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Sharing science to find answers
Find RECOVER Publications
Researchers within the RECOVER Initiative share their progress to understand, treat, and prevent Long COVID through research publications. Follow the latest science from RECOVER’s research studies below.
Visit the Research Summaries page to learn about RECOVER’s Long COVID research in a format that’s easy to understand.
Abstract: More than one-third of individuals experience post-acute sequelae of SARS-CoV-2 infection (PASC, which includes long-COVID). The objective is to identify risk factors associated with PASC/long-COVID diagnosis. This was a retrospective case-control study including 31 health systems in the United States from the National COVID Cohort Collaborative (N3C). 8,325 individuals with PASC (defined by the presence of the International Classification of Diseases, version 10 code U09.9 or a long-COVID… Continue reading
Authors: Elaine L Hill, Hemalkumar B Mehta, Suchetha Sharma, Klint Mane, Sharad Kumar Singh, Catherine Xie, Emily Cathey, Johanna Loomba, Seth Russell, Heidi Spratt, Peter E DeWitt, Nariman Ammar, Charisse Madlock-Brown, Donald Brown, Julie A McMurry, Christopher G Chute, Melissa A Haendel, Richard Moffitt, Emily R Pfaff, Tellen D Bennett; N3C Consortium; RECOVER Consortium
Keywords: COVID-19; Long-COVID; PASC; Post-acute sequelae of SARS-CoV-2; Risk factors
Abstract: The NIH-funded RECOVER study is collecting clinical data on patients who experience a SARS-CoV-2 infection. As patient representatives of the RECOVER Initiative's Mechanistic Pathways task force, we offer our perspectives on patient motivations for partnering with researchers to obtain results from mechanistic studies. We emphasize the challenges of balancing urgency with scientific rigor. We recognize the importance of such partnerships in addressing post-acute sequelae of SARS-CoV-2… Continue reading
Authors: C Kim, Benjamin Chen, Sindhu Mohandas, Jalees Rehman, Zaki A Sherif, K Coombs, RECOVER Mechanistic Pathways Task Force, RECOVER Initiative
Caution: Preprints are preliminary reports of work that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Abstract: Vaccination reduces the risk of acute COVID-19 in children, but it is less clear whether it protects against long COVID. We estimated vaccine effectiveness (VE) against long COVID in children aged 5-17 years. This retrospective cohort study used data from 17 health systems in the RECOVER PCORnet electronic health record (EHR) Program for visits between vaccine availability, and October 29, 2022. Conditional logistic regression was used to estimate VE against long COVID with matching on age… Continue reading
Authors: Hanieh Razzaghi, Christopher B Forrest, Kathryn Hirabayashi, Qiong Wu, Andrea Allen, Suchitra Rao, Yong Chen, H Timothy Bunnell, Elizabeth A Chrischilles, Lindsay G Cowell, Mollie R Cummins, David A Hanauer, Miranda Higginbotham, Benjamin D Horne, Carol R Horowitz, Ravi Jhaveri, Susan Kim, Aaron Mishkin, Jennifer A Muszynski, Susanna Naggie, Nathan M Pajor, Anuradha Paranjape, Hayden T Schwenk, Marion R Sills, Yacob G Tedla, David A Williams, Charles Bailey
Abstract: Post-acute infection syndromes (PAIS) may develop after acute viral disease. Infection with SARS-CoV-2 can result in the development of a PAIS known as "Long COVID" (LC). Individuals with LC frequently report unremitting fatigue, post-exertional malaise, and a variety of cognitive and autonomic dysfunctions; however, the biological processes associated with the development and persistence of these symptoms are unclear. Here, 273 individuals with or without LC were enrolled in a cross-sectional… Continue reading
Authors: Jon Klein, Jamie Wood, Jillian Jaycox, Rahul M Dhodapkar, Peiwen Lu, Jeff R Gehlhausen, Alexandra Tabachnikova, Kerrie Greene, Laura Tabacof, Amyn A Malik, Valter Silva Monteiro, Julio Silva, Kathy Kamath, Minlu Zhang, Abhilash Dhal, Isabel M Ott, Gabrielee Valle, Mario Peña-Hernandez, Tianyang Mao, Bornali Bhattacharjee, Takehiro Takahashi, Carolina Lucas, Eric Song, Dayna Mccarthy, Erica Breyman, Jenna Tosto-Mancuso, Yile Dai, Emily Perotti, Koray Akduman, Tiffany J Tzeng, Lan Xu, Anna C Geraghty, Michelle Monje, Inci Yildirim, John Shon, Ruslan Medzhitov, Denyse Lutchmansingh, Jennifer D Possick, Naftali Kaminski, Saad B Omer, Harlan M Krumholz, Leying Guan, Charles S Dela Cruz, David van Dijk, Aaron M Ring, David Putrino, Akiko Iwasaki
