RECOVER Research Update: March 2026

Intrauterine SARS-CoV-2 exposure and infant neurodevelopment through 18 months of age: Findings from the RECOVER pregnancy study (The Journal of Pediatrics, January 2026)

• Researchers found that having COVID-19 during pregnancy did not affect how a baby’s brain developed in the first 12 to 18 months of life.
• In this study, researchers focused on babies whose mothers had the Omicron variant of SARS-CoV-2, the virus that causes COVID-19, before they were born (in utero).
• Researchers gave tests to over 1,000 children when they were 12 and 18 months old. These tests measured brain health and development, including mobility, ability to communicate, problem-solving skills, and emotional maturity. 
• The children whose mothers had COVID-19 did not score significantly lower on these tests than children whose mothers did not have COVID-19.
• These findings are important because in utero exposure to viruses, like HIV and Zika, can negatively impact a baby’s brain health. Data collected early in the pandemic suggested that SARS-CoV-2 might have similar effects on some babies. 
• The researchers pointed out limitations to their study. First, the study did not include many children exposed to earlier (pre-Omicron) variants of SARS-CoV-2. Other studies suggest that children exposed to pre-Omicron variants may have experienced delays in their social and emotional development more often than children exposed to the Omicron variant. Second, the children included in the study were too young to have reached several important developmental milestones.
• RECOVER’s pregnancy study will continue to follow these children as they get older to better understand their development. Read this news story to learn more about the progress RECOVER is making to understand how COVID-19 and Long COVID can affect mothers and their babies.

Post-acute dyslipidemia and abnormal BMI in children and adolescents with COVID-19: A cohort study from the RECOVER Initiative (The Journal of Pediatrics, January 2026)

• Researchers found that COVID-19 may cause changes in a young person’s metabolism, which is how the body converts food and drink into energy. 
• Using electronic health record (EHR) data from 25 RECOVER study sites across the United States, researchers compared the body fat and blood fat (cholesterol) levels of young people who’d had COVID-19 with those who had not. These young people included babies, children, and adolescents up to age 21. 
• Young people who’d had COVID-19 had a 24% higher risk of developing high levels of cholesterol in their blood than those who hadn’t had COVID-19. Young people who’d had COVID-19 had a 15% higher risk of having higher levels of body fat as indicated by their body mass index (BMI) than those who hadn’t had COVID-19. Healthcare providers use BMI to diagnose obesity (being very overweight).
• These changes in a young person’s metabolism can have lifelong health effects. Changes in metabolism can reduce the body’s ability to remove cholesterol from the blood. Over time, cholesterol can then build up in blood vessels, creating blockages that increase a person’s chance of experiencing a heart attack or stroke. High cholesterol can also damage the liver. Obesity can also lead to diabetes and long-term heart problems.
• To prevent the development of these conditions, the researchers recommend that healthcare for young people who have had COVID-19 include monitoring of (paying close attention to) their weight, cholesterol levels, and other indicators of metabolic health.

Social determinants of health and pediatric Long COVID in the US (JAMA Pediatrics, January 2026)

• Researchers found a link between several social determinants of health (SDOH) and an increased risk of Long COVID in children aged 6 to 17. 
• SDOH are the nonmedical conditions in a person’s daily life that can impact their health. One of the most important of these impacts is stress, which can have long-lasting effects on a child who is still growing.
• When analyzing survey data provided by more than 4,500 children and adolescents taking part in the RECOVER pediatric observational cohort study, researchers found that 2 SDOH were most associated with higher chances of developing Long COVID: not having reliable access to food or not having a strong support network of family, friends, and neighbors. 
• These findings show the importance of considering the whole person, including their dietary (food-related), mental, and emotional needs, when providing COVID and Long COVID care.

Long COVID involves activation of proinflammatory and immune exhaustion pathways (Nature Immunology, January 2026) 

• Researchers used RECOVER data and blood samples to ensure the accuracy of (validate) the findings of a non-RECOVER study showing that Long COVID can change how the body’s immune system works.
• Specifically, researchers found that SARS-CoV-2 can weaken the immune system and cause long-lasting inflammation (part of the body’s response to infection). A weaker immune system is less able to protect the body against disease-causing infections, but an overactive immune system can overreact to infection and start attacking healthy parts of the body.
• These findings suggest that inflammation may be one of the primary reasons why some people experience Long COVID symptoms like pain, cough, brain fog, and fatigue.
• This study also shows how RECOVER is helping the larger scientific community answer a wider range of important questions about the long-term effects of COVID-19. These answers could improve the ability to diagnose, prevent, and treat Long COVID.

