Science & Tech Spotlight: Long COVID | U.S. – Government Accountability Office

How many individuals within the U.S. have developed “lengthy COVID“?
It could possibly be within the vary of 7.7–23 million, some estimates say.
We focus on what’s and is not identified about lengthy COVID—new, returning, or ongoing well being issues 4 or extra weeks after an preliminary case of COVID-19. For instance, some individuals with the situation expertise continual fatigue and need to cease working, which might have an effect on their revenue and medical health insurance. However different financial results are nonetheless unclear.
The federal authorities is taking steps to fund extra analysis and assist affected individuals. We describe challenges it may encounter and supply questions for policymakers to think about.
person wearing gloves holding a COVID-19 diagnostic test swab and container
Lengthy COVID has probably affected as much as 23 million Individuals, pushing an estimated 1 million individuals out of labor. The complete magnitude of well being and financial results is unknown however is predicted to be important. The causes of lengthy COVID should not absolutely understood, complicating prognosis and remedy. The situation raises coverage questions, comparable to how finest to help sufferers.
What’s it? Lengthy COVID, based on the Facilities for Illness Management and Prevention (CDC), is the incidence of latest, returning, or ongoing well being issues 4 or extra weeks after an preliminary an infection with SARS-CoV-2, the virus that causes COVID-19. It is usually identified by different names, together with post-acute COVID, post-COVID situations, and continual COVID.
Signs of lengthy COVID range from individual to individual. They might embrace fatigue, cognitive impairment (or “mind fog”), muscle or joint ache, shortness of breath, coronary heart palpitations, sleep difficulties, and temper modifications (see fig. 1). Lengthy COVID can have an effect on a number of organ programs and trigger tissue harm.

Determine 1. Some reported signs of lengthy COVID.
Lengthy COVID is a post-viral syndrome. Publish-viral syndromes are effectively documented for a variety of infections. For instance, one examine discovered that greater than 27 % of survivors from one other coronavirus, extreme acute respiratory syndrome (SARS), had continual fatigue syndrome 4 years after their preliminary an infection.
What is understood? Lengthy COVID can have severe impacts. Some people have reported a necessity to regulate their work hours or cease working altogether as a result of continual fatigue or cognitive impairment. One examine of practically 4,000 lengthy COVID sufferers discovered that 45 % lowered their work hours. For some, the change in job standing can have an effect on medical health insurance, which might additional complicate remedy choices. People have additionally stated their signs intrude with childcare, train, and social actions. This disruption of their every day lives may cause psychological well being points. One other examine used the digital well being data of greater than 200,000 COVID-19 survivors and located that inside 6 months following preliminary an infection, one-third skilled neurological or psychological signs comparable to anxiousness, despair, post-traumatic stress dysfunction, and psychosis.
What are the information gaps? Researchers don’t but absolutely perceive the chance elements, causes, and results of lengthy COVID. Danger elements embrace preexisting situations, comparable to kind 2 diabetes. Severity of COVID-19 might also be a predictor, though individuals with delicate or asymptomatic infections may develop the syndrome. Whether or not vaccination for COVID-19 reduces an contaminated particular person’s threat of growing lengthy COVID is unclear. Some research have urged that vaccination reduces threat by as much as 50 %, whereas others have discovered no discount in threat.
Researchers have recognized a number of attainable causes of lengthy COVID and have urged that causes might range from individual to individual (see fig. 2). For some, COVID-19 might trigger the physique to provide an antibody that mimics SARS-CoV-2 and triggers an autoimmune response through which the immune system assaults its personal antibodies. For others, SARS-CoV-2 virus might persist within the physique and trigger signs. One other attainable trigger is organ harm from COVID-19. Analysis additionally means that microclots might kind in blood vessels, blocking blood movement and inflicting tissue harm. And COVID-19 might disrupt the immune system and reactivate different beforehand contracted viruses, comparable to Epstein-Barr.

Determine 2. Some attainable causes of lengthy COVID as urged by researchers.
Researchers are working to develop strategies to reliably diagnose and deal with lengthy COVID. Well being care suppliers might use COVID-19 antibody assessments in an try to substantiate earlier an infection, then rule out different situations which will trigger comparable signs. Remedy methods are based mostly on sufferers’ particular signs and will embrace present therapeutics, comparable to steroids or anti-inflammatory medicine. Trials are underway to check new therapeutics for lengthy COVID sufferers.
The broader public well being, social, and financial results of lengthy COVID are unclear. Research within the U.S. estimate that 10 to 30 % of COVID-19 survivors develop lengthy COVID. In that case, 7.7 million to 23 million individuals within the U.S. might have developed lengthy COVID as of February 2022. In January 2022, the Brookings Establishment performed a meta-analysis to recommend that lengthy COVID could also be chargeable for over 1 million employees being out of the labor pressure at any given time.
What’s being finished? The federal authorities is taking steps to fund extra lengthy COVID analysis. For instance, the Nationwide Institutes of Well being launched the $1.15 billion Researching COVID to Improve Restoration (RECOVER) Initiative, which mixes information throughout greater than 200 analysis websites. The initiative is utilizing digital well being data to group frequent traits of tens of 1000’s of volunteers to higher determine threat elements and causes of lengthy COVID. Equally, the CDC has contracted for a examine through which sufferers voluntarily share their well being information via a cloud-based private well being platform.
The federal authorities has additionally taken steps to help lengthy COVID sufferers. For instance, the Departments of Justice and Well being and Human Providers (HHS) issued steering stating that the situation generally is a incapacity underneath the Individuals with Disabilities Act of 1990. Some lengthy COVID sufferers might qualify for Social Safety Incapacity Insurance coverage (SSDI) in the event that they meet sure necessities. The CDC has developed lengthy COVID steering for well being care suppliers and the general public. One other HHS company, the Administration for Group Residing, revealed a information to community-based assets to assist join affected individuals to companies like transportation and private care attendants.
Non-governmental consultants and organizations are additionally addressing lengthy COVID. For instance, the Nationwide Academies of Sciences, Engineering, and Medication will maintain a public workshop in March 2022 to debate a number of lengthy COVID subjects, together with results on kids, psychological well being, and labor, in addition to the results of vaccines. As well as, researchers are making use of machine studying to affected person information to determine signs, and lots of hospital programs are forming specialised clinics to deal with and help sufferers.
For extra data, contact Karen Howard at 202-512-6888 or HowardK@gao.gov.
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