Long COVID remains a problem for many patients

In a new report from the National Academies of Sciences, Engineering, and Medicine (NASEM), long COVID "can impact people across the life span, from children to older adults, as well as across sex, gender, racial, ethnic and other demographic groups."

In the report, researchers cited data from 2022 that suggested that almost 18 million U.S. adults and nearly a million children have had long COVID at some point. At the time of the survey, around 8.9 million adults and 362,000 reported currently having the condition.

In 2023, surveys suggested that the prevalence of long COVID decreased, but it has risen again this year. As of January, almost 7% of U.S. adults reported having long COVID.

Currently, there's no standardized way to diagnose long COVID, since it's "associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system," the researchers wrote.

Some of the most common symptoms of long COVID include chronic fatigue, post-exertional symptom exacerbation, post-COVID cognitive impairment, and autonomic dysfunction. Some symptoms, including brain fog and chronic fatigue, can also be severe enough to impair people's ability to work and live their lives normally.

"Long Covid can result in the inability to return to work (or school for children and adolescents), poor quality of life, diminished ability to perform activities of daily living, and decreased physical and cognitive function for six months to two years or longer," the report said.

Although researchers are studying potential drugs or treatments that could help long COVID patients, there is currently no definitive way to treat or cure the condition. "There is no one-size-fits-all approach to rehabilitation, and each individual will need a program tailored to their complex needs," the report said.

"We conclude that long Covid is a real condition," said Paul Volberding, a professor emeritus of medicine at the University of California, San Francisco and chair of the committee that produced the report. "People suffering from it have to be listened to and have to be believed and deserve the best access possible to the management strategies."

How long do long COVID symptoms last?

Although some people may recover from long COVID over time, a new study published in Nature Medicine suggests that symptoms may last for more than three years.

In the study, researchers analyzed EHR data from over 135,000 patients in the Veterans Affairs health system who had contracted COVID-19 between March and December 2020. This information was then compared to 5.2 million patients who had not contracted COVID-19.

According to Ziyad Al-Aly, an epidemiologist and the study's senior author, the nervous system, lungs and airways, and gastrointestinal system were the most likely to experience prolonged effects from COVID-19. These symptoms may be due to viral persistence, chronic inflammation, or immune dysfunction.

Patients who were originally hospitalized for a COVID-19 infection also have more health risks than those who weren't hospitalized. Although the risk of death is less significant for non-hospitalized COVID-19 patients after the first year, those who were hospitalized had a 29% higher chance of dying in their third year compared to uninfected individuals.

"We are used to thinking about infections as acute events with health effects that manifest around the time of infection," Al-Aly said. "The data shows that Covid can cause health effects even three years later."

Can long COVID patients receive disability benefits?

According to Stephanie Rennane, an economist at the RAND Corporation, long COVID is difficult to map to Social Security Administration's (SSA) current eligibility requirements for disability insurance since the condition can vary significantly for patients.

"The severity and duration of the condition can vary a lot, and in ways that we can't fully predict yet," Rennane said.

Although SSA has a listing of conditions and impairments that are considered severe enough to impair a person's ability to work, long COVID is not included on the list. Because of this, "most individuals with long Covid applying for Social Security disability benefits will do so on the basis of health effects not covered in the Listings," the NASEM report wrote.

In addition, the report noted that while SSA has issued guidance on how to handle long COVID applications, "it does not provide sufficient guidance for assessing functional status or weighing severity."

"The ambiguity in diagnosis and variation in symptoms, severity and duration of long COVID and limited knowledge base make it difficult to include long COVID as a listed impairment for SSA at this point," Rennane said. "But hopefully this [NASEM] report will give some guidance as to indicators to watch for (such as a prior hospitalization for COVID) which may help determine when the impacts and duration could be severe enough to meet SSA's eligibility standards for disability insurance." (Cueto, STAT, 6/6; Belluck, New York Times, 6/5; Gale, Bloomberg, 5/30)

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