Comparison of new and recurring post-acute infection syndrome – results from a German population-based cohort

Comparison of new and recurring post-acute infection syndrome – results from a German population-based cohort. Download PDF Abstract New respiratory infections after or while experiencing post-acute infectious syndromes (PAIS) can lead to resurgence of symptoms. Data comparing symptoms, related impairment, and duration of first and recurring PAIS episodes are lacking.

This cross-sectional study was conducted in September/October 2025 within a large population-based digital cohort in Germany (DigiHero, registered under DRKS00025600). We included data from 2,801 participants retrospectively reporting a respiratory infection between September 2024 and August 2025 with subsequent long-lasting symptoms ≥ 12 weeks after infection. We compared self-reported first and recurring PAIS episodes.

Of detected PAIS cases, 57% ( n = 1,609) were the first episode and 43% ( n = 1,192) already experienced a PAIS episode in the past. While symptom patterns were broadly similar, those reporting recurring PAIS without full recovery from a previous episode ( n = 308) displayed a higher number and longer duration of long-lasting symptoms and a higher level of impairment due to their symptoms compared to those with first PAIS episodes or recurring cases that were fully recovered at the time of the new infection ( n = 303). Among participants with recurring PAIS who compared their most recent with their first episode, 43% reported similar impairment, while 32% reported greater and 26% lower impairment.

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