Long COVID

Last update: Tuesday 3/21/23

This reference page Provides links to long COVID research reports, plus links to authoritative discussions of its likely victims, prevention, and treatments. 

... Under continuing reconstruction ... 

Note: Alerts about updates to this reference page are posted on this blog's @neoskeptics Twitter account from time to time. Updates are highlighted (yellow) or printed in bold (red)

A.  Essentials | B. Symptoms | C. Research

A. Essentials 

• What is long COVID?
  Long Covid is strange. There are no tests for long COVID because long COVID is "defined" as whatever unhealthy symptoms an infected person displays after the infection should have left the person's body, symptoms that were not present before the person became infected. The CDC's list of about 20 symptoms that have been identified as long COVID can be found in the next section of this note
  
  
• How long after infection are the persistent new symptoms regarded as long COVID?
  The CDC says at least 4 weeks, but the World Health Organization (WHO) says three months
  
  
• How long does long COVID last?
  Weeks, months, more than a year. Indeed, some patients have endured symptoms for more than two years.
  
  -- "Many long-COVID patients report symptoms 2 years later", Mary Van Beusekom , CIDRAP, 5/12/22
  
  
• Does long COVID always produce symptoms that doctors don't immediately understand?
  No, some of the new symptoms are clear indicators of well known health conditions, e.g., diabetes and heart disease.
  
  -- "Diabetes risk rises after COVID, massive study finds", Clare Watson, Nature, 3/31/22
  -- "Heart-disease risk soars after COVID — even with a mild case", Saima May Sidik, Nature, 2/10/22
  
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• Are older people more likely to experience long COVID than younger people?
  Yes, as with all things COVID
  
  -- "Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021", Lara Bull-Otterson, Sarah Baca1,Sharon Saydah,  et al., CDC, 5/24/22 
  

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B. Symptoms 

• Centers for Disease Control (CDC) ... more details ... 5/20/22
  "Most people with COVID-19 get better within a few days to a few weeks after infection, so at least four weeks after infection is the start of when post-COVID conditions could first be identified." These conditions involve a wide array of symptoms
  
  Fatigue ==> "Tiredness or fatigue that interferes with daily life ... Symptoms that get worse after physical or mental effort (also known as 'post-exertional malaise') ... Fever"
  
  Respiratory and heart symptoms ==> "Difficulty breathing or shortness of breath ... Cough ... Chest pain ... Fast-beating or pounding heart (also known as heart palpitations)"
  
  Neurological symptoms ==> "Difficulty thinking or concentrating (sometimes referred to as 'brain fog') ... Headache ... Sleep problems ... Dizziness when you stand up (lightheadedness) ... Pins-and-needles feelings ... Change in smell or taste ... Depression or anxiety"
  
  Digestive symptoms ==> "Diarrhea ... Stomach pain"
  
  Other symptoms ==> "Joint or muscle pain ... Rash ... Changes in menstrual cycles"
  
   
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• World Health Organization (WHO) ... more details
  "Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months, that cannot be explained by an alternative diagnosis."
  
  
• National Institutes of Health (NIH/NIAID)  ... more details
  "Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) refers to the prolonged symptoms or new or returning symptoms that people may develop after recovery from initial SARS-CoV-2 infection. Large numbers of people have reported symptoms such as fatigue, shortness of breath, 'brain fog,' sleep disorders, gastrointestinal issues, chronic cough, anxiety, and depression, which can persist for months and range from mild to incapacitating."
  
  
• HHS Long COVID page

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C. Research

• "Long-term cardiovascular outcomes of COVID-19", Yan Xie, Evan Xu, Benjamin Bowe & Ziyad Al-Aly , Nature Medicine, 2/7/22  
  -- "Heart-disease risk soars after COVID — even with a mild case", Saima May Sidik, Nature, 2/10/22 
  
  
• "Risks and burdens of incident diabetes in long COVID: a cohort study", Yan Xie and Ziyad Al-Aly, The Lancet, 3/22/22  
  -- "Diabetes risk rises after COVID, massive study finds", Clare Watson, Nature, 3/31/22 
  
  
• "High-dimensional characterization of post-acute sequelae of COVID-19", Ziyad Al-Aly, Yan Xie & Benjamin Bowe, Nature, 4/22/21 ... Note: Authors say that "We show that beyond the first 30 days of illness, people with COVID-19 exhibit a higher risk of death and use of health resources."
  
