An Update on Long COVID

“…at the time of this writing, over 6.6 million lives internationally have been taken and attributed to COVID-19.”

As 2023 quickly approaches, it is nearing the third anniversary of the start to the COVID-19 pandemic. January 10, 2020, marked the first time the WHO announced the outbreak of a novel coronavirus (2019-nCoV) in Wuhan, China. Little did anyone know the speed with which this virus would spread, and the destruction it would cause as it dominated our human existence over the next few years. According to the WHO dashboard, at the time of this writing, over 6.6 million lives internationally have been taken and attributed to COVID-19. The development of safe, effective vaccines has undoubtedly saved countless more lives, and now that the CDC has approved their use in everyone over 6 months of age, these holidays – for many families – may be the first with semblance of normalcy.

“…we still do not know the consequences of having the virus and symptoms may persist months after the acute infection…”

While vaccination decreases the severity of symptoms experienced by COVID-19, it is important to acknowledge that it does not stop one from catching the virus. Masking remains the best way to prevent transmission. The reality remains that we still do not know the consequences of having the virus and symptoms may persist months after the acute infection, resulting in Long COVID. A previous blog post described the theory that an excessive immune response primed by the virus plays a role in the perpetuation of symptoms, most commonly fatigue, shortness of breath, anxiety, depression, and impaired attention, concentration, memory, and sleep. Since the release of that post, a new study published in the Journal of the American Medical Association (JAMA) provides updated estimates on the global proportions of individuals suffering from Long COVID.

“Approximately 15.1% of patients with Long COVID continued to experience symptoms at 12 months.”

Through their pooled analysis of 54 studies and 2 medical record databases, researchers identified as the Global Burden of Disease Long Covid Collaborators, examined data from 1.2 million individuals with symptomatic COVID-19, across 22 countries, collected between March 2020 and January 2022. The main outcome of interest was the proportion of individuals with persistence of greater than three months of at least 1 of 3 symptoms: fatigue with bodily pain or mood swings, cognitive problems, or respiratory illness. Estimates were separated for hospitalized versus non-hospitalized individuals aged 20 or older, younger than age 20, and by sex. Of the 1.2 million individuals, 3.2% experienced persistent fatigue, 3.7% had ongoing respiratory problems, and 2.2% had cognitive problems. Interestingly, this study adjusted for health status prior to COVID-19 infection. Long COVID symptoms were more common in women greater than 20 years old than men, and the duration of those symptoms were longer in hospitalized patients (9.0 months) compared to non-hospitalized individuals (4.0 months). Approximately 15.1% of patients with Long COVID continued to experience symptoms at 12 months.

As this study demonstrates, COVID – especially its long-term impact – not only emphasizes the significant impact this infection has on some patients, and that it remains of great interest to the medical and research community. There is still much to be learned about the impact of the virus, and its potential consequences, which have significant implications for our society. This holiday season, we can be simultaneously joyful and grateful that the pandemic is over, but also cognizant that the virus still exists and careful in our interactions, as we celebrate with our friends, families, and loved ones.


MariaLisa Itzoe, DO, MPH is an Internal Medicine resident at Pennsylvania Hospital of the University of Pennsylvania, with a passion for helping patients who experience disorders of brain-gut interaction. She has a special interest in neuro-gastroenterology and health communication. MariaLisa is also a certified yoga instructor who loves cooking and sharing nutritious meals with family and friends.