Abstract: Obstructive sleep apnea (OSA) has been associated with more severe acute coronavirus disease-2019 (COVID-19) outcomes. We assessed OSA as a potential risk factor for Post-Acute Sequelae of SARS-CoV-2 (PASC). We assessed the impact of preexisting OSA on the risk for probable PASC in adults and children using electronic health record data from multiple research networks. Three research networks within the REsearching COVID to Enhance Recovery initiative (PCORnet Adult, PCORnet Pediatric, and the… Continue reading
Authors: Hannah L Mandel, Gunnar Colleen, Sajjad Abedian, Nariman Ammar, L Charles Bailey, Tellen D Bennett, M Daniel Brannock, Shari B Brosnahan, Yu Chen, Christopher G Chute, Jasmin Divers, Michael D Evans, Melissa Haendel, Margaret A Hall, Kathryn Hirabayashi, Mady Hornig, Stuart D Katz, Ana C Krieger, Johanna Loomba, Vitaly Lorman, Diego R Mazzotti, Julie McMurry, Richard A Moffitt, Nathan M Pajor, Emily Pfaff, Jeff Radwell, Hanieh Razzaghi, Susan Redline, Elle Seibert, Anisha Sekar, Suchetha Sharma, Tanayott Thaweethai, Mark G Weiner, Yun Jae Yoo, Andrea Zhou, Lorna E Thorpe
Researchers wanted to see if patients who had difficulty breathing while sleeping (Obstructive Sleep Apnea; OSA) were at higher risk for developing Long COVID compared to people without OSA. By comparing the electronic health record (EHR) data of COVID positive patients, researchers looked at the risk of developing Long COVID in patients with and without a previous diagnosis of OSA.
Researchers found that adults with a previous diagnosis of OSA had an increased chance of developing Long COVID when compared to patients that did not have a previous diagnosis of OSA.
Abstract: As clinical understanding of pediatric Post-Acute Sequelae of SARS CoV-2 (PASC) develops, and hence the clinical definition evolves, it is desirable to have a method to reliably identify patients who are likely to have post-acute sequelae of SARS CoV-2 (PASC) in health systems data. In this study, we developed and validated a machine learning algorithm to classify which patients have PASC (distinguishing between Multisystem Inflammatory Syndrome in Children (MIS-C) and non-MIS-C variants) from… Continue reading
Authors: Vitaly Lorman, Hanieh Razzaghi, Xing Song, Keith Morse, Levon Utidjian, Andrea J Allen, Suchitra Rao, Colin Rogerson, Tellen D Bennett, Hiroki Morizono, Daniel Eckrich, Ravi Jhaveri, Yungui Huang, Daksha Ranade, Nathan Pajor, Grace M Lee, Christopher B Forrest, L Charles Bailey
Abstract: Inflammation can trigger lasting phenotypes in immune and non-immune cells. Whether and how human infections and associated inflammation can form innate immune memory in hematopoietic stem and progenitor cells (HSPC) has remained unclear. We found that circulating HSPC, enriched from peripheral blood, captured the diversity of bone marrow HSPC, enabling investigation of their epigenomic reprogramming following coronavirus disease 2019 (COVID-19). Alterations in innate immune phenotypes and… Continue reading
Authors: Jin-Gyu Cheong, Arjun Ravishankar, Siddhartha Sharma, Christopher N Parkhurst, Simon A Grassmann, Claire K Wingert, Paoline Laurent, Sai Ma, Lucinda Paddock, Isabella C Miranda, Emin Onur Karakaslar, Djamel Nehar-Belaid, Asa Thibodeau, Michael J Bale, Vinay K Kartha, Jim K Yee, Minh Y Mays, Chenyang Jiang, Andrew W Daman, Alexia Martinez de Paz, Dughan Ahimovic, Victor Ramos, Alexander Lercher, Erik Nielsen, Sergio Alvarez-Mulett, Ling Zheng, Andrew Earl, Alisha Yallowitz, Lexi Robbins, Elyse LaFond, Karissa L Weidman, Sabrina Racine-Brzostek, He S Yang, David R Price, Louise Leyre, André F Rendeiro, Hiranmayi Ravichandran, Junbum Kim, Alain C Borczuk, Charles M Rice, R Brad Jones, Edward J Schenck, Robert J Kaner, Amy Chadburn, Zhen Zhao, Virginia Pascual, Olivier Elemento, Robert E Schwartz, Jason D Buenrostro, Rachel E Niec, Franck J Barrat, Lindsay Lief, Joseph C Sun, Duygu Ucar, Steven Z Josefowicz
Abstract: Data supporting dementia as a risk factor for coronavirus disease 2019 (COVID-19) mortality relied on ICD-10 codes, yet nearly 40% of individuals with probable dementia lack a formal diagnosis. Dementia coding is not well established for people with HIV (PWH), and its reliance may affect risk assessment.