  
• "Many long-COVID patients report symptoms 2 years later", Mary Van Beusekom, CIDRAP, 5/12/22
• "Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study", Charlotte Bermingham, Koen B Pouwels, et al., BMJ, 5/18/22
  
  
• "Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021", Lara Bull-Otterson, Sarah Baca1, Sharon Saydah,  et al., CDC, 5/24/22  
  -- "More than 1 in 5 adult Covid survivors in the U.S. may develop long Covid, a C.D.C. study suggests.", Pam Belluck, NY Times, 5/24/22 
  
  
• "Long COVID after breakthrough SARS-CoV-2 infection", Ziyad Al-Aly, Benjamin Bowe & Yan Xie, Nature Medicine, 5/25/22  
  -- "Long COVID risk falls only slightly after vaccination, huge study shows", Sara Reardon, Nature, 5/25/22 
  
  
• "How common is long COVID? Why studies give different answers", Heidi Ledford, Nature, 6/22/22
• "Long COVID, Household Pulse Survey", CDC, 6/23/22
• "Possible cause of long COVID 'brain fog'", Tania Ewing , La Trobe University, 6/29/22
  
  
• CDC, "Why Some Stay Sick -- Unraveling Long COVID Alongside Other Post-viral Illnesses", CDC, 6/30/22
  
• "Long-COVID treatments: why the world is still waiting", Heidi Ledford, Nature, 8/9/22
• "Risk of ‘brain fog’ and other conditions persists up to two years after Covid infection",  Elizabeth Cooney, STAT, 8/17/22 
  
  
• "Reduced Incidence of Long Coronavirus Disease Referrals to the Cambridge University Teaching Hospital Long Coronavirus Disease Clinic ", Benjamin A Krishna, Marina Metaxaki, Mark R Wills, Nyaradzai Sithole, Clinical Infectious Diseases, 8/1/22  
  -- "Referrals to long COVID clinic fell by 79% following roll-out of the vaccine", University of Cambridge, Craig Brierley, 10/6/22
  
  
• "Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021", Global Burden of Disease Long COVID Collaborators, JAMA, 10/10/22  ***
  -- "Long Covid Disables Millions Worldwide, Even as Rates Ease, Study Shows", Jason Gale, Bloomberg via MSN, 10/10/22 
  
  
• "Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study", Claire E. Hastie and associates, Nature, 10/12/22  ***
  -- "Large study provides powerful evidence of long covid’s lasting impact", Frances Stead Sellers, Washington Post, 10/12/22
  -- "Nearly Half of Covid Patients Haven’t Fully Recovered Months Later, Study Finds", Benjamin Mueller, NY Times, 10/12/22
  
  
• "What 2 new studies reveal about long COVID in Canada", Mike Crawley, CBC, 10/17/22
  
  
• "Long COVID", CDC National Center for Health Statistics and U.S. Census Bureau, 10/26/22
  -- "Long Covid is affecting women more than men, national survey finds", Spencer Kimball, CNBC, 10/31/22
  
  
• "Prevalence and Correlates of Long COVID Symptoms Among US Adults", Roy H. Perlis, MD, MSc1,2; Mauricio Santillana, PhD3; Katherine Ognyanova, PhD4; et al,  JAMA Network Open, 10/27/22
  -- "Long Covid is affecting women more than men, national survey finds", Spencer Kimball, CNBC, 10/31/22
  
  
• Executive summary of "Prevalence of post COVID-19 condition symptoms: a systematic review and meta-analysis of cohort study data, stratified by recruitment setting", European Centre for Disease Prevention and Control (ECDC), 10/31/22 ... PDF of full report found ==> HERE *** 
  -- "More severe COVID-19 may raise risk of long COVID", Stephanie Soucheray, CIDRAP, 10/31/22 
  
  
• "Nirmatrelvir and the Risk of Post-Acute Sequelae of COVID-19", Yan Xie, Taeyoung Choi, and Ziyad Al-Aly, medRxiv, 11/5/22
  -- "Paxlovid May Reduce Risk of Long Covid in Eligible Patients, Study Finds", Pam Belluck, NY Times, 11/7/22
  
  
• "Acute and postacute sequelae associated with SARS-CoV-2 reinfection", Benjamin Bowe, Yan Xie & Ziyad Al-Aly, Nature Medicine, 11/10/22
  -- "Repeat COVID-19 infections riskier than first bout with virus, study finds", Nancy Lapid, CTV News, 11/11/22 ...This news article contains an incisive comment that should apply to all of the massive Veterans Administration data studies produced by this prolific team ==> "Experts not involved with the study said the VA population does not reflect the general population. Patients at VA health facilities are generally older, sicker people and often men, a group that would typically have more than normal health complications, said John Moore, a professor of microbiology and immunology at Weill Cornell Medical College in New York."
  
