The worldwide spread of SARS-CoV-2 profoundly affected almost all aspects of public life and challenged international and national health institutions of all different medical care levels including Europe up from the very beginning in 2020 until today. Public and press perception might have been weighed somehow towards third level health care providers offering treatment options like ECMO therapy for Covid-19 patients with the worst disease course, the majority of patients who needed hospital care were treated in hospitals of the first level. These hospitals provided about 50% of intensive care treatments in the federal state of Rhineland Palatinate (RLP) in Germany, too [1]. According to the Destatis [2] about 71000 additional deaths were registered in Germany during the first 12 months (02/2020 – 02/2021) of pandemic of which about 50000 could be attributed to Covid-19 as given in the medical death reports. However, only few data has been published on the concrete disease course and patient´s outcome on the scale of a single treatment site. Thus, this analysis provides routine data on patient´s characteristics, treatment modalities and outcome in a single first level hospital in RLP during the first three Covid-19 surges during 03/2020 – 07/2021.