Study: Long COVID remains serious and persistent; more than 200 symptoms identified

According to the 265-page report from the National Academies of Sciences, Engineering and Medicine, long COVID, or continuing symptoms from a COVID-19 infection, affects millions of Americans.

A new report from a group that advises federal agencies on science and medicine shows that COVID is a legitimate medical issue that remains serious and persistent, The New York Times reported.

According to the 265-page report from the National Academies of Sciences, Engineering and Medicine, long COVID, or continuing symptoms from a COVID-19 infection, affects millions of Americans.

“Long Covid can impact people across the life span, from children to older adults, as well as across sex, gender, racial, ethnic and other demographic groups,” the group said in the study, adding that “long Covid is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system.”

While there is no standard way to diagnose long COVID, the report cites data from 2022 that suggests that nearly 18 million adults and nearly a million children in the United States have had long COVID at some point since the pandemic was declared in March 2020.

The effects are so varied that there isn’t one treatment for the condition, the report said.

“There is no one-size-fits-all approach to rehabilitation, and each individual will need a program tailored to their complex needs,” the study said.

Long COVID appears to be a chronic illness, the report noted. Few patients “will achieve full remission,” the report said.

Some symptoms are like those of other conditions that people experience after they have had serious infections.

What causes the symptoms is unclear, though some believe inflammation, fragments of remaining virus or immune system dysregulation is the source, the Times reported.

Children are less likely than adults to develop long COVID, and women are about twice as likely to develop it as men.

Other risk factors in developing long COVID, the study said, include not being adequately vaccinated against the coronavirus, smoking and having preexisting medical conditions or disabilities.

The more seriously ill a person was with a COVID-19 infection, the more likely they are to have long COVID, the study showed, though “even individuals with a mild initial course of illness can develop long COVID with severe health effects.”

Last year, the National Institutes of Health began a handful of studies to test possible treatments for long COVID, The Associated Press reported.

“This is a year or two late and smaller in scope than one would hope but nevertheless it’s a step in the right direction,” said Dr. Ziyad Al-Aly of Washington University in St. Louis, who isn’t involved with NIH’s project but whose own research highlighted long COVID’s toll. Getting answers is critical, he added, because “there’s a lot of people out there exploiting patients’ vulnerability” with unproven therapies.


According to the Centers for Disease Control and Prevention, people who experience Long COVID most commonly report (not a complete list):

General symptoms

  • 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.

Symptoms that are hard to explain and manage

Some people with long COVID have symptoms that are not explained by tests or easy to manage.

“People with Long COVID may develop or continue to have symptoms that are hard to explain and manage,” the CDC wrote. “Clinical evaluations and results of routine blood tests, chest X-rays, and electrocardiograms may be normal.

“People with these unexplained symptoms may be misunderstood by their healthcare providers, which can result in a delay in diagnosis and receiving the appropriate care or treatment.”

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