  
• "Cardiovascular disease and mortality sequelae of COVID- 19 in the UK Biobank", Zahra Raisi- Estabragh et al., BMJ,  8/8/22
  -- "People who caught mild Covid had increased risk of blood clots, British study finds", Spencer Kimball, CNBC, 10/25/22
  
  
• "Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study", Barak Mizrahi et al., BMJ, 1/11/23
  -- "For most mild infections, long Covid symptoms clear after a year, large study finds", Elizabeth Cooney, STAT, 1/12/23
  
  
• "Long COVID: major findings, mechanisms and recommendations", Hannah E. Davis, Lisa McCorkell, Julia Moore Vogel & Eric J. Topol, Nature Reviews Microbiology,  1/13/23
  -- "‘We’re all vulnerable’: One in 10 people will end up with long COVID, new study says", Ashleigh McMillan, Sydney Morning Herald, 1/16/23
  
  
• "Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021", Global Burden of Disease Long COVID Collaborators, Nature, 10/10/22
  --  "Long COVID stemmed from mild cases of COVID-19 in most people, according to a new multicountry study", Sarah Wulf Hanson and Theo Vos, The Conversation, 1/5/23
  
  
• "Long COVID: What Do the Latest Data Show?", Alice Burns6, KFF, 1/26/23
  
  
• "Persistent COVID-19 Symptoms at 6 Months After Onset and the Role of Vaccination Before or After SARS-CoV-2 Infection", Stephanie A. Richard, Simon D. Pollett, Anthony C. Fries, et al, JAMA Network Open, 1/18/23
  -- "Lack of vaccination, severe illness tied to higher risk of long COVID", Mary Van Beusekom, CIDRAP, 1/19/23
  
  
• "The Epidemiology of Long COVID in US Adults", McKaylee M Robertson et al, Clinical Infectious Diseases, 12/21/22
  -- "Estimate says 19 million US adults have long COVID", Mary Van Beusekom, CIDRAP, 12/21/22
  
  
• "Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 2 February 2023", Office of National Statistics, 2/5/23
  
• "Vaccination status and long COVID symptoms in patients discharged from hospital", Teresa Cristina D. C. Nascimento, et al., Nature, 2/11/23
  
  
• "Association of COVID-19 Vaccination With Risk for Incident Diabetes After COVID-19 Infection", Alan C. Kwan, MD, MSc1; Joseph E. Ebinger, MD1; Patrick Botting, MSPH1; et al, JAMA Network Open, 2/14/23
  -- "Verified: COVID-19 Infection Increases Diabetes Risk", Cara Martinez, Cedars Sinai, 2/14/23
  -- "New study suggest people previously infected with COVID-19 could have increased risk for diabetes", Staff, CBS Los Angeles, 2/14/23
  
  
• "Multi-organ impairment and long COVID: a 1-year prospective, longitudinal cohort study", Andrea Dennis, Daniel J Cuthbertson, […], and Amitava Banerjee , Journal of the Royal Society of medicine, 2/14/23
  -- "Organ damage for 59% of patients with long COVID continues a year after initial symptoms", Royal Society of Medicine, 2/15/23
  
  
• "Racial/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program",  Dhruv Khullar MD, MPP et al., Journal of General Internal Medicine, 2/16/23
• "Effect of covid-19 vaccination on long covid: systematic review", Oyungerel Byambasuren1, XPaulina Stehlik1, Clark1, Kylie Alcorn2 and XPaul Glasziou1, BMJ, 2/28/23
  
  
• "Neurocognitive and psychiatric symptoms following infection with COVID-19: Evidence from laboratory and population studies", Peter A. Hall et al., Brain, Behavior, & Immunity - Health, 3/1/23
  -- "Long COVID linked to lower brain oxygen levels, cognitive problems and psychiatric symptoms", Waterloo News, 3/1/23
  
  
• "One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database", Andrea DeVries, Sonali Shambhu, Sue Sloop, et al, JAMA Health Forum, 3/3/23
  -- "Long Covid is associated with significantly increased risk of death, heart and lung problems, study finds", Janelle Chavez, CNN, 3/3/23
  
  
• "Outpatient Treatment of COVID-19 and the Development of Long COVID Over 10 Months: A Multi-Center, Quadruple-Blind, Parallel Group Randomized Phase 3 Trial", Carolyn Bramante and John B. Buse, The Lancet, 3/6/23
  
  
• "Long-term gastrointestinal outcomes of COVID-19, Evan Xu, Yan Xie & Ziyad Al-Aly ,Nature Communications, 3/7/23
  -- "Long Covid Patients More Likely to Have Gastrointestinal Problems, Study Finds", Long Covid Patients More Likely to Have Gastrointestinal Problems, Study Finds", Pam Belluck, NY Times, 3/7/23
  
  
• "Long-covid symptoms are less common now than earlier in the pandemic", 
  Amy Goldstein

   and 
  Dan Keating
  , Washington Post, 3/20/23
  
  
• "Association of Treatment With Nirmatrelvir and the Risk of Post–COVID-19 Condition", Yan Xie, Taeyoung Choi, Ziyad Al-Aly, JAMA Network, 3/23/23
  -- "Vaccination, Paxlovid decrease risk of long Covid, studies show", Janelle Chavez, CNN, 3/23/23
  
  
• "Risk Factors Associated With Post−COVID-19 Condition", Vasiliki Tsampasian, Hussein Elghazaly,Rahul Chattopadhyay, et al, JAMA Network, 3/23/23
  -- "Who Is Most at Risk for Long Covid?", Pam Belluck, NY Times, 3/23/23
  
  

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Links to related notes on this blog:  

• "Long COVID Chart" -- Last Update: 2/16/23