Long COVID is a global public health crisis. Over 400 million people worldwide have been impacted by Long COVID .
Long COVID is common. As of fall 2024, at least 1 in 19 US adults are currently living with Long COVID
similar to the rate of diabetes – with many additional cases likely going undiagnosed or misdiagnosed.
The vast majority of Long COVID cases happen after a mild acute infection. Studies show between 76%3 to 90%4 of Long COVID cases happen after a mild infection.
Recovery from Long COVID is rare. Only 6-9% of people with Long COVID are recovered at 2-3 years.
Long COVID incidence remains high, even among those fully vaccinated and with more recent variant strains. a. The incidence of people currently living with Long COVID has remained between 5.3-6.1% of the US adult population from December 2022 to September 2024. b. 17% of study participants developed Long COVID after Omicron infection, compared to 23% after pre-Omicron variants.
Each additional COVID infection increases the risk of developing Long COVID, even in those fully vaccinated. Studies on reinfection show: a. People are 1.7x more likely to develop Long COVID after 2 infections, and 2.6x more likely to develop Long COVID after 3 infections. b. Long COVID occurred in 24% of reinfections. c. Reinfections lead to higher incidence and severity of Long COVID. d. Reinfections increase the rates of long-term health problems including heart, lung, and brain issues. e. Reinfections are associated with increased chance of getting Long COVID, and worsened existing Long COVID.
People infected with COVID are more susceptible to other infections. a. Those infected with COVID had higher rates of bacterial, mycoplasma, and influenza infections. b. Children aged 0-5 who had COVID were 1.4x more likely to get RSV that required medical attention. c. Reinfections increased the odds of reporting poor immune health, including having many other infections and taking longer to recover from common infections.
Common new-onset conditions in Long COVID include serious and lifelong disorders. a. This includes vascular events like heart attacks and strokes, as well as permanent conditions like dysautonomia, myalgic encephalomyelitis, and diabetes. b. In non-hospitalized people, COVID increases the risk of 30 neurological disorders for at least a year, including Alzheimer’s, ischemic stroke and TIA, memory problems, peripheral neuropathy, migraine, epilepsy, and hearing and vision abnormalities. c. In non-hospitalized people, COVID increases the risk of 18 cardiovascular conditions for at least a year, including myocarditis, pulmonary embolism, and heart failure.
Long COVID has caused the highest rates of serious, persistent cognitive problems in the US population than any time in the last 15 years. a. The cognitive impairment includes problems with memory, reasoning, executive functioning, language, and processing speed, and younger people may have worse and more marked impairment.
Long COVID patients experience severe functional limitations, poor quality of life, and extreme fatigue at least as detrimental as many serious illnesses, including Parkinson’s disease and certain cancers. a. Long COVID patients’ functional ability scores ranked lower than stroke and were on par with those found in Parkinson’s disease on a scale measuring ability to work, manage the household, engage in leisure, and maintain social relationships. b. Long COVID patients’ quality of life scores ranked lower than those in advanced/metastatic cancers. c. Long COVID patients’ fatigue scores were worse than those in end stage renal failure.
Long COVID substantially impacts patients’ livelihoods and ability to work, with most being unable to work or needing reduced hours. a. At 2 years, only 40% of Long COVID patients could work full-time. b. 52% had reduced work hours and lost an average of 25% of their monthly income. c. People with Long COVID are nearly twice as likely to report housing insecurity. d. People with Long COVID report high rates of food insecurity 29 30 and difficulty paying utility bills.
COVID increases risks during pregnancy and childbirth, and is associated with reproductive health issues like altered menstruation and erectile dysfunction. a. COVID infections are associated with early miscarriages, stillbirths, preterm births and cesarean deliveries , and preeclampsia and maternal mortality. b. Long COVID is associated with many reproductive health disorders including menstrual issues, endometriosis, erectile dysfunction, and others.
Long COVID disproportionately impacts people from already marginalized groups. a. Rates of Long COVID are higher in Hispanic/Latine and Black people, trans people, disabled people, and women.
Children are greatly impacted by Long COVID. a. An estimated 6 million children are estimated to have Long COVID as of early 2024. b. Children have similar rates of Long COVID to adults, as well as similar findings regarding organ system complications, new-onset conditions, and biological mechanisms. c. Many pathological findings in adults, such as impaired function on a CPET, have also been found in children.
Long COVID has a highly destructive impact on the economy. a. The global economic cost of Long COVID is estimated at $1 trillion per year. b. In 2024, 1.5 billion work hours were lost in the US due to Long COVID corresponding to a potential cost of more than US $152.6 billion. c. Long COVID is responsible for massive GDP losses worldwide – including $24.4 billion in Saudi Arabia, $12.3 billion in Taiwan, and $11 billion in Brazil. d. Five years of Long COVID burden is projected to cost $3.7 trillion to the US economy in reduced quality of life, lost earnings, and increased medical spending. e. Long COVID disproportionately impacts certain labor sectors, particularly those with high exposure to COVID infections, like low-wage workers, farm workers, and those in education and the service industry. f. A quarter of US Marines who had COVID developed Long COVID, with long-term decrease in functional performance. g. Lost productivity of caretakers in the UK was estimated at £4.8 billion.
Medical provider education about Long COVID is inadequate. a. Only 7% of physicians are very confident diagnosing Long COVID and only 4% are very confident treating it. b. A majority of Long COVID patients have experienced a negative experience with a healthcare provider.
Lack of public awareness is causing crucial delays in care and support. a. Over ⅓ of people have still not heard of Long COVID despite its wide impact. b. Communities of color are particularly affected.
There is a significant amount of Long COVID research. a. Over 86,000 research papers have demonstrated wide-ranging biological abnormalities in Long COVID. b. Up-to-date review papers include the scope of mechanisms and possible therapeutics , viral persistence and mechanisms to target persisting reservoirs, designing and optimizing clinical trials, and roadmaps for Long COVID research and policy. c. An incredible breadth of biological mechanisms have been found in Long COVID, including reduced cerebral blood flow and disrupted neurovascular function, tissue damage and skeletal muscle necrosis after exercise, changes to the brainstem74 and hippocampus, viral persistence and persisting antigen, induced Long COVID in mice by transferring IgG from Long COVID patients, and innumerable more.
The vast majority of the public and physicians believe Long COVID needs more research funding. 82% of physicians and 76% of the public believe it is important to increase research funding for Long COVID.
