use. Following the first two Long COVID round tables in <a href="https://www.bmg-longcovid.de/en/discourse/long-covid-round-table/long-covid-round-table-september-2023" target="_blank" rel="noopener noreferrer">September 2023</a> and <a href="https://www.bmg-longcovid.de/en/discourse/long-covid-round-table/2nd-long-covid-round-table-december-2023" target="_blank" rel="noopener noreferrer">December 2023</a>, the third round table once again provided a space for sharing interdisciplinary ideas and solutions.

The BMG hosted the third Long COVID round table

The Federal Ministry of Health is on the highest federal agencies of the Federal Republic of Germany. It has its head office or the first office in the city of Bonn and its second office in Berlin. The responsible Federal Minister in the Scholz cabinet is Prof Dr Karl Lauterbach of the SPD, from 8 December 2021.

Federal Ministry of Health

Das Foto zeigt Bundesgesundheitsminister Prof. Dr. Karl Lauterbach im Rahmen des dritten Runden Tisches

The Federal Ministry of Health is establishing a funding priority on “investigation and strengthening of needs-based care addressing the long-term health effects of COVID-19 (Long COVID)”. The funding will be used for the development of novel and transferable care approaches and their integration into existing services, the generation of knowledge and networking of skills in the quest to sustainably enhance the care of persons living with Long COVID.&nbsp;
The funding will go towards projects structured into four modules. The projects are scheduled to launch in autumn 2024 and will be eligible for funding until 2028. Project outlines can be submitted no later than 29 April 2024 for modules 2 and 3 and no later than 21 May 2024 for modules 1 and 4.
<h4>Module 1: Pilot projects for integrated and/or coordinated care</h4>
The projects in this module can set up and evaluate concepts to enhance the integrated or coordinated care of Long COVID patients.
<h4>Module 2: Innovations in care</h4>
To enable improved clinical characterisation and treatment, pilot projects and other initiatives that set out to develop novel innovative tools for diagnosis and therapy support as well as better monitoring of the quality of Long COVID care can be eligible for funding.&nbsp;
<h4>Module 3: Investigating the situation in care and epidemiological aspects</h4>
Research in this context will focus on the current situation in care and epidemiological aspects. The areas eligible for funding will be, in particular, healthcare research looking into epidemiological issues, uptake and utilisation rates of care services, perspectives and perceptions of the general population and stakeholders as well as health economic analysis.
<h4>Module 4: Central coordinating unit and overall evaluation</h4>
It is envisaged to complement modules 1 to 3 with a coordinating unit to ensure the targeted, structured and regular integration of all of the projects funded. In addition, the coordinating unit will have further tasks specifically related to the pilot projects of modules 1 and 2. These include, in particular, the timely definition and establishment of joint requirements and standards.&nbsp;
The projects will be selected in a two-step procedure. The Federal Ministry of Health has commissioned the Deutsches Zentrum für Luft- und Raumfahrt (DLR Projektträger) to implement this procedure as a project manager. For further information, please visit the DLR project manager’s website.&nbsp;

Federal Ministry of Health establishes funding priority

Ärztinnen und Ärzte sowie Pflegerinnen und Pfleger legen die Hände übereinander als Zeichen der Zusammenarbeit

Significantly fewer people had to take sick leave last year due to post or long COVID or chronic fatigue syndrome (CFS) than in the years 2021 and 2022. However, the periods of sick leave of those affected are still long. This is the result of a current analysis conducted by the AOK Research Institute.
The evaluation found that between March 2020 and December 2023, more than one in three of all members of the AOK health insurance funds, who were in permanent gainful employment, were written at least one sick leave certificate in connection with an acute COVID-19 infection. 1.8 percent of those insured with AOK took sick leave at least once due to long COVID, post COVID or CFS.
The trend decreases over time. While in March 2022, 416 per 100,000 employees insured with AOK received a sick note for long COVID, post COVID or CFS, the number had decreased to 110 per 100,000 employees by December 2023.
Often, those affected are absent from work for longer time periods. For long COVID, the average duration of incapacity for work was 36.6 days – without considering the duration of the acute infection. The duration per case was 31.6 days for post COVID and 29.9 days for CFS, respectively.
The evaluation also shows that older employees are absent from work due to late sequelae of a COVID-19 infection more frequently than would be expected compared with other diseases. In more than 44 percent of all long COVID cases, those affected are aged between 50 and 59 years. The situation is similar for post COVID and CFS.

Long and post COVID: declining number of sick notes, but long periods of absence from work

Since 1976, the AOK Research Institute (Wissenschaftliches Institut der AOK – WIdO), the research and consultation institute of the AOK health insurance funds, provides expert opinions on all service areas of the statutory health insurance. Research focuses on issues related to outpatient care, medicinal products and therapeutic measures, health services research, hospitals, multisectoral care, workplace health promotion as well as long-term care and nursing care.

The AOK Research Institute (WIdO)

Eine Grafik, die ein Balkendiagramm über erkrankte Long COVID, Post COVID und CFS Patienten zeigt.

Researchers at Trinity College and St. James's Hospital in Ireland are currently investigating the causes of the so-called “brain fog”, which is affecting many people suffering from Long COVID. The symptom refers to impaired mental performance. This manifests itself, among other things, in a reduced ability to concentrate and memory difficulties.
The research team had already taken blood samples from 76 COVID-19 patients in the spring of 2020. Compared to a control group without COVID-19 disease, they observed increased levels of a protein (“S100 beta”), which is an indicator of an impaired blood-brain-barrier. The blood-brain-barrier is the transition between the bloodstream and the central nervous system and normally protects the brain from harmful substances.&nbsp;
The researchers also examined 10 healthy persons, 11 persons with Long COVID without brain fog and 11 persons with Long COVID who suffer from the symptom of brain fog.
Using MRI images and a special contrast media, the research team was able to show that more contrast media passes through the blood-brain-barrier in people with Long COVID. The blood vessels have become more permeable due to the viral infection. The blood-brain-barrier can be disrupted both during an acute COVID-19 illness and in people suffering from Long COVID. Among other things, this allows cells and neurotransmitters of the immune system to reach the brain more easily. The researchers assume that more permeable blood vessels and an overactive immune system are primarily responsible for the “brain fog”.&nbsp;
In future, the permeability of the blood-brain-barrier could be an important indicator of the neurological consequences of COVID-19 disease. More precise connections and possible treatment methods derived from this are still being researched.

