As COVID Infections Continue, Long COVID Numbers Rise

Three important findings have emerged from recent research on COVID-19. First, long COVID -- the persistence of symptoms after the acute infection -- is common and can cause significant suffering and disability. Second, the ability of the bivalent booster to broaden recipients' immune response and reduce the frequency of hospitalizations and deaths has exceeded expectations. Third, the data argue for an intensive effort to convince more Americans to get the bivalent booster and to wear masks in moderate- and high-risk situations.

Although most people who get COVID recover within a few days or, at most, weeks, we cannot ignore that this infection has already killed some 1.1 million Americans, and the death toll is currently about 4.000 per week. In addition, even those with only mild infections can experience the syndrome of "long COVID," which is marked by persistent, sometimes debilitating symptoms that last for months or even years following the acute infection.

According to a recent article in Nature Reviews Microbiology by Scripps Research’s Dr. Eric Topol and coworkers:

At least 65 million individuals around the world have long COVID, based on a conservative estimated incidence of 10% of infected people and more than 651 million documented COVID-19 cases worldwide; the number is likely much higher due to many undocumented cases. The incidence is estimated at 10–30% of non-hospitalized cases, 50–70% of hospitalized cases and 10–12% of vaccinated cases.

Moreover, the largest number of long COVID cases are in non-hospitalized patients who have experienced a mild acute illness – not because they are more susceptible, but simply because this population represents by far the majority of overall COVID-19 cases.

The most common long COVID symptoms and the pathological damage responsible for them are shown in this figure from the Topol et al. article:



From Topol et al,

This bodes ill for many Americans in the short- and long term. As the number of infections continues to climb, so will cases of long COVID, often causing prolonged pain and suffering so severe that those affected are unable to work; it is thought that there are already perhaps a million such people in the U.S.

In addition, as shown in the figure below, the CDC has identified the onset of new conditions following COVID infection that "might be related to their previous COVID-19 illness." Think of it as long COVID on steroids.