Work participation after medical rehabilitation due to post-COVID: analyses using routine data of the German Pension Insurance

Background: Post-COVID syndrome (PCS) describes a complex condition characterized by persistent and fluctuating physical, cognitive, and psychological symptoms that continue for months after an acute SARS-CoV-2 infection. Heterogeneous symptoms, including fatigue, shortness of breath, and cognitive impairments, affect not only health and functional capacity but also often lead to substantial limitations in work participation. Medical rehabilitation services can help reduce health-related and functional impairments. Despite increasing evidence regarding return to work among individuals with PCS, representative and comprehensive analyses of longer-term work participation following medical rehabilitation are still lacking. BECO therefore aims to examine work participation for up to two years following completion of post-COVID rehabilitation using routine data from the German Pension Insurance (GPI).

Methods: The analyses include working-age individuals who completed medical rehabilitation provided by the GPI between 2021 and 2024 and who had a documented PCS diagnosis (ICD-10: U08.9, U09.9, or U10.9). Data from the Rehabilitation Statistics Database (RSD) of the GPI are used for the analyses. The primary outcome is the proportion of rehabilitation participants in stable employment at 12 and 24 months after completion of rehabilitation, defined as employment subject to social security contributions for at least four months. The secondary outcome is the receipt of a disability pension within the follow-up period of up to two years. The results are intended to contribute to the identification of risk groups and prognostic factors based on administrative data and to provide insights for more targeted healthcare and support services for individuals with PCS.