Healthcare utilization patterns and medication burden in post-COVID syndrome: a cross-sectional analysis reveals four phenotypes.

Post-COVID syndrome has emerged as a major public health challenge, yet comprehensive characterization of healthcare utilization patterns and medication burden within single cohorts remains limited. This cross-sectional analysis examined baseline data from 76 patients (49 ± 12 years, 62% female) enrolled in a randomized trial of psychosomatic treatment interventions for functional post-COVID syndrome. Participants completed the Health Care Utilization Questionnaire (HCU) assessing physician visits, hospitalizations, alternative healing methods, and other healthcare services over the preceding 12 months. Medication and other preparation (MOP) use was systematically documented and classified using the Anatomical Therapeutic Chemical (ATC) classification system. K-means clustering identified distinct patient phenotypes, and correlations between MOP count and healthcare utilization were examined using Spearman correlation coefficients. Healthcare utilization was universal, with 100% of participants engaging with healthcare services and a mean of 43.5 contacts per year. Medication burden was substantial, with 85.5% taking at least one medication, a mean of 4.57 medications per patient, and polypharmacy (≥5 MOP, all types) present in 39.5% of the cohort (46.1% of patients with any MOP). K-means clustering identified four distinct patient phenotypes: Low Utilizers (64.5%, n = 49), Moderate-High Utilizers (27.6%, n = 21), High-Intensity Users (6.6%), and one outlier. High-Intensity Users demonstrated the most striking profile with 9.60 mean medications, 75.0 total healthcare contacts annually, and mean out-of-pocket costs of €2,881. MOP count showed significant positive correlations with total doctor visits (ρ = 0.471, p < 0.001), total healthcare contacts (ρ = 0.344, p = 0.002), and out-of-pocket costs (ρ = 0.375, p = 0.001). Post-COVID syndrome patients demonstrate high healthcare engagement, substantial medication burden, and meaningful heterogeneity in utilization patterns. The identification of distinct patient clusters and strong correlations between medication burden and healthcare utilization provide insights for developing targeted clinical management strategies. This study is based on a selected clinical cohort, and findings should be interpreted with caution regarding generalizability to the broader post-COVID population. These findings may inform clinical management strategies and health system planning for post-COVID patients.