The role of co-infection in the pathogenesis of acute SARS-CoV-2 infection and development of post-acute sequelae: A perspective (eLife, November 2025)

• This publication is a review paper, meaning that it summarizes findings from other scientific publications to achieve a better understanding of a specific topic.
• The topic under review in this paper is whether Long COVID symptoms could be caused or affected by bacteria, fungi, or viruses other than SARS-CoV-2. The illnesses caused by other bacteria, fungi, or viruses, like the flu or Lyme disease, are called co-infections because they can occur before, during, or after a person gets COVID-19.
• Researchers found evidence in previous research studies that co-infections could contribute to the development and worsening of Long COVID symptoms. They also found evidence that a SARS-CoV-2 infection could cause the symptoms of co-infections to worsen.
• However, researchers also found that many of these previous studies were too small or narrowly focused to determine whether co-infections can cause Long COVID.
• The findings from this review show the need for more longitudinal studies like the ones RECOVER researchers are conducting. Because longitudinal studies look at the health of large groups of people over a long period, they can collect the amount of data needed to better understand the relationship between co-infections and Long COVID.

Long COVID trajectories in the prospectively followed RECOVER-Adult US cohort (Nature Communications, November 2025)

• Researchers found that the timing and burden of Long COVID symptoms can vary across groups of people and that different patterns of timing and burden can be grouped.
• Over 15 months, 3,659 adults (people aged 18 or older) enrolled in RECOVER’s observational study shared their symptom data with researchers. Researchers then evaluated these data for patterns in how participants’ symptoms changed over time (trajectories).
• Research found 8 common trajectories, each one unique in terms of when symptoms began, how long they lasted, how burdensome they were, and whether they got worse, stayed the same, or got better over time. For example, some study participants had lasting and consistent symptoms of Long COVID, whereas others did not experience Long COVID symptoms early on but started having health problems many months after having COVID-19.
• Read a recap of the R3 Seminar, “Long COVID trajectories in adults,” (February 10, 2026) to learn more about this study and how its findings could lead to advancements in Long COVID diagnosis and treatment. 

Evaluation of interventions for cognitive symptoms in Long COVID: A randomized clinical trial (JAMA Neurology, November 2025)

• Researchers delivered findings from the RECOVER-NEURO clinical trial, which are the first research findings from the RECOVER Clinical Trials (RECOVER-CT) program. 
• Researchers tested whether possible nondrug treatments could help people with Long COVID who have trouble remembering things, focusing, or thinking clearly (cognitive symptoms). These possible treatments included a computerized brain training program and electrical stimulation of the brain.
• Researchers found that each of the treatments they tested helped all people enrolled in the trial make small improvements in thinking, focus, and memory, but no one treatment performed significantly better than the others. 
• Although this study did not identify an effective treatment for cognitive symptoms of Long COVID, its findings will inform future clinical trials and research studies.

Schizophrenia, bipolar, or major depressive disorder and postacute sequelae of COVID-19 (JAMA Network Open, October 2025)

• Researchers found that people living with certain mental health conditions are more likely to develop Long COVID. 
• By analyzing the EHRs of more than 1.5 million adults who got COVID-19, researchers found that almost 28% of those who had been diagnosed with a serious mental illness (SMI) like depression, schizophrenia, or bipolar disorder also developed Long COVID. In comparison, about 24% of people in the study without an SMI developed Long COVID.
• Some people in the study with an SMI were even more likely to develop Long COVID, including people aged 45 to 64, Black people, Hispanic people, and people living with other chronic health conditions like heart disease and diabetes.
• These findings support findings from earlier studies identifying risk factors for Long COVID. Awareness of these risk factors can inform treatment and care for people with COVID-19.

Preventive effect of vaccination on Long COVID in adolescents with SARS-CoV-2 infection (Vaccine, October 2025)

• Researchers found that COVID-19 vaccines can help prevent Long COVID in young people aged 12 to 17 (adolescents).
• In this observational study, adolescents who received a COVID-19 vaccine in the 6 months before getting COVID-19 for the first time were about one-third less likely to develop Long COVID.
• These are the first findings from RECOVER’s pediatric observational study that show that COVID-19 vaccines can provide protection against Long COVID in adolescents. These results support findings from several RECOVER EHR studies investigating the impact of vaccination on Long COVID.