Study explores causes of “brain fog”

Trinity College is a renowned university in Dublin, Ireland. Established in 1592, it is one of the oldest universities in the world.&nbsp;

Trinity College

St. James's Hospital is a hospital in Dublin, Ireland. It co-operates with Trinity College as an academic partner.&nbsp;

St. James’s Hospital

Nature is an important medical journal published monthly by the Nature publishing group. It publishes articles on current topics in biomedical research aimed at scientists and the medical profession.&nbsp;&nbsp;&nbsp;

Nature 

This guest article by Katrin Kunert, Vice President of recreational, preventive and rehabilitation sports at the National Paralympic Committee Germany (DBS) e.V. places a focus on the holistic approach of rehabilitation exercise as a promising approach to addressing the diverse physical and psychological impairments of patients with Long COVID.

Rehabilitation exercise – an opportunity for patients with Long COVID

Katrin Kunert is the Vice President of recreational, preventive and rehabilitation sports at the National Paralympic Committee Germany (DBS) e.V. A graduate engineer and former member of the Defence Committee and spokesperson of her party's parliamentary group on the Sports Committee of the German Bundestag (from 2009 until 2017), she has been on the DBS Executive Committee since 2017.&nbsp;

Guest article Katrin Kunert

The diagnosis of Long COVID is still challenging due to the diffuse symptoms. Researchers from an international team led by the University of Zurich have now identified parameters, which could be used to better distinguish Long COVID from other disease symptoms. The study was published in the scientific journal Nature.
The researchers examined the blood of 113 persons suffering from COVID-19 and 39 healthy persons and analysed more than 6,000 proteins. Of the 113 people, 40 have developed Long COVID. Their blood was analysed again after 6 and 12 months. This showed that the concentration of various proteins, that have important functions for balance in the immune system, was altered. The team also identified other so-called “biomarkers” for tissue damage and altered blood clotting. Biomarkers are relevant, measurable biological parameters, which indicate an illness.&nbsp;
Taken together, the biomarkers indicate, among other things, a faulty activation of the immune system, which could contribute to the development of symptoms in persons suffering from Long COVID. The findings are a new starting point for research into Long COVID diagnosis.

New research approach for the diagnosis of Long COVID

The University of Zurich (UZH for short) is the largest university in Switzerland. As a comprehensive university, it unites all the classical faculties under its roof: Theology, Law, Economics, Medicine, Veterinary Medicine, Philosophy and Mathematics/Natural Sciences.

University of Zurich

Science is a major medical journal, which is published weekly by the&nbsp;American Association for the Advancement of Science (AAAS). It publishes articles on current topics in biomedical research, which are aimed at scientists and the medical fraternity.

Science

Probenröhrchen werden in Zentrifuge gegeben.

In a current study, Dutch scientists are investigating what happens at the cellular level in the bodies of persons suffering from Long COVID during exertion. This is because many persons severely affected by Long COVID suffer from Post-Exertional Malaise (PEM), a typical worsening of symptoms after strain, which leads to persistent or permanent worsening of symptoms after even brief physical activity or mental activity.&nbsp; &nbsp;
Twenty-five Long COVID patients who had been suffering from symptoms for more than six months were observed. The comparison group consisted of 21 patients who had recovered from COVID-19 illness. All participants completed a 15-minute sports session. One week before and one day after the athletic strain, the scientists analysed the blood and thigh muscle samples of the study participants. Overall, the data suggests that the lower physical performance observed in Long COVID patients is related to a higher proportion of quickly fatiguing muscle fibres (high-fatigable glycolytic fibres) and an impaired function of the mitochondria. Mitochondria convert nutrients into energy for the organism. This process appears to be disrupted in patients with Long COVID.

New study on the causes of post-exertional malaise (PEM) in Long COVID

The VU University Amsterdam is one of the two major universities in the Dutch capital Amsterdam. It was established at the end of the 19th century.&nbsp;

VU University Amsterdam

Nature Communications is a scientific journal published by the Nature publishing group. It publishes articles on current scientific topics and is aimed at scientists.&nbsp;

Nature Communications

Anja Piel, Member of the Federal Executive Board of the German Trade Union Confederation (DGB), explains in her guest article why Long COVID is a challenge for society as a whole and what is needed in order to better help those affected.&nbsp;

Long COVID: A challenge for society as a whole

Anja Piel is a Member of the Federal Executive Board of the German Trade Union Confederation (DGB). Qualified as an industrial management assistant and previous leader of the parliamentary group of the Green Party in Lower Saxony, she is also alternate chair of the Administrative Board of the Federal Employment Agency (Bundesagentur für Arbeit) and of the Board of the German Pension Insurance Association (Deutsche Rentenversicherung Bund – DRV Bund) as well as a member of the German Social Advisory Council.

Guest article Anja Piel

In this guest article, Peggy Heinz, deputy CEO of NAKOS, the National Contact and Information Centre for the Encouragement and Support of Self-Help Groups, explains the development and added value of self-help groups in the context of Long COVID and Post COVID in Germany. She also talks about the structures needed to support and empower the self-help groups.&nbsp;

Self-help as an essential pillar of the healthcare system

Peggy Heinz is deputy CEO of the National Contact and Information Centre for the Encouragement and Support of Self-Help Groups (NAKOS).
In the years 2022 and 2023, she managed the project “Hilfe nach COVID-19. Zugänge zur gesundheitlichen Selbsthilfe fördern” (Help after COVID-19. Promoting access to health-related self-help) (financed by the AOK-Bundesverband (Federal Association of the Local Health Insurance Funds)) and helped set up the coronavirus database at NAKOS.
NAKOS operates as a nationwide point of contact and pools information on collective self-help and self-help support. It publishes materials and expert information on different topics, independently and free of charge.

