In a recent study published in the journal PLOS One, researchers have conducted an extensive analysis of data collected from nearly 500,000 Americans to assess the nationwide prevalence and implications of long-COVID. Their findings underscore the significant variations in long-term COVID’s grip on different states, with Hawaii reporting the lowest prevalence at 11% and West Virginia the highest at 18%. Moreover, long-COVID’s impact is influenced by ethnicity, as White Americans are found to be more susceptible to this condition compared to Black and Asian populations. Notably, the study reveals that individuals with long-COVID experience adverse mental health outcomes, in contrast to those with short COVID who, surprisingly, report improved well-being compared to those without COVID. Additionally, long-COVID survivors face physical challenges, particularly related to mobility. The study also highlights the positive effects of vaccination on both long- and short-COVID cohorts.
A Brief Overview of Long-COVID
Since the emergence of the coronavirus disease 2019 (COVID-19) in December 2019, the pandemic has afflicted over 771 million people worldwide and claimed nearly 7 million lives, making it one of the most devastating pandemics in human history. Unfortunately, a substantial portion of the 760 million survivors continues to grapple with persistent COVID-19-like symptoms long after their initial infection, colloquially referred to as ‘long-COVID.’
Global estimates indicate over 65 million confirmed long-COVID cases, but due to its novelty and limited public awareness, this number is likely an underestimation. Research suggests that approximately 43% of COVID-19 patients experience one or more long-COVID symptoms. Although the disease lacks a universally agreed-upon clinical definition, the World Health Organization (WHO) defines it as the persistence or development of symptoms for at least three months following the initial COVID-19 diagnosis, lasting two months or more.
Long-COVID poses a significant threat to quality of life and results in economic losses, as studies in the United Kingdom and Europe reveal that its symptoms may endure for two years or longer. Individuals with long-COVID are substantially less likely to engage in gainful employment, affecting job markets in the UK and Europe.
While long-COVID remains a relatively new and poorly understood phenomenon, a growing body of research has identified more than 200 symptoms associated with the condition. Worryingly, a majority of long-COVID patients report experiencing “dozens of symptoms across multiple organ systems,” and the incidence and prevalence of physical and cognitive impairments are still not well-defined.
About the Study
In this study, researchers first conducted a comprehensive review of existing literature on long-COVID, with a particular focus on reported physical and cognitive impairments associated with the condition. Subsequently, they leveraged a substantial dataset from the United States government, collected through the UN Census Bureau’s Household Pulse Survey (HPS), to explore the prevalence of long-COVID nationwide.
The data encompassed responses from HPS sweeps #46 to #53, spanning from June 2022 to January 2023, and involved a sample size of 461,550 participants. Statistical analyses primarily utilized descriptive methods, including individual weighting against non-response bias using the person weight variable (PWEIGHT). Regression analysis of unweighted data was employed to assess correlations between long-COVID at any time, long-COVID persistence during the survey period, and long-COVID with substantial symptoms, all coded as binary variables (0,1). Ordinary Least Squares (OLS) were used to derive a composite metric for assessing the adverse impacts of COVID-19 on the American population.
Key Findings
The study’s analysis revealed that 46.7% of all respondents had experienced a COVID-19 infection, with 14.4% reporting long-COVID symptoms lasting over three months. Among the 66,349 individuals reporting long-COVID, 29,839 still experienced symptoms at the time of data collection. Additionally, 13.3% of all COVID-19 survivors reported severe long-COVID symptoms. Notably, the prevalence of long-COVID was significantly higher among individuals with long-COVID (31%) compared to those with short COVID (7%).
Troublingly, 6.9% of participants experiencing long-COVID reported significant limitations in their daily activities. The prevalence of long-COVID varied across the United States, influenced by factors such as location, age, gender, ethnicity/race, and education level. Hawaii recorded the lowest incidence at 11%, while West Virginia reported the highest at 18%. The midlife age group (47-63) faced a higher risk of long-COVID compared to other age groups, and women were notably more susceptible to long-COVID than men. White Americans reported substantially higher long-COVID prevalence compared to Black and Asian Americans.
The study highlighted that education and vaccination status played a significant role in reducing the likelihood of contracting long-COVID, in alignment with previous research. Linear regression analyses underscored the detrimental effects of COVID-19 on the physical and mental well-being of long-COVID respondents. Physical consequences included impaired mobility and difficulties in activities such as bathing and dressing, while mental impacts encompassed memory loss, reduced cognitive capacity, and mental health challenges, including anxiety and depression. Surprisingly, individuals who survived short COVID reported improved well-being, surpassing those who had never contracted COVID-19.
Concluding Remarks
The study offers an in-depth examination of the prevalence and impacts of long-COVID among a diverse cross-section of the American population. Analyzing data from nearly half a million individuals, the study revealed that approximately 14% of Americans experience enduring effects of the condition. Prevalence varies by location, gender, age, education level, ethnicity/race, and vaccination status, with vaccination showing a positive influence in reducing the risk of long-COVID. These findings shed light on the complex and multifaceted nature of long-COVID, underscoring its far-reaching implications for public health and well-being.
