Since 2020, the so-called protracted COVID-19 condition has spread around the world, impacting millions of people’s health and quality of life while costing economies billions of dollars in lost worker productivity and a general decline in the labor force.
More than 24,000 scholarly articles have been produced as a result of the enormous scientific effort that COVID provoked, making it the most researched health issue in any four years in recorded human history.
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The collection of long-term health consequences brought on by SARS-CoV-2 virus infection is referred to as “long COVID.” These include lifelong illnesses like diabetes and heart failure, as well as persistent respiratory symptoms like shortness of breath and crippling exhaustion or fog that prevents people from working.
As a physician scientist, I have spent the early stages of the epidemic extensively researching extended COVID. I have written extensively about long-term COVID, testified before the U.S. Senate as an expert witness, and been recognized for my work in this field as one of Time’s 100 most influential people in health in 2024.
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A swarm of stories and scholarly studies on extended COVID provided more insight into this complicated ailment throughout the first half of 2024. These include, in particular, new information on viral persistence and immunological dysfunction that persists for months or years after initial infection, as well as insights into how COVID-19 can continue cause havoc in numerous organs years after the virus first infects.
How long COVID affects the body
According to a recent study my colleagues and I published on July 17, 2024 in the New England Journal of Medicine, there was a decrease in the likelihood of long-term COVID during the epidemic. Approximately 10.4% of adults with COVID-19 who contracted the progenitor strain of SARS-CoV-2 in 2020, when vaccinations were unavailable, developed protracted COVID. When the omicron family of variations became dominant in early 2022, that rate dropped to 3.5% for individuals who had received vaccinations and 7.7% for adults who had not. That is, the risk of developing lengthy COVID was more than twice as high in those who had not received the vaccination.
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The influx of new patients into long COVID clinics has been comparable to 2022, although researchers like me do not yet have hard statistics on the present rate in mid-2024 because of the time it takes for long COVID cases to be reflected in the data.
We discovered that two major factors contributed to the decline: the development of vaccinations and modifications to the virus’s properties, which decreased the virus’s propensity to produce severe acute infections and may have also lowered its capacity to linger in the human body long enough to induce chronic illness.
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Even a 3.5% chance is significant despite the long-term COVID risk declining. Millions of new long-term COVID cases are caused by new and recurring COVID-19 infections, adding to the already startling number of individuals afflicted with this illness.
In the first year of the pandemic, estimates indicate that at least 65 million people worldwide have experienced long-term COVID-19. My team and a number of other top scientists will shortly release new estimates of the worldwide cost of long-term COVID-19 and its effects on the world economy through 2023.
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Furthermore, a comprehensive new paper from the National Academies of Sciences, Engineering, and Medicine outlines every health consequence that long-term COVID causes. The Social Security Administration ordered the study in order to ascertain how extended COVID will affect its disability payouts.
It comes to the conclusion that extended COVID is a complicated chronic illness that can have over 200 health impacts on various body systems. They consist of recent onset or deterioration:
- heart disease
- neurologic problems such as cognitive impairment, strokes and dysautonomia. This is a category of disorders that affect the body’s autonomic nervous system — nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.
- post-exertional malaise, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks
- gastrointestinal disorders
- kidney disease
- metabolic disorders such as diabetes and hyperlipidemia, or a rise in bad cholesterol
- immune dysfunction
Long COVID can impact individuals of all ages, from young toddlers to elderly adults, as well as those of different racial and ethnic backgrounds and health statuses. Notably, minor COVID-19 infections were present in over 90% of those with prolonged COVID.
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The National Academies report also found that prolonged COVID can lead to low quality of life, impaired physical and cognitive function, inability to return to work or education, and decreased capacity to do daily tasks for months or years after the first infection.
According to the report, a number of long-term COVID health effects, including chronic fatigue and post-exertional malaise, cognitive impairment, and autonomic dysfunction, are not currently included in the Social Security Administration’s Listing of Impairments but can have a substantial impact on a person’s capacity to engage in work or education.
A long road ahead
Furthermore, COVID-19-related health issues may not go away for years after the first infection.
In the third year following the original infection, even those with mild SARS-CoV-2 infections continued to have additional health issues connected to COVID-19, according to a comprehensive study released early in 2024.
These results are consistent with other studies that demonstrate the virus lives on in different organ systems for several months or years following COVID-19 infection. Furthermore, studies are demonstrating that immunological reactions to mild infections persist for two to three years after the initial infection. When taken as a whole, these investigations could help explain why an old SARS-CoV-2 infection could persist for a long time and result in new health issues.
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Also, a great deal of work is being made in comprehending the mechanisms by which extended COVID causes havoc on the body. Two early studies from the United States and the Netherlands demonstrate that when auto-antibodies—antibodies produced by an individual’s immune system that target their own tissues and organs—are transferred from individuals with long-term COVID-19 into healthy mice, the mice begin to exhibit long-term COVID-19 symptoms, such as impaired muscle tone and balance.
According to these findings, long-term COVID may be caused by an aberrant immune response that is assumed to be the source of these auto-antibodies. Removing these auto-antibodies may be a promising therapy option.
An ongoing threat
Even with copious evidence of COVID-19’s wide-ranging hazards, a lot of messaging implies that the public is no longer at risk. Despite the lack of empirical support, the popular narrative has been infused with this false information.
The data, however, tells a different story.
More people are becoming infected with COVID-19 than with the flu, and it also causes more hospital stays and deaths overall. Additionally, COVID-19 causes more severe long-term health issues. Realistically, COVID-19 cannot be dismissed as a minor cold or confused with the flu.