Guest article Peggy Heinz

On 21 December 2023, the Federal Joint Committee (G-BA) adopted a new guideline for faster and more needs-based care for patients with suspected Long COVID. This Long COVID guideline defines requirements for care and describes so-called care pathways, i.e. the course of medical treatment.
A medical contact person is envisaged. This person will be responsible for the specific coordination required for diagnosis and treatment. In this way, the existing outpatient structures and services are utilised according to the severity and complexity of the illness and the right healthcare professions are involved.
The guideline applies both to those affected by Long COVID or with illness following a COVID-19 vaccination and to patients whose illnesses have similar causes or symptoms to Long COVID. This includes ME/CFS, for example.

Long-COVID guideline is published

The Joint Federal Committee (G-BA) is the highest decision-making body of the joint self-administration of physicians, dentists, psychotherapists, hospitals and health insurance companies in Germany. Representatives of patient organisations have the right to submit proposals and to participate in consultations in all committees of the G-BA. The main task of the G-BA is to define the content of care in more detail in guidelines, and to decide which services are covered by the statutory health insurance. The G-BA also defines measures for quality assurance of medical care as well as requirements for structured treatment programmes (disease management programmes, DMPs for short) and evaluates the benefits of medicines with new active ingredients.

Joint Federal Committee (G-BA)

Das Foto zeigt eine Ärztin, die im Gespräch mit einer Patientin ist

On <a href="https://www.bmg-longcovid.de/en/discourse/long-covid-round-table/2nd-long-covid-round-table-december-2023" target="_blank" rel="noopener noreferrer">4 December 2023, the second Long COVID Round Table</a> took place in Berlin and continued the dialogue on dealing with the challenges of Long COVID. Federal Minister of Health Prof Dr Karl Lauterbach once again invited experts and various affected groups to discuss the topics of research, pharmaceuticals, rehabilitation and participation. The event provided an open platform for the exchange of interdisciplinary ideas, current research findings and discussions on new therapeutic approaches to improve long-COVID care in Germany. The <a href="https://www.bmg-longcovid.de/en/discourse/long-covid-round-table/long-covid-round-table-september-2023" target="_blank" rel="noopener noreferrer">first round table</a> on the topic was held in September 2023.

The BMG organised the second "Long COVID" round table

Bundesgesundheitsminister Prof. Dr. Karl Lauterbach im Austausch mit Expertinnen und Experten beim zweiten Runden Tisch Long COVID

At the end of the year, the previously parallel information services on the topic of Long COVID from the Federal Centre for Health Education (BZgA) and the Federal Ministry of Health (BMG) will be merged into a single portal on the website bmg-longcovid.de. The website longcovid-info.de, which was previously provided by the BZgA, will then no longer be available. All content available there has also been accessible on the BMG portal since November 2023. From 1st December 2023 onwards, visitors will be automatically redirected to the website bmg-longcovid.de. In addition to the previous content, you will also find constantly updated scientific information and a comprehensive discourse section with guest contributions and video statements from national and international experts and other stakeholders.

Information services from the BZgA and BMG on the topic of Long COVID are brought together in one portal

The second Long COVID Congress was held on 24th and 25th November 2023, jointly organised by the Long COVID Medical Association and University Hospital of Jena. The BMG initiative Long COVID participated with an information programme. Federal Health Minister Prof. Dr. Karl Lauterbach acted as patron together with Thuringia's Prime Minister, Bodo Ramelow.&nbsp;
The aim of the event was to discuss new findings on the development of the disease and secondary diseases as well as therapy studies on Long COVID. Another focus was on participation in social life, such as the impact of Long COVID on the social and working life of patients suffering from the disease. Experts from all scientific fields, dealing with Long COVID, were involved in the exchange. Participants also included practitioners from various medical specialities to discuss new approaches for the treatment of affected persons. The congress was aimed at both professionals and affected persons.

Second congress of the Long COVID Medical Association  from 24 to 25 November 2023 in Jena

Jena University Hospital (UKJ) is the largest hospital in the Free State of Thuringia. It is also where the Thuringian university medicine facility is located. The scientists at UKJ work on patient-related research and basic research. The university hospital offers scheduled high-performance medicine services, and thus ensures maximum care in the region.

Universitätsklinikum Jena 

The primary task of the Long COVID Doctors' Association is to research the long-term effects of COVID-19, to make knowledge available in a centralised manner and to promote the establishment of care facilities in order to improve the treatment of Long COVID patients.

Long COVID Medical Association

Das Foto zeigt einen Informationsstand zur BMG Initiative Long COVID beim zweiten Kongress des Ärzte- und Ärztinnenverbandes Long COVID vom 24. - 25. November 2023 in Jena

The scientific team of the IGeL-Monitor rates the two procedures under discussion, "blood washing" ("H.E.L.P.-Apheresis") and "Hyperbaric Oxygen Therapy" for the treatment of Long COVID, each with "unclear". Why: No study data is available for the apheresis procedure. For hyperbaric oxygen therapy, one study was identified, however, it failed to yield a benefit.

IGeL Monitor: Benefits of H.E.L.P. apheresis ("blood washing") and hyperbaric oxygen therapy remain unclear

The IGeL Monitor is an institution of the Federal Medical Service. An interdisciplinary team from the fields of "evidence-based medicine" and public relations – supported by scientists from outside – analyses and evaluates so-called individual health services (IGeL), which are not covered by the statutory health insurance (GKV), for the sake of striking a balance between actual benefit and possible harm.

IGeL Monitor

Illustration: Doctor and young patient in conversation

A recent study by the Perelman School of Medicine, published in the journal Cell in October 2023, indicates that a deficiency of the hormone serotonin could contribute to the development of long-COVID symptoms and influence their course. Serotonin is a messenger substance that influences the immune system, the nervous system and the inflammatory response, among other things.&nbsp;
The study found that people with Long COVID had lower serotonin levels compared to recovered persons. The reduced serotonin level could therefore possibly be involved in the development of Long COVID symptoms and lead to impaired brain function and nervous system. Altered blood clotting could also be a consequence of the reduced serotonin level - this can lead to small blood clots ("microthrombi"), which are being discussed as a cause of Long COVID.&nbsp;&nbsp;

New study by US researchers from the Perelman School of Medicine investigates the link between serotonin deficiency and long COVID

