Infectious Disease

Survey results indicate nearly 19 million US adults may have long COVID

January 18, 2023

2 min read

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Disclosures:
Nash reports receiving support from Abbvie and Pfizer, as well as grants/contracts with the , New York City Council and New York State AIDS Institute paid to his institution. Please see the study for all other authors’ relevant financial disclosures.

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The results of a population-based survey suggest that nearly 19 million US adults may have long COVID, with some reporting symptoms more than 12 months after their initial infection.

“Most studies of long COVID are in select samples of people, such as people hospitalized with COVID or people who seek health care for COVID symptoms or long COVID symptoms, but there were no studies that tried to get at what the true burden of long COVID is in the general population,” Denis Nash, PhD, MPH, executive director of City University of New York (CUNY) Institute for Implementation Science in Population Health and distinguished professor of epidemiology at the CUNY School of Public Health, told Healio.

IDN0123 Robertson_Graphic_01_WEB

Robertson MM, et al. Clin Infect Dis. 2022;doi:10.1093/cid/ciac961.

“More than 2 years into the pandemic, after most people in the US have had COVID at least once, we wanted to assess how many people had lingering symptoms and to assess risk factors for having long COVID in the general population of US adults,” Nash said.

Nash and colleagues conducted a population-representative survey of a random sample of 3,042 US adults aged 18 years or older between June 30, 2022, and July 2, 2022. The survey used questions developed by the UK’s Office of National Statistics routinely uses the survey to update long COVID estimates in the UK every weeks.

According to the study, the survey began asking respondents if they had COVID-19 June 5, 2022, diagnosed either by a health care or testing provider or an at-home rapid test. If yes, respondents were then asked if they believed they have long COVID, defined as experiencing symptoms such as fatigue, difficulty concentrating shortness of breath more than 4 weeks after diagnosis that are not explained by something else.

This was then followed up with questions regarding impact on day-to-day activities, as well as any possible comorbidities that could increase severity of COVID-19 such as cancer, diabetes, obesity, lung disease, liver disease, heart disease, high blood pressure, a recent organ transplant or an immunodeficiency.

The survey showed an estimated 7.3% (95% CI, 6.1-8.5%) of all respondents reported long COVID, corresponding to approximately 18,828,696 adults.

According to the study, 25.3% of respondents with long COVID reported their day-to-day activities were impacted “a lot” (95% CI, 18.2-32.4%), despite 28.9% having had SARS-CoV-2 infection more than 12 months of the survey.

The researchers found that the prevalence of long COVID was higher among respondents who were female (adjusted prevalence ratio [aPR] = 1.84; 95% CI, 1.4-2.42), those who had comorbidities (aPR = 1.55; 95% CI, 1.19-2) or those who were not boosted (aPR = 1.67; 1.19-2.34) or not vaccinated at all (aPR = 1.41 ; 95% CI, 1.05-1.91).

Nash explained that the study gave an estimate of long COVID burden in the US larger than that of the UK 2 million (2.8%) of the total UK population aged 2 years or older despite similar rates of COVID-19 transmission being reported in both countries .

Denis Nash, PhD, MPH

“It suggests that we could be doing a better job of preventing long COVID,” he said. “Long COVID can be prevented by preventing more infections. But it is also increasingly clear that vaccination and especially being up to date on vaccines reduces the risk of long COVID. Yet, despite it being a major public health issue, we don’t have much messaging around preventing long COVID (eg, as an important reason to be up to date on vaccines).”

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