Authors: Douglas R Wilcox, Emily A Rudmann, Elissa Ye, Ayush Noori, Colin Magdamo, Aayushee Jain, Haitham Alabsi, Brody Foy, Virginia A Triant, Gregory K Robbins, M Brandon Westover, Sudeshna Das, Shibani S Mukerji
Abstract: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.
Authors: Tanayott Thaweethai, Sarah E Jolley, Elizabeth W Karlson, Emily B Levitan, Bruce Levy, Grace A McComsey, Lisa McCorkell, Girish N Nadkarni, Sairam Parthasarathy, Upinder Singh, Tiffany A Walker, Caitlin A Selvaggi, Daniel J Shinnick, Carolin C M Schulte, Rachel Atchley-Challenner, George A Alba, Radica Alicic, Natasha Altman, Khamal Anglin, Urania Argueta, Hassan Ashktorab, Gaston Baslet, Ingrid V Bassett, Lucinda Bateman, Brahmchetna Bedi, Shamik Bhattacharyya, Marie-Abele Bind, Andra L Blomkalns, Hector Bonilla, Patricia A Bush, Mario Castro, James Chan, Alexander W Charney, Peter Chen, Lori B Chibnik, Helen Y Chu, Rebecca G Clifton, Maged M Costantine, Sushma K Cribbs, Sylvia I Davila Nieves, Steven G Deeks, Alexandria Duven, Ivette F Emery, Nathan Erdmann, Kristine M Erlandson, Kacey C Ernst, Rachael Farah-Abraham, Cheryl E Farner, Elen M Feuerriegel, Judes Fleurimont, Vivian Fonseca, Nicholas Franko, Vivian Gainer, Jennifer C Gander, Edward M Gardner, Linda N Geng, Kelly S Gibson, Minjoung Go, Jason D Goldman, Halle Grebe, Frank L Greenway, Mounira Habli, John Hafner, Jenny E Han, Keith A Hanson, James Heath, Carla Hernandez, Rachel Hess, Sally L Hodder, Matthew K Hoffman, Susan E Hoover, Beatrice Huang, Brenna L Hughes, Prasanna Jagannathan, Janice John, Michael R Jordan, Stuart D Katz, Elizabeth S Kaufman, John D Kelly, Sara W Kelly, Megan M Kemp, John P Kirwan, Jonathan D Klein, Kenneth S Knox, Jerry A Krishnan, Andre Kumar, Adeyinka O Laiyemo, Allison A Lambert, Margaret Lanca, Joyce K Lee-Iannotti, Brian P Logarbo, Michele T Longo, Carlos A Luciano, Karen Lutrick, Jason H Maley, Jai G Marathe, Vincent Marconi, Gailen D Marshall, Christopher F Martin, Yuri Matusov, Alem Mehari, Hector Mendez-Figueroa, Robin Mermelstein, Torri D Metz, Richard Morse, Jarrod Mosier, Christian Mouchati, Janet Mullington, Shawn N Murphy, Robert B Neuman, Janko Z Nikolich, Ighovwerha Ofotokun, Elizabeth Ojemakinde, Anna Palatnik, Kristy Palomares, Tanyalak Parimon, Samuel Parry, Jan E Patterson, Thomas F Patterson, Rachel E Patzer, Michael J Peluso, Priscilla Pemu, Christian M Pettker, Beth A Plunkett, Kristen Pogreba-Brown, Athena Poppas, John G Quigley, Uma Reddy, Rebecca Reece, Harrison Reeder, W B Reeves, Eric M Reiman, Franz Rischard, Jonathan Rosand, Dwight J Rouse, Adam Ruff, George Saade, Grecio J Sandoval, Shannon M Schlater, Fitzgerald Shepherd, Zaki A Sherif, Hyagriv Simhan, Nora G Singer, Daniel W Skupski, Amber Sowles, Jeffrey A Sparks, Fatima I Sukhera, Barbara S Taylor, Larissa Teunis, Robert J Thomas, John M Thorp, Paul Thuluvath, Amberly Ticotsky, Alan T Tita, Katherine R Tuttle, Alfredo E Urdaneta, Daisy Valdivieso, Timothy M VanWagoner, Andrew Vasey, Monica Verduzco-Gutierrez, Zachary S Wallace, Honorine D Ward, David E Warren, Steven J Weiner, Shelley Welch, Sidney W Whiteheart, Zanthia Wiley, Juan P Wisnivesky, Lynn M Yee, Sokratis Zisis, Leora I Horwitz, Andrea S Foulkes,
RECOVER researchers used data from the RECOVER observational cohort study in adults ages 18 and over. They compared symptoms reported in surveys by participants who did and did not have COVID.
Researchers found 37 symptoms that participants who had COVID reported more often after having COVID compared to participants who never had COVID. 12 of these symptoms could identify participants with Long COVID, including feeling tired and unwell after activity, feeling weak and tired (fatigue), and brain fog. A definition of Long COVID based on symptoms is important for future research, including to find treatments.