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RECOVER at mid-year: 2026 progress and what’s ahead

  • Feature
  • July 1, 2026
  • 13 min read

The initiative shares 2026 progress and looks forward to additional milestones this year, including clinical trial results and a new pathobiology research funding opportunity.

In 2026, the RECOVER Initiative has continued its work to advance Long COVID science and produce research that can help patients, scientists, and clinicians better understand, diagnose, prevent, and treat the condition. The RECOVER Clinical Trials program (RECOVER-CT) shared additional clinical trial results this year with more findings on the way. Meanwhile, the initiative’s next phase of clinical trials, RECOVER-Treating Long COVID (RECOVER-TLC), started enrolling participants in one of its 4 planned studies. 

RECOVER also launched the next phase of its adult observational study, which will enable an additional 2 years of study participation, data collection, and discovery. Similarly, the National Institutes of Health (NIH) decided to continue the RECOVER pediatric observational study for 2 more years. This may help researchers understand how children’s health changes over time and whether symptoms get better, stay the same, or get worse. In addition, researchers working on pathobiology and tissue pathology (autopsy) studies continue to make strides in understanding what happens inside the body when people are living with Long COVID. 

Through the year, RECOVER has published scientific papers that represent nearly all the types of studies it conducts to learn more about Long COVID. The initiative also continues to integrate feedback from RECOVER Representatives and the public, keeping the lived experience of people with Long COVID central to its work.

RECOVER-CT shares clinical trial designs and findings

RECOVER-CT continues to share findings from its 8 clinical trials, which have tested 13 possible treatments for Long COVID symptoms. In March, researchers shared initial results from the RECOVER-AUTONOMIC (Ivabradine) trial at the American College of Cardiology Annual Conference. A paper describing the full findings and analysis is expected to be published in the coming months.

Results from the RECOVER-VITAL clinical trial are also available on ClinicalTrials.gov. Researchers expect to publish a paper describing the full findings soon.

As data analysis for the other clinical trials continues, researchers have published study design papers for RECOVER-AUTONOMIC and RECOVER-VITAL. Study design papers are important because they explain how researchers organized and conducted a study to meet its goals.

RECOVER-CT expects to share additional results later this year. Members of the team will provide an update on clinical trials at a RECOVER Research Review (R3) Seminar on July 14. Learn more about the upcoming R3 Seminar.

RECOVER-TLC moves Long COVID clinical trials forward

RECOVER-TLC is advancing 4 Long COVID clinical trials, with 1 trial currently enrolling participants and 3 trials in development. 

The first of these studies, REVERSE-LC, continues to enroll participants at 17 study sites across the United States, including 11 new sites supported by RECOVER-TLC. This trial is testing whether the drug baricitinib—a treatment approved by the U.S. Food and Drug Administration (FDA) for rheumatoid arthritis and COVID-19—can improve brain function, heart and lung function, and quality of life for adults with Long COVID. Learn how to participate in the REVERSE-LC trial.

RECOVER-TLC is developing the full study plans (protocols) for 3 additional clinical trials. These trials are expected to begin enrolling participants later this year:  

  • Brave-LC will test whether low-dose naltrexone (LDN) can help with fatigue and other Long COVID symptoms among children and young adults aged 6 to 25. 
  • Tame-LC will test whether the drug semaglutide (a glucagon-like peptide-1 receptor agonist, or GLP-1 RA) can improve health-related quality of life and other Long COVID symptoms in adolescents and adults aged 12 to 70. 
  • Block-LC will test whether a procedure called a stellate ganglion nerve block (SGB) can improve health-related quality of life and other Long COVID symptoms in adults aged 18 to 65. 

Visit the FNIH website for updates on these trials.

To share updates, RECOVER-TLC will host its next webinar on July 16, which will cover how clinical trials work, what to know about safety and enrollment, and the current status of its trials. Learn about this webinar.

RECOVER-TLC will also hold its yearly workshop on Wednesday, November 4, and Thursday, November 5, in Bethesda, Maryland. Registration for the event will open in late September with options to attend online or in person. 

Public feedback integrated into RECOVER-TLC study plans 

As part of its trial planning process, RECOVER-TLC sought feedback from the public on each of the possible treatments they plan to test. RECOVER-TLC received 70 public comments on its plans for the LDN trial, Brave-LC. The comments were reviewed by the trial’s Protocol Working Group, a group of people helping to plan the study. The group includes scientists, statisticians (experts who collect and analyze data), study managers, doctors who treat children and adults with Long COVID, and people caring for children with Long COVID. 

Public comments supported keeping fatigue as the primary outcome (the main symptom a clinical trial is designed to measure). In response to comments, the Protocol Working Group has added plans to examine how the drug affects participants who also have related health conditions, including dysautonomia, postural orthostatic tachycardia syndrome (POTS), post-exertional malaise (PEM), and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). 

To reduce participant burden, the trial will offer telehealth options for certain study visits and encourage flexible scheduling for visits. The working group emphasized the importance of ensuring participant safety—particularly with children and young adults as study participants—and will keep certain visits in person. 