The Perelman School of Medicine at the University of Pennsylvania is the oldest medical school in the USA and is one of the most prestigious universities in the country. In 2023, professors Katalin&nbsp;<a href="https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=&amp;cad=rja&amp;uact=8&amp;ved=2ahUKEwjYsbOJwK-CAxU_g_0HHY7bBUkQFnoECBsQAQ&amp;url=https%3A%2F%2Fwww.aerztezeitung.de%2FPanorama%2FKariko-Weissman-Die-Nobelpreistraeger-im-Kurzportraet-443402.html&amp;usg=AOvVaw0M2GNBCbXhYTmhtQCNb5KV&amp;opi=89978449" target="_blank" rel="noopener noreferrer">Karikó </a>and Drew Weissmann, who conduct research at the university, were awarded the Nobel Prize in Medicine for their research on mRNA vaccines.&nbsp;

Perelman School of Medicine

Cell is a renowned scientific journal. The articles published are subject to special peer review. Cell primarily publishes articles on current research topics in the field of experimental cell biology.&nbsp;&nbsp;

Cell

In order to improve the care of children and adolescents with Long COVID, the state of Baden-Württemberg is supporting the “MOVE-COVID-BW” model project at the university hospitals in Freiburg, Heidelberg, Tübingen and Ulm. Among other things, a cross-sectoral care structure is to be established and tested, which will be supplemented by a telemedicine service. Scientific data will be collected at all four locations according to defined criteria, e.g. by means of standardised questionnaires. This will be included in a register. The aim is to enable further systematic and targeted research into the pathology, for example through special virological, immunological and radiological diagnostics. This way, the project can contribute to gaining new insights into the development mechanisms of the disease and its treatment - especially in children and adolescents. Information on the pathology and treatment options are provided on a website.

Baden-Württemberg: Model project on Long COVID in children and adolescents

The model project “MOVE-COVID-Baden-Württemberg” (Molecular immunological characterisation &amp; multimodal-multicentric intersectoral care of Long COVID in childhood and adolescence in Baden-Württemberg) is funded by the Ministry of Social Affairs, Health and Integration.
Ministry of Social Affairs, Health and Integration, Baden-Württemberg
The Ministry of Social Affairs, Health and Integration, Baden-Württemberg, is a supreme state authority. It is one of twelve ministries in the administration of the state of Baden-Württemberg.&nbsp;

MOVE-COVID-Baden-Württemberg

A research team at Yale University in the US led by Professor Akiko Iwasaki has conducted a study on possible changes in the immune system of Long COVID patients. Blood samples from 268 people were analysed: Some continued to suffer from symptoms one year after a coronavirus infection, others had already fully recovered and a third group consisted of people who had not yet been infected with the coronavirus.&nbsp;
Various changes in the defence system were discovered in the patients with persistent symptoms. The number of certain defence cells and their activity were altered compared to healthy individuals. A reactivation of antibodies against various viruses was also detected, for example against the SARS-CoV-2 coronavirus and the Epstein-Barr virus (the pathogen that causes "Pfeiffer's glandular fever"). Sufferers also had lower concentrations of the stress hormone cortisol in their blood.&nbsp;
The results could help to understand possible changes in biological processes in long COVID. Based on this, relevant, measurable biological parameters (so-called "biomarkers") could be developed for diagnostics.

Yale University study examines blood count of Long COVID patients

Yale University is a renowned university in the USA. The study "Distinguishing features of long COVID identified through immune profiling" was published in the renowned journal "Nature”.&nbsp;&nbsp;

Yale University 

For a lot of people, COVID-19 has become a thing of the past. Unfortunately however, others are still suffering from the long-term effects of the infection with the SARS-CoV-2 virus. COVID-19 has fortunately ceased to be a pressing issue for many people. However, some people are still suffering from the after-effects of infection with the SARS-CoV-2 coronavirus. Long COVID still poses a challenge to medicine and science, as well as to our society as a whole. We have launched the BMG-Long COVID initiative to ensure that patients suffering from the virus and their relatives receive the best possible support. This website is intended to be a contact point for people affected by Long COVID who are looking for answers, insights and help.

Welcome to the website of the BMG Long COVID initiative

The question of how we in society should deal with Long COVID has occupied medicine, science, business and politics. Prof. Dr. Karl Lauterbach, Federal Minister of Health, therefore invites experts and those affected to a round table: On 12th September 2023, patients, representatives of patients, treatment providers, researchers, employers, insurers and political decision-makers will come together in Berlin to discuss the need for action to provide care for patients.

Federal Minister Lauterbach invites to the “Long COVID” Round Table

People sit in a circle made using curved tables

A recent study by the Charité - Universitätsmedizin Berlin and the Max Delbrück Center conducted research on people suffering from chronic fatigue after COVID-19 disease. For this purpose, the researchers collected various parameters from patients suffering from long COVID symptoms at several points in time over a period of 20 months.&nbsp;
Here is what the results revealed: People who develop chronic fatigue syndrome (ME/CFS) after their SARS-CoV-2 infection tend to remain severely ill for a long time. Their symptoms usually persist unchanged for up to 20 months. In contrast, there are people with similar symptoms who do not meet the criteria for ME/CFS. In most cases, their symptoms improve slowly over time.&nbsp;
The researchers also emphasise the importance of "pacing" as a way to manage persistent symptoms. Such strategies could help improve the quality of life of those suffering from the disease.&nbsp;

A new study by the Charité and the Max Delbrück Center: Findings on ME/CFS in patients affected by Long-COVID

The Max Delbrück Center for Molecular Medicine (Max Delbrück Center) is one of 18 institutions of the Helmholtz Association of German Research Centres. It combines basic research in molecular biology with clinical research. The research teams aim to rapidly transfer findings into medical application.

Max Delbrück Center for Molecular Medicine (Max Delbrück Center) 

: Bildschirmaufnahme: Pressemitteilung Charité-Universitätsmedizin Berlin

In a study published in the journal "Nature Medicine", people who were infected with SARS-CoV-2 were followed up for two years. They were then tested against people without a proven SARS-CoV-2 infection (the so-called control group). The objective of this study was to investigate the mortality risk and various secondary diseases that occur after a SARS-CoV-2 infection.&nbsp;&nbsp;
It showed that the mortality risk was elevated over the two years in people who were hospitalised due to a severe progression of the disease in comparison to people who did not have to be hospitalised due to their infection. In addition, after hospitalisation for a severe progression, there was a higher rate of persistent sequelae in various organ systems.&nbsp;
Yet another study was published in the scientific journal JAMA International Medicine. Over a two-year period, the researchers followed more than 200,000 veterans who had previously contracted COVID-19. The data collected was compared with data from people who did not have COVID-19. Those with a mild progression (no hospitalisation) showed an increased risk of mortality only in the first six months after infection.&nbsp; &nbsp;
The results of the studies were summarised by the US cardiologist Eric J. Topol in his blog.&nbsp;
&nbsp;
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New studies have investigated secondary diseases and mortality risk in patients who have been infected with SARS-CoV-2.

