The aftereffects of the covid-19 pandemic have dissipated over time, but not entirely. Research out today shows that a sizeable number of Americans continue to struggle with symptoms tied to long covid.
Scientists from Yale University and others examined nationally representative survey data. They estimated that about one in 12 U.S. adults had reported ever having long covid by 2024, a slight majority of whom have since recovered. Though the risk of developing and still having long covid is on the decline, plenty of people even now are suffering with no reliable treatment available, the researchers say.
“Many adults, particularly those 35 years or older, continue to experience lasting symptoms,” they wrote in their paper, published Monday in JAMA Network Open.
The rise and fall of long covid
There remains much we don’t know about long covid, including its origins. It’s a complex condition likely caused by more than one thing, including a dysfunctional immune response to the earliest covid infection or the persistent presence of the coronavirus itself.
Scientists have also struggled to pin down the actual risk of developing long covid, with wildly varying prevalence rates from one study to the next. There’s no clear biomarker or test that can currently diagnose it, leaving plenty of room for interpretation (a person with brain fog linked to covid might have gotten sick from something else, for instance). That said, research has generally suggested that important factors like past immunity, from vaccines and/or infection, and the emergence of less severe variants like Omicron have steadily lowered the risk of long covid over time.
Keeping these limitations in mind, the researchers say that self-reported rates of long covid can still serve as a barometer for its impact on the population. They analyzed data from the National Health Interview Survey (NHIS), a long-running annual and nationally representative poll of Americans’ health and lifestyle habits. For several years, the NHIS has included questions about long covid.
One such question goes: “Did you have any symptoms lasting 3 months or longer that you did not have prior to having coronavirus or COVID-19.” Another asks if the person is experiencing these symptoms currently.
Based on NHIS data collected from 2022 to 2024, the researchers estimated that 8.3% of U.S. adults—around 21.3 million people—reported ever having long covid in 2024. Of those with long covid, roughly 60% reported having recovered from their symptoms.
They also estimated that the odds of developing long covid have decreased over time, from a 19.7% prevalence rate among those infected at the start of the pandemic to a 13.7% rate in 2024. Similarly, the odds of recovery have increased during this period, from a 51.2% recovery rate of long covid cases at the pandemic’s start to 59.7% in 2024.
The lingering specter of long covid
But the researchers admit to a few caveats. At least some self-reported cases of long covid and recovery could both be misclassified. It’s possible some people’s symptoms were caused by something else, for instance. And someone whose long covid symptoms flare up intermittently could mistakenly be considered a recovery.
At the same time, the team’s numbers do roughly line up with other studies examining the recent toll of long covid in the U.S., including the NIH’s RECOVER initiative. Other studies have also supported the lowering incidence of long covid over time.
Long covid isn’t gone, though. Based on the team’s results, around 8 million Americans were estimated to have the condition in 2024. For some context, that’s a bit more than the number of people currently living with Alzheimer’s disease in the U.S. Covid-19 itself remains a real, if lessened, threat too, meaning more long covid cases in the future. And these individuals need our help, the researchers say.
“With no [long covid] treatment demonstrating clear efficacy, greater investment in understanding biological mechanisms, including immunotypic differences between those who recover and those who do not, may provide insights into pathways of persistence and potential targets for intervention,” they wrote.
For most of us, the pandemic has become an ever-fading memory. Unfortunately, lots of people are still dealing with its shadow.
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