Study plans for the GLP-1 RA trial (Tame-LC) and the SGB trial (Block-LC) have also been posted for public comment. Each trial’s Protocol Working Group is currently reviewing comments and making updates to the full study plans (protocols). Summaries of the comments and the resulting changes to the study plans will be posted to the RECOVER-TLC Collaborator Portal in the upcoming months.

In addition to receiving feedback through public comments and from community representatives participating in Protocol Working Groups, RECOVER-TLC has formed a Community Advisory Board, which includes 12 Patient, Caregiver, and Community Representatives. The Board meets each month to review and provide feedback on study plans, information, and recruitment materials for planned clinical trials; discuss best practices to reach communities impacted by Long COVID; and develop accessible, easy-to-understand resources for participants. 

RECOVER-TLC continues to accept treatment ideas through its submission portal. Anyone can submit information about a drug, medical device, or other possible treatment that could help people suffering from symptoms of Long COVID. 

Observational studies continue to next phase

In May, RECOVER’s adult observational study, which includes women who were pregnant during or after 2020, began its next phase of research. This phase will continue for 2 years and will allow researchers to follow about 5,000 people for a longer period to better understand how Long COVID affects them over time. The observational study will continue to focus on learning more about symptoms that have been identified as especially burdensome, including neurocognitive symptoms (symptoms that affect the brain) and cardiopulmonary symptoms (symptoms that affect the heart and lungs). Learn about the next phase of the observational study.

RECOVER’s pediatric observational study will also continue for 2 more years. During this phase, researchers will keep following children, teenagers, and young adults to answer important questions about how Long COVID symptoms may change as people grow and develop.

Researchers from the pediatric observational study continue to publish papers about the many ways Long COVID can look different in children of all ages. A recent publication from the study described the difficulties that children with Long COVID may face in school. Researchers following the babies of pregnant women from the adult observational study explored whether babies’ early brain development is impacted by their mothers having COVID-19 while pregnant.

Electronic health record studies increase understanding of pediatric Long COVID

RECOVER researchers have analyzed data collected during routine clinical care to learn more about Long COVID. These data, drawn from 3 research networks and the electronic health records (EHRs) of millions of patients, supported 3 new publications about pediatric Long COVID this year. Researchers found that:

RECOVER’s EHR studies have completed their final analyses, with 26 studies and their findings to be published in the future.

See all publications from RECOVER’s EHR studies.

New funding cycle for pathobiology studies expected soon

RECOVER’s pathobiology studies work to understand what happens inside the bodies of people who have Long COVID. Twenty pathobiology studies, which were funded by a 2024 Research Opportunity Announcement (ROA) (PDF, 7 pages) and launched in March 2025, continue this data collection and analysis. These studies use data and biosamples collected from RECOVER’s adult and pediatric observational studies, tissue pathology (autopsy) studies, and outside sources. The projects expand on existing RECOVER data and analyses and provide important insights that could eventually inform Long COVID treatment. The most recent pathobiology research opportunity (OTA-21-015K) closed in April. 

A new research opportunity to expand pathobiology studies will open this summer. This opportunity will invite proposals that address critical gaps in our understanding, diagnosis, prevention, and treatment of Long COVID, including identifying biomarkers and mechanistic pathways for treatments. To learn more about RECOVER’s pathobiology research, explore the full list of studies and findings shared by researchers.

RECOVER data supports ongoing Long COVID research

RECOVER continues to make its study data and biosamples available to authorized researchers. Through ancillary studies and awarded research opportunities, researchers seek to answer questions not examined by foundational RECOVER studies. Review the Research Opportunities and Data Access Flowchart (PDF, 1 page) to understand the steps required to apply.

To date, RECOVER’s repository of data contains 82 million datapoints and 1.5 million biosamples. The number of datapoints and biosamples available for new Long COVID studies will continue to grow as observational studies and clinical trials continue.

Authorized researchers continue to access RECOVER data through NHLBI BioData Catalyst® (BDC), a secure cloud-based ecosystem. BDC provides tools and resources to support Long COVID research and data analysis. Recently, RECOVER made electronic health record (EHR) data from the adult observational study available. Explore available RECOVER data to inform a future study proposal on BDC Powered by PIC-SURE.

Tissue pathology (autopsy) study gains new insights into potential causes of Long COVID

Researchers shared the first findings from RECOVER’s tissue pathology (autopsy) study at the 115th Annual Meeting of the United States and Canadian Academy of Pathology (USCAP) on March 23, 2026. 

Researchers found that some people may develop Long COVID-related heart problems because of viral persistence. Viruses like SARS-CoV-2, the virus that causes COVID-19, can remain active (persist) in the body even after a person has recovered from the acute (initial) phase of their illness. 

In this study, RECOVER pathologists and pathobiologists worked together to analyze small samples of blood and tissue (biosamples) collected from people who died after having COVID-19. These analyses identified a group of people whose heart tissue contained SARS-CoV-2 that was likely still making copies of itself (replicating) more than 60 days after the individuals got COVID-19. People in this group were also more likely to have changes in their immune system and heart structure than people without SARS-CoV-2 in their heart tissue. These changes in the immune system and heart can lead to symptoms like a fast or pounding heartbeat (palpitations), chest pain, shortness of breath, and feeling extremely tired (fatigue).

