Data & evidence

Burden of disease

COVID-19 still causes severe outcomes, long-term harm and a burden that routine data under-count.

In brief: does COVID-19 still impose a significant burden?

Yes. COVID-19 continues to cause hospital deaths and longer-term harm, while declining testing and uneven surveillance mean that routine figures can understate its true burden in Europe.

COVID-19 remains associated with severe outcomes

COVID-19 continues to be associated with substantial mortality among patients requiring hospital care. During the 2023–2024 winter, hospitalised COVID-19 patients had a 5.7% thirty-day mortality (Xie et al., JAMA 2024).

That is higher than seasonal influenza over the same period — 4.2% for influenza versus 5.7% for COVID-19, a 35% higher risk of death. Infected individuals also showed elevated six-month mortality compared with influenza and RSV (Bajema et al., JAMA Intern Med 2025).

The impact extends well beyond the acute infection

COVID-19 is linked to significant longer-term health consequences, particularly cardiovascular disease — including heart disease, stroke, heart failure and blood clots, even among people not hospitalised initially (Xie et al., Nat Med 2022).

The estimated excess burden was around 45 additional cardiovascular events per 1,000 people in the year after COVID-19 compared with uninfected individuals, with higher risks among those with severe initial illness.

The threat is often underrepresented by inadequate data collection

COVID-19 continues to circulate widely across Europe, with repeated transmission waves across the EU/EEA.

Reported case numbers substantially underestimate the true burden of infection: as testing has declined, many infections go undetected, and hospitalisations and deaths appear significantly under-reported. UK data show a higher burden than EU/EEA figures, suggesting reporting inconsistencies rather than real epidemiological differences.

Sources

  1. Xie Y, et al. Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall–Winter 2023–2024. JAMA. 2024;331(22):1963–1965.
  2. Bajema KL, et al. Severity and Long-Term Mortality of COVID-19, Influenza, and Respiratory Syncytial Virus. JAMA Internal Medicine. 2025. DOI:10.1001/jamainternmed.2024.7452.
  3. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nature Medicine. 2022;28:583–590.

Some data refer specifically to England.

Figures and citations migrated verbatim from the CTI evidence pages; interactive charts can be added at implementation.

Editorial responsibility: COVID Transition Initiative group members. Named scientific reviewer and review date: content required from Fourtold before publication.

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