Long COVID affects more than one in 10 patients following a SARS-CoV-2 infection, according to a new study exploring the trajectory of the condition and how its symptoms present over time.
The report findings will help physicians understand and explain variances in intensity and duration of long COVID symptoms and “better manage patients who are experiencing these symptoms,” said Jimmy Widmer, MD, an internist familiar with caring for long COVID patients and the young physician representative on the Texas Medical Association Board of Trustees.
The research followed U.S. patients participating in the National Institutes of Health-funded Researching COVID to Enhance Recovery (RECOVER) initiative. Those patients first contracted SARS-CoV-2 during the omicron variant era (after Dec. 1, 2021). Six Texas entities – medical schools and teaching hospitals – are among the RECOVER consortium members listed in the study as contributing to the overall initiative.
According to Mass General Brigham researchers, 10.3% of the 3,659 patients studied had long COVID symptoms three months after a SARS-CoV-2 infection, with 81% of those patients continuing to experience persistent or intermittent symptoms a year later.
“That seems to be consistent with a lot of the other high-quality epidemiologic data we have,” said W. Michael Brode, MD, assistant professor in the Department of Internal Medicine at The University of Texas at Austin Dell Medical School and medical director of UT Health Austin’s Post-COVID-19 Program. “This is not at all a rare or niche disease, and it’s not just people who got sick early in the pandemic or were hospitalized.”
Dr. Brode notes that the study underscores that long COVID affects a sizable percentage of the population that is infected. He additionally cautioned, based on the researchers’ findings, that the risk of contracting long COVID is cumulative with each subsequent infection.
RECOVER participants in the Mass General Brigham study completed a comprehensive symptom questionnaire at three, six, nine, 12, and 15 months post-infection to track changes over time. Those answers were compared against the long COVID research index, previously developed by Mass General Brigham researchers and published in JAMA in 2023.
Long COVID symptoms in the index include:
- Postexertional malaise (debilitating fatigue that is exacerbated by physical or mental activity);
- Loss of or change in smell or taste;
- Gastrointestinal symptoms;
In 2024, the National Academies of Sciences, Engineering, and Medicine developed a long COVID definition: “An infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.”
Similarly, in this latest study, Mass General Brigham researchers identified eight different trajectories for long COVID patients, including:
- Persistently severe symptoms;
- Intermittently severe symptoms;
- Gradually improving symptoms;
- Gradually worsening symptoms; and
- Mild symptoms that only appeared after 15 months.
The findings reinforce that long COVID is “not a static disease process or medical condition,” Dr. Widmer said. “It is quite dynamic, and there’s a great deal of heterogeneity within that spectrum.”
Check out the infectious diseases resources available on the TMA website.
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.