These findings add to the growing evidence that there may be different types of Long COVID and that each type may be influenced by multiple factors, including how recently a person had COVID and whether they felt very sick when they had COVID. 

Visit the USCAP website to read more about this study and its findings.

Autopsy study reaches enrollment goal 

Findings from the autopsy study have been made possible by the 304 people enrolled—with permission of their family or caregiver—in the autopsy study. The study enrolled its final participant on January 31, 2026. According to James Stone, MD, PhD, chair of the RECOVER Autopsy Cohort Coordinating Committee, the study also exceeded its enrollment goal for people with Long COVID. Enrolling more people with Long COVID in the study gives researchers greater opportunities to pinpoint changes in the body that lead to Long COVID—and eventually design treatments to stop or reverse those changes.

One key to achieving the study’s broader goals is sharing access to the biosamples collected through the autopsy study. Authorized researchers can access the biosamples and, in some cases, images of biosamples through the study’s Digital Slide Archive.

Before adding images to the archive, researchers may treat the biosamples, which are preserved on microscope slides, with chemicals called stains to reveal details in the tissues that would not otherwise be visible. Staining allows researchers to look closely at the tissues on the slides for specific COVID-related changes, like scarring, tiny blood clots, and cell damage, in different tissues and organs. The slides allow researchers to examine samples from more than 50 locations in the body, including the brain, heart, lungs, and gut. The study team anticipates that analyses of stained slides will be completed by the end of March 2027.

Dr. Stone also shared that researchers are preparing 2 additional sets of study findings for publication later this year. The first publication will discuss a study comparing causes of death in people with and without Long COVID. The second publication will discuss a study examining samples taken from the back of the throat and behind the nose (nasopharyngeal swabs) for evidence of viral persistence.

RECOVER shares new discoveries

RECOVER has published 14 papers this year, advancing our understanding of Long COVID. Key findings covered results from RECOVER’s clinical trials, the impact of Long COVID on children and adolescents, insights into the biological changes that may lead to Long COVID, and ways that RECOVER is engaging people from all backgrounds and walks of life to help inform research. The publications represented a wide range of study approaches and data sources, including:

Learn more about the recent findings by exploring the March RECOVER Research Update and June RECOVER Research Update.

RECOVER also produces Discover RECOVER videos that highlight key research findings in plain language. Recently, RECOVER published the latest video, which discusses research that found 8 distinct symptom patterns experienced by adults who have Long COVID. The initiative also hosted an R3 Seminar in February that discussed these findings. Watch the Discover RECOVER video on YouTube. A Spanish language version of the video is also available.

Representatives continue meaningful contributions to RECOVER

RECOVER Patient, Caregiver, and Community Representatives continue to inform and contribute to RECOVER research in concrete ways. They also help make sure the experiences and needs of people living with Long COVID are reflected in the initiative’s work.

In the first half of 2026, Representatives:

  • Developed resources for people with Long COVID covering workplace challenges, financial support, mental health, and symptom tracking. These resources are expected to be made publicly available later this year.
  • Provided feedback on RECOVER’s website content and structure to help ensure that information is easy to find and understand.
  • Contributed to 6 accepted research manuscripts and 1 poster abstract through RECOVER authorship activities, working with research teams to share study findings in clear and meaningful ways for the scientific community and the public.
  • Reviewed recruitment and retention materials for the next phase of the adult observational study, helping to make them more relevant, accessible, and responsive to the needs of study participants.
  • Revised the Representative Charter to strengthen roles, responsibilities, and collaboration across the National Community Engagement Group (NCEG). 
  • Participated in listening sessions organized and facilitated by the NCEG (the Representatives’ leadership group) to share key insights about the needs of people living with Long COVID, including challenges related to diagnosis, treatment, financial support, and workplace accommodations. The NCEG developed a report to share findings from these sessions (PDF, 3 pages). 
  • Contributed to development of study plans for RECOVER-TLC trials as participants in Protocol Working Groups.
  • Helped inform RECOVER-TLC clinical trial planning through participation in the Community Advisory Board, where they reviewed study plans, participant materials, and recruitment approaches.
  • Presented at the Society for Clinical Trials 2026 Annual Meeting to share insights from RECOVER's clinical trials from the patient and caregiver perspective.

Stay updated on future RECOVER findings

This year, RECOVER will continue to publish findings, including additional EHR analyses and new clinical trial results. The initiative will also continue its work to better understand Long COVID symptoms and the changes in the body that cause these symptoms. Ultimately, these discoveries can help researchers determine which treatments might work best for specific people.

Stay up to date on RECOVER’s progress:

  • Subscribe to the RECOVER Report to get monthly updates about the initiative and its work.
  • Visit the Findings page to read research summaries written in plain language and to watch Discover RECOVER videos that discuss key results.
  • Attend an R3 Seminar to hear RECOVER researchers and Representatives discuss RECOVER studies and findings.
This story was first announced in the RECOVER Report, RECOVER’s monthly email newsletter. Complete this form to subscribe and receive the latest updates from RECOVER.

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