Long-COVID incidence proportion in adults and children between 2020 and 2024

View Publication on PubMed

Published

February 2025

Journal

Clinical Infectious Diseases

Abstract

Background: Incidence estimates of post-acute sequelae of SARS-CoV-2 infection, also known as long-COVID, have varied across studies and changed over time. We estimated long-COVID incidence among adult and pediatric populations in three nationwide research networks of electronic health records (EHR) participating in the RECOVER Initiative using different classification algorithms (computable phenotypes). Methods: This EHR-based retrospective cohort study included adult and pediatric patients with documented acute SARS-CoV-2 infection and two control groups-- contemporary COVID-19 negative and historical patients (2019). We examined the proportion of individuals identified as having symptoms or conditions consistent with probable long-COVID within 30-180 days after COVID-19 infection (incidence proportion). Each network (the National COVID Cohort Collaborative (N3C), National Patient-Centered Clinical Research Network (PCORnet), and PEDSnet) implemented its own long-COVID definition. We introduced a harmonized definition for adults in a supplementary analysis. Results: Overall, 4% of children and 10-26% of adults developed long-COVID, depending on computable phenotype used. Excess incidence among SARS-CoV-2 patients was 1.5% in children and ranged from 5-6% among adults, representing a lower-bound incidence estimation based on our control groups. Temporal patterns were consistent across networks, with peaks associated with introduction of new viral variants. Conclusion: Our findings indicate that preventing and mitigating long-COVID remains a public health priority. Examining temporal patterns and risk factors of long-COVID incidence informs our understanding of etiology and can improve prevention and management. 

Authors

Hannah Mandel, Yun J Yoo, Andrea J Allen, Sajjad Abedian, Zoe Verzani, Elizabeth W Karlson, Lawrence C Kleinman, Praveen C Mudumbi, Carlos R Oliveira, Jennifer A Muszynski, Rachel S Gross, Thomas W Carton, C Kim, Emily Taylor, Heekyong Park, Jasmin Divers, J Daniel Kelly, Jonathan Arnold, Carol Reynolds Geary, Chengxi Zang, Kelan G Tantisira, Kyung E Rhee, Michael Koropsak, Sindhu Mohandas, Andrew Vasey, Abu Saleh Mohammad Mosa, Melissa Haendel, Christopher G Chute, Shawn N Murphy, Lisa O'Brien, Jacqueline Szmuszkovicz, Nicholas Guthe, Jorge L Santana, Aliva De, Amanda L Bogie, Katia C Halabi, Lathika Mohanraj, Patricia A Kinser, Samuel E Packard, Katherine R Tuttle, Kathryn Hirabayashi, Rainu Kaushal, Emily Pfaff, Mark G Weiner, Lorna E Thorpe, Richard A Moffitt

Keywords

Not available