The Nature Medicine journal is published monthly by the Nature publishing group. It publishes articles on current topics in biomedical research geared towards scientists and those working in the medical profession.

Nature Medicine

JAMA Internal Medicine is a scientific journal published by the American Medical Association. It publishes original research relevant to internal medicine and related fields.

JAMA Internal Medicine

Eric J. Topol is a US cardiologist and author. He is Professor of Molecular Medicine, Executive Vice President of Scripps Research and Founder and Director of the Scripps Research Translational Institute. Topol has published over 1,300 scientific articles and three best-selling books on the future of medicine.&nbsp;&nbsp; &nbsp;

Eric J. Topol

The National Institutes of Health (NIH) in the USA announce the launch of new clinical studies. They do research on new therapies for the treatment of long COVID complaints. In the RECOVER-VITAL study, for example, a therapy with the drug Paxlovid is being researched. This is a possible therapeutic approach if SARS-CoV-2 viruses remain in the body even after the acute infection has ended. Another example is the RECOVER-NEURO study, in which therapies for impaired mental abilities are being researched, such as web-based training programmes. The RECOVER-SLEEP study aims to do research on possible therapies for sleep disturbances. Among other things, the RECOVER-AUTONOMIC study will do research on therapy for disorders of the circulatory system. A further study will focus on the treatment of stress intolerance and fatigue.
The studies are part of the NIH’s RECOVER (Researching COVID to Enhance Recovery) initiative. This is a national research programme in the USA. It aims to understand, prevent and treat long COVID. The following English-language website of the initiative provides extensive information about the programme:&nbsp; <a href="https://recovercovid.org/" target="_blank" rel="noopener noreferrer">https://recovercovid.org/</a>&nbsp;

National Institute of Health: New clinical studies on long COVID therapies launched

The National Institutes of Health (NIH) is headquartered in Bethesda (Maryland). It is part of the American Department of Health and Human Services, and encompasses 27 institutes and centres. These attend to basic medical research, clinical research and translational research. They research the causes of diseases, as well as possible treatments and medicines.&nbsp;

Die National Institutes of Health

The Deutsche Ärzteblatt was started in the year 1872. It is an official organ of the medical profession. It is published by the German Medical Association and the National Association of Statutory Health Insurance Physicians. It is published by the Cologne-based Deutsche Ärzteverlag GmbH, and is its highest-circulation publication.

Deutsches Ärzteblatt

A new offer of support is now available in Lower Saxony for those affected by long COVID. The Lower Saxony Ministry of Health, together with AOK and Hannover Medical School (MHH), has set up a telephone hotline that has been open for use from 1 August 2023. The hotline is intended to provide guidance and information about existing support services. It is also intended to show those affected that their health complaints are being taken seriously. The hotline also provides information about vaccination side effects.
Ill people, their relatives and employers can get advice from Monday to Friday, from 1000 hours to 1400 hours. The telephone number is (0511) 120 29 00.&nbsp;

New long COVID hotline in Lower Saxony

The Lower Saxony State Health Office is subordinate to the Lower Saxony Ministry for Social Affairs, Health and Equality. The State Health Office takes measures to prevent and combat diseases. It also advises the public health service, medical facilities (e.g. hospitals) and professional groups in the healthcare sector.

Niedersächsisches Landesgesundheitsamt

AOK stands for ‘Allgemeine Ortskrankenkasse’. The AOK is made up of eleven independent regional health insurance companies spread across the whole of Germany. The AOK community with its eleven organisations makes a major contribution to statutory healthcare in Germany.

Allgemeine Ortskrankenkasse (AOK)

The Hannover Medical School (MHH) is a university institution in Lower Saxony. The MHH combines more than 70 hospitals, institutes and research facilities on the campus. When it was founded, the MHH opted for the integration model, which is based on the following three pillars: medical care, research and education. The MHH treats 160,000 outpatients and more than 50,000 inpatients every year. As a supra-maximum medical care hospital, a wide range of treatment options is provided for patients, some of whom are seriously ill.

Hannover Medical School (MHH)

Bildschirmaufnahme: Beratungshotline Long COVID Niedersachsen

Researchers at King's College London spent two years investigating how an infection with the SARS-CoV-2 virus affects the cognitive performance of patients. Towards this end, the researchers compared people with and without an infection that had been overcome. To measure cognitive performance, the participants took two online tests, one in 2021 (3,335 participants) and one in 2022 (1,768 participants who had also taken the first online test). Among other things, their memory performance, attention and ability to concentrate were measured.&nbsp;&nbsp;
The results, which have now been published in the specialist journal e-ClinicalMedicine (part of The Lancet Discovery Science), show that people who contracted COVID-19 and made a full recovery had no measurable cognitive impairment two years later. A different picture emerged in patients who were still reporting complaints 12 weeks after the acute SARS-CoV-2 infection or whose complaints were particularly severe: Cognitive deficits following a SARS-CoV-2 infection were still detectable almost two years after the infection.&nbsp;

British study: Long COVID could affect brain function for over two years

King's College London is a member of the Association of Commonwealth Universities and the Russell Group, an association of the UK's most research-intensive universities. The humanities, law, social sciences and human science faculties are particularly highly respected internationally. The King's College Hospital (university hospital) is connected to the university. Clinical studies and patient care are carried out at King's College Hospital.&nbsp;

King’s College London 

The Lancet is one of the oldest and most prestigious peer-reviewed medical journals in the world. The peer review process is the most common procedure for checking the quality of articles before they are published in scientific journals. The articles are reviewed by independent experts in the field.&nbsp;

