Long Covid contributed to thousands of deaths in the United States over the last few years, according to a new study from CDC—findings that underscore the potential severity of lingering symptoms after a Covid-19 infection.

Study details and key findings

For the study, researchers from CDC's National Center for Health Statistics (NCHS) examined death certificates dated between Jan. 1, 2020, and June 30, 2022, from all 50 states and the District of Columbia.

In total, there were 1,021,487 death certificates that included Covid-19 as an underlying or contributing cause of deaths. Of this group, 3,544 (0.3%) also included terms related to long Covid, such as "post-Covid syndrome," "chronic Covid," or "long-haul Covid."

The researchers also found that deaths from long Covid became more prevalent after 2020 and that the condition was more likely to appear on death certificates in the weeks or months after Covid-19 cases had peaked.

Of the deaths attributed to long Covid, 78.5% were among white Americans, and almost 57% were among people ages 75 and older. Men were also slightly more likely to die from long Covid than women (51.5% vs. 48.5%, respectively).

"A lot of people think of long covid as associated with long-term illness," said Farida Ahmad, an NCHS health scientist and the study's lead author. "This shows it can be a cause of death."

According to the researchers, the long Covid deaths identified in the study are most likely a significant underestimate. During most of the study period, long Covid was not a well-defined condition, and a diagnostic code for it was not released until October 2021, which also has not yet been included in death certificate data.

Commentary

According to health experts, the study's findings highlight the potential danger of long Covid, but further research is needed to truly understand the impact of the condition for patients.

"This is just scratching the surface—this is a first look," said David Putrino, director of rehabilitation innovation at Mount Sinai Health System.

Benjamin Abramoff, director of the Post-Covid Assessment and Recovery Clinic at Penn Medicine, also noted that more information about the patients' medical histories and the severity of their Covid-19 infections is needed to draw more definitive conclusions about their deaths.

"A death at weeks following severe infection leading to Covid pneumonia and hospitalization paints a different picture than deaths in non-hospitalized patients months following infection," Abramoff said.

Some patient advocacy groups have also noted that suicides attributed to long Covid are often overlooked.

"I doubt most coroners are even familiar with the definition of long Covid, let alone the coding," said Diana Güthe, founder of Survivor Corps. "Not a week goes by that I don't hear of another suicide due to long covid, but I have yet to hear of a single one of those deaths labeled long Covid."

Overall, the number of deaths related to long Covid is likely to grow over time as more providers are educated on the condition and use of long Covid diagnostic codes become more commonplace.

"This communicates that the risk of long covid and deaths from long covid will increase as long as infections continue," said Hannah Davis, co-founder of the Patient-Led Research Collaborative.

Currently, the federal government is working to bring more attention to long Covid and improve diagnoses and treatment for the condition. In August, the Biden administration announced the National Research Action Plan on Long Covid, which aims to better understand how to prevent, diagnose, and treat the chronic condition.

However, many providers who treat long Covid patients said that more needs to be done to raise awareness about the condition and help patients get necessary treatment. In particular, more funding is needed for both research and long Covid treatment clinics.

"We are very under-resourced and we are completely inundated with patients," said Janna Friedly, executive director of the University of Washington Post-Covid Rehabilitation and Recovery Clinic. "We are booked out for more than a year at this point. It's not a good way to provide care to patients."

"It's becoming largely forgotten," Friedly said. "We're seeing less attention to the lingering effects of Covid, which are still here and will be for years to come." (Mahr, Politico, 12/14; Healy, Los Angeles Times, 12/13; Sellers, Washington Post, 12/14; Belluck, New York Times, 12/14; Stein, NPR, 12/14)