The Lancet

The new platform "Patient Feedback for Patient Safety" allows patients affected by Long COVID and medical professionals to share their respective experiences with Long COVID treatment anonymously and free of charge. To this end, it is possible to use telephone hotlines and also submit case reports online.&nbsp;&nbsp;
A team of experienced experts is dedicated to the evaluation and documentation of these reports. Results of the analyses and corresponding comments are published on the platform. In addition, where appropriate, recommendations are given on how reported risks could be minimised in the future.&nbsp;
The platform is funded by the Federal Ministry of Health as part of the "OptiCIRS" project. OptiCIRS is a project of the Techniker Krankenkasse, which is organised by the non-profit Deutsche Gesellschaft für Patientensicherheit gGmbH.&nbsp;&nbsp;

The “Patient Feedback for Patient Safety” platform goes viral

Techniker Krankenkasse (TK) is Germany's largest health insurance company with more than 11 million insured.&nbsp; It is a member of the Verband der Ersatzkassen (vdek). Since September 2016, the health insurance company has been operating under the name Die Techniker.&nbsp;

Techniker Krankenkasse (TK)

The non-profit German Society for Patient Safety works closely with medical professionals and is committed to implementing measures for patient safety. It carries out projects to research and improve patient safety. It works towards optimising the framework conditions of the health care system for patient safety.&nbsp;

German Society for Patient Safety

Bildschirmaufnahme: Plattform Patientenfeedback für Patientensicherheit 

Since the beginning of the coronavirus pandemic, more than 32,500 people across Germany have undergone medical long COVID rehabilitation. Deutsche Rentenversicherung reports an increase in applications over the last three years: In 2020, ca. 1,500 rehabilitations were carried out, in 2021 there were around 10,000, and in 2022 the number of rehabilitations was around 21,000.
Deutsche Rentenversicherung considers the increase in rehabilitation applications to be a positive development. This means that a large number of affected persons can be helped in a targeted manner. The scheduled services are tailored to the individual long COVID disease pattern in each case. Towards this end, doctors from various medical specialities are involved in the medical treatment. Such rehabilitation measures are designed to help patients return to their everyday and professional lives.

32,500 long COVID rehabilitations since the beginning of the pandemic

Deutsche Rentenversicherung Bund (DRV) is the largest pension insurance provider in Germany. It also performs fundamental and cross-sectional tasks, including public relations work, research, statistics and the joint affairs of all pension insurance providers.

Deutsche Rentenversicherung Bund

Bildschirmaufnahme: Post-COVID: Mit Reha neue Kraft tanken

The Innovation Committee at the Joint Federal Committee (G-BA) has selected a Charité research project on Long-COVID care research for funding.&nbsp;
The project called “LCovB - Improving the care situation of people affected by Long-COVID” aims to analyse the symptoms and current health care in detail. For this purpose, health insurance data is evaluated and standardised surveys are conducted with 200 affected people. Also, 15 severely ill people are to be interviewed in a structured manner and medically examined. Based on the results, the researchers plan to develop guidelines for people suffering from Long-COVID and for their primary care providers, mostly family doctors.

Charité research project on Long-COVID care research selected for funding by the Innovation Committee of the Joint Federal Committee (G-BA)

The Federal Minister Prof Dr Karl Lauterbach announces the start of the BMG Initiative on Long COVID in a press conference. This initiative shall contribute to the providing the populace with clarification on Long COVID. The new website www.bmg-longcovid.de offers information on the current knowledge and research as well as support and help offers for long haulers and their relatives. The website is also aimed at other groups involved with Long COVID, e.g., doctors, healthcare professionals, researchers, employers. A service phone for long haulers and their relatives supplements the offering. Here, you can primarily ask questions related to consultation and support offers.&nbsp;

The BMG Initiative on Long COVID: for everyone who would like to obtain information on COVID

есс-конференция, посвященная началу реализации инициативы BMG, демонстрирует министра Лаутербаха, г-жу Шейбенбоген и г-на Шиффера

WATCH –&nbsp;‘Mobile care close to home to manage cross-sector therapy for post-COVID-19 in Thuringia’ is the name of the new care and therapy study at Jena University Hospital. This is aided by the Federal Joint Committee (G-BA).
The aim of the project is to improve the care structure and participation for long COVID patients in rural areas. Towards this end, a bus is being converted into a mobile post-COVID ambulance, the so-called PoCO bus. The bus enables those affected to be examined and cared for close to home..&nbsp;Those affected will complete 12 weeks of training units on concentration and attention (BRAIN module), phased rehabilitation sports programmes (BODY module) and behavioural-therapy-related therapy offers (SOUL module).
The first use of the bus is scheduled for 01.11.2023. The 624 affected persons who can take part in the study will be selected at random. In the long term, research is also being done into whether the procedure can be transferred to standard care.&nbsp;

Jena University Hospital launches WATCH care and therapy study for those affected by long COVID

From September 2023, Hannover Medical School (MHH) wants to help GPs in Lower Saxony to treat people affected by Long-COVID. For this purpose, a virtual rehabilitation clinic is to be set up, which will pool scientific findings and practical treatment knowledge into Long COVID. This telemedical offer includes, among other things, professional consultations and further training for practitioners. GPs can present their patients to the specialists at the MHH through interdisciplinary video consultations. GPs must register with the virtual clinic via the MHH in order to participate. The project is implemented by the Klinik für Rehabilitations- und Sportmedizin and the Institut für Allgemeinmedizin und Palliativmedizin and in cooperation with the Hausärzteverband Niedersachsen.

Hannover Medical School to support general practitioners with virtual clinic in future

Screen recording: Press release on the MHH website

Up to 36 million Europeans could have developed more prolonged health problems in the course of the past 3 years after a Corona virus infection. This is the estimate of the Institute for Health Metrics and Evaluation (IHME) cites the World Health Organization’s (WHO) regional director for Europe, Dr Hans Henri P. Kluge, in a statement. According to him, Long COVID remains “[...] a complex condition we still know little about.”

Estimation: Up to 36 million Europeans could have developed Long COVID in the last three years

The World Health Organization (WHO) is a specialized agency of the United Nations headquartered in Geneva. The constitution of the WHO lays down its purpose as helping all nations in attaining the best possible health standards. The WHO was founded on 7 April 1948; it proclaimed the right to health as a fundamental human right and today counts 194 member states on-board.

The World Health Organization (WHO)

The Institute for Health Metrics and Evaluation (IHME) is a research institute working in the field of global health statistics and impact evaluation at the University of Washington in Seattle. The institute’s functions include the evaluation of health initiatives and national health systems.

The Institute for Health Metrics and Evaluation (IHME)

At their meeting in Japan, the health ministers of the G7 countries have agreed to carry out better research on Long COVID. To this end, a joint research initiative is to be created, which is to be concretised in the coming year 2024 under the Italian presidency.

G7 Health Ministers wish to strengthen Long-COVID research

Photo: G7 health ministers in a row on stage

The article explains how a COVID-19 disease can lead to exercise intolerance (post-exertional malaise, PEM), citing the example of a person affected. The author also discusses the pacing strategy for dealing with PEM and explains which aspects need to be considered in specific rehabilitation offers.

Radio report on Deutschlandfunk Kultur on exercise intolerance with Long COVID

Deutschlandfunk Kultur is the nationwide cultural programme of the national radio station.

Deutschlandfunk Kultur

In Rhineland-Palatinate, health experts met for a round table to discuss how people suffering from Long COVID can be better supported in a systematic way. By the summer of 2023, there should be a pilot structure as well as five anchor centres in order to be able to provide those affected with appropriate services more quickly.

Roundtable on Long COVID in Rhineland-Palatinate

SWR is the state broadcasting corporation of the states of Baden-Württemberg and Rhineland-Palatinate. Its programme is intended to inform, educate, advise and entertain the citizens of these states, and specifically to offer input on culture. SWR was formed in 1998 as a merger of Süddeutscher Rundfunk and Südwestfunk.

The federal state of Rhineland-Palatinate was created in 1946 by uniting parts of Prussia - the south of the Rhine Province and the west of Hesse-Nassau - with the Bavarian administrative district of Palatinate and Rhine-Hesse. With around 4.1 million inhabitants, Rhineland-Palatinate ranks sixth among Germany's federal states in terms of the number of its inhabitants and ninth in terms of its area. With just under 220,000 inhabitants, the state capital Mainz is also the most populous city in the state. Other major centres are the regions around Ludwigshafen, Koblenz, Trier and Kaiserslautern.

Federal state of Rhineland-Palatinate

Researchers at University Hospital Schleswig-Holstein are investigating Long COVID and, in the course of the COVIDOM study, have developed a score to help doctors refer patients to the right specialist. The score is intended to help classify the patients' symptoms. For this purpose, twelve possible symptom areas were identified, to which a point value is assigned depending on the severity of the complaints. According to the researchers, what is new is that this score represents the entire spectrum of symptoms.
According to the first author of the study, Prof. Bahmer, this score makes it possible to "[...] objectively distinguish between different degrees of severity of PCS symptoms".

University Hospital Schleswig-Holstein develops "Post-Covid-Score"

The North German Broadcasting Corporation (NDR) is a joint state broadcasting corporation for the Free and Hanseatic City of Hamburg and the states of Mecklenburg-Western Pomerania, Lower Saxony and Schleswig-Holstein. It is a member of the ARD and has the legal form of a non-profit institution under public law. Its programme is intended to inform, educate, advise and entertain the citizens of these states, and specifically to offer input on culture. The NDR State Treaty also notes the appropriate consideration of the diverse northern German regions and their culture and language in the programme.

Christian-Albrechts-Universität zu Kiel (CAU) is the only comprehensive university in Schleswig-Holstein. It was founded in 1665 and is named after its founder, Duke Christian Albrecht of Schleswig-Holstein-Gottorf. The university has been home to seven Nobel Prize winners. Since 2006, the CAU has successfully participated in the Excellence Initiative. Kiel University offers the opportunity to learn a lot and interact with many people in more than 190 degree courses. In addition to classical subjects such as law and medicine, the humanities, social sciences and natural sciences are also catered for.

Christian-Albrechts-Universität zu Kiel (CAU)

The University Hospital Schleswig-Holstein (UKSH) is a university hospital in the federal state of Schleswig-Holstein with locations in Kiel and Lübeck. The UKSH is supported by the Christian-Albrechts-Universität zu Kiel (CAU) and the Universität zu Lübeck. The students of the medical faculties and the dental faculty are educated at UKSH. The research foci of the Universities of Kiel and Lübeck at UKSH include the fields of "Infection and Inflammation", "Brain, Hormones, Behaviour", "Genetic Medicine" and "Age-dependent Mechanisms of the Manifestation of Disease", "Oncology", "Clinical Genome Research", "Neurosciences", "Endocrine Control and Regulation" and "Biomedical Technologies".

The University Hospital Schleswig-Holstein (UKSH) 

The research project <a href="https://www.bmg-longcovid.de/en/timeline/post-acute-health-consequences-of-covid-19" target="_blank" rel="noopener noreferrer">"Post-acute health consequences of COVID-19" led by the Robert Koch Institute (RKI), which started in December 2021,</a> has published further results.
The project "Post-COVID-19 Monitoring in Routine Health Insurance Data" (POINTED) is coordinated by the Centre for Evidence-based Health Care (ZEGV) at the University Hospital Dresden and the RKI and is part of the research initiative "Post-acute health consequences of COVID-19".
In this sub-project, the researchers analysed data from the statutory health insurance funds (SHI) from January 2019 to June 2021. The researchers included a total of 641,704 patients with COVID-19. When comparing the frequency of newly diagnosed autoimmune diseases between the COVID-19 group and the corresponding control group, it was found that those suffering from COVID-19 had a 42.63% higher probability of developing an autoimmune disease. Those with a more severe course of COVID-19 had a higher risk of developing autoimmune disease.

Further results of a sub-project of the research project "Post-acute health consequences of COVID-19" have been published

The Robert Koch Institute (RKI) is a federal institute in the portfolio of the Federal Ministry of Health. The RKI is the central institution of the Federal Government in the field of disease surveillance and prevention and thus also the central institution of the Federal Government in the field of application and action-oriented biomedical research. The core tasks of the RKI include the detection, prevention and control of diseases, especially infectious diseases. It develops scientific findings as a basis for health policy making, advises the responsible federal ministries, notably the Federal Ministry of Health (BMG), and informs the expert public and, to a greater extent, the population at large.

Robert Koch Institute (RKI)

The University Hospital Carl Gustav Carus Dresden is a maximum care hospital and part of the Technical University of Dresden. Until the end of 1993, the hospital formed the Dresden Medical Academy together with the Medical Faculty of the TU Dresden. The history of the faculty can be traced back to 1748, when the "Collegium medico chirurgicum" was founded in Dresden.
Today, Dresden University Hospital unites 26 clinics and polyclinics, six institutes and 17 interdisciplinary centres. Through cooperation with, for example, the Centre for Regenerative Therapies (CRTD), the Biotechnology Centre or the Max Planck Institute, medical research at the Dresden location also plays an important role on an international level.

University Hospital Carl Gustav Carus Dresden

A National Clinical Study Group (NKSG) is being established at Charité – Universitätsmedizin Berlin to conduct the first clinical trials with drugs for the treatment of Long COVID and Chronic Fatigue Syndrome (ME/CFS). The project is funded by the Federal Ministry of Education and Research (BMBF) with about ten million euros.

Charité launches clinical trial on Long COVID and Chronic Fatigue Syndrome ME/CFS

The National Clinical Study Group (NKSG) is an interdisciplinary network of physicians and scientists with the aim of developing translational research and therapy studies for the treatment of Chronic Fatigue Syndrome (ME/CFS) and Long COVID. The studies will be conducted at the Experimental and Clinical Research Center (ECRC), a joint facility of Charité and the Max Delbrück Center, and at the Department of Neurology with Experimental Neurology at Charité.

National Clinical Study Group (NKSG)

Photo: Charité building from the outside

The research project <a href="/en/timeline/rki-research-project-post-acute-health-consequences-of-covid-19-gets-underway" target="_blank" rel="noopener noreferrer">"Post-acute health consequences of COVID-19" led by the Robert Koch Institute (RKI), which started in December 2021,</a> has now published its first results.
The project "Post-COVID-19 Monitoring in Routine Health Insurance Data" (POINTED) is coordinated by the Centre for Evidence-based Health Care (ZEGV) at the University Hospital Dresden and the RKI and is part of the research initiative "Post-acute health consequences of COVID-19".&nbsp;
In one sub-project, the researchers analysed data from the statutory health insurance funds (SHI) from January 2019 to December 2020. The researchers identified a total of 157,134 people with a PCR-confirmed COVID-19 diagnosis (including 11,950 children/adolescents and 145,184 adults) and compared them to a control group of people of the same age and gender and with similar pre-existing conditions without COVID-19. They recorded medical conditions documented by a doctor at least three months after the date of COVID-19 diagnosis. These results show that people of all ages are at risk for Long COVID and that the range of health problems varies between age groups.
&nbsp;A limitation of the study is that it is unclear whether the group that developed Long COVID differed from the control group in unobserved characteristics. Thus, it cannot be ruled out that these unobserved characteristics have an influence on the risk of developing Long COVID symptoms.

Sub-project of the research project "Post-acute health consequences of COVID-19" publishes results

Illustration: Hand of a person wearing a gown and protective glove while working with ampoules

In a study by Prof. Dr. Winfried Kern and his research group from the University Medical Centre Freiburg, a total of 12,053 adults were closely monitored for six to twelve months after suffering from a predominantly mild COVID-19 disease. The study, conducted in cooperation with several universities in southern Germany, shows that even twelve months after the acute phase of COVID-19 disease, a considerable burden of a number of different symptoms can still be present. For most symptoms, women showed a higher level of impairment than men. Despite methodological limitations (e.g. low participation rate, lack of control group), this study shows a considerable burden of post-acute symptom complexes: Fatigue and impairment of cognitive functions were observed most frequently, even in young and middle-aged adults.

Study on the long-term effects of COVID-19 published

The journal "The BMJ" is a medical scientific journal published by the BMJ Group (owned by the British Medical Association) in London. The magazine has been in existence since 1840 and is published weekly in English with a circulation of over 100,000 copies. The focus of the publications of "The BMJ" are articles and classifications from the field of evidence-based medicine. The journal is subject to strict peer review and is one of the most recognised and renowned journals in the scientific community.

&nbsp;The University Medical Centre Freiburg is the fourth largest hospital in Germany in terms of the number of physicians employed. The hospital was certified for the first time in 2005 and recertified in 2008 as one of the first university hospitals in Germany. Research foci at the University Hospital are immunology and infectiology, molecular cell research and regenerative medicine, epigenetics and functional genetics, neuroscience, oncology and functional imaging. The University Hospital is one of the most important locations for medical research in Germany. This is demonstrated, among other things, by the fact that in 2007, together with three other cancer clinics, it was awarded the title of Top Oncological Centre by the German Cancer Aid and has received continuous funding ever since.

University Medical Centre Freiburg

An evaluation by the Central Institute for Health Insurance Physicians (Zi) shows that some pre-existing conditions can increase the risk of Long COVID. However, people without pre-existing conditions can also develop Long COVID, although this is statistically less likely.

Connection between pre-existing conditions and Long COVID? Let us discuss the first conjectures

Bayerischer Rundfunk (BR) is the state broadcasting corporation in the Free State of Bavaria with its headquarters in Munich. It is a member of the ARD (Working Group of the Public Service Broadcasters of the Federal Republic of Germany) and has the legal form of an institution under public law.

The comparative study by the Central Institute for Statutory Health Insurance in Germany (Zi) was carried out on the basis of cross-insurance and nationwide statutory health insurance (SHI) billing data.
The Zi is a research institute in the legal form of a foundation under civil law. The sponsors of the foundation are the Associations of Statutory Health Insurance Physicians and the Federal Association of Statutory Health Insurance Physicians. As a central institution in the system of the Associations of Statutory Health Insurance Physicians, the Zi conducts research at the interface between science and practice on crucial questions of the outpatient care situation.

Central Institute for Statutory Health Insurance in Germany (Zi) 

Experts from the German Disabled Sports Association (DBS) explain which rehabilitation sport offers could help alleviate Long COVID symptoms. However, special caution is advised in the case of fatigue and exercise intolerance: Here, even the slightest exertion can lead to problems and aggravate complaints.

BMG Long COVID Initiative