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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.

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53 Results

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EHR Adult
Pfaff, ER; Girvin, AT; Crosskey, M; et. al., Journal of American Medical Informatics Association
Published:
Journal: Journal of American Medical Informatics Association
Abstract: Machine learning (ML)-driven computable phenotypes are among the most challenging to share and reproduce. Despite this difficulty, the urgent public health considerations around Long COVID make it especially important to ensure the rigor and reproducibility of Long COVID phenotyping algorithms such that they can be made available to a broad audience of researchers. As part of the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, researchers with the National COVID Cohort… Continue reading
Authors: Emily R Pfaff, Andrew T Girvin, Miles Crosskey, Srushti Gangireddy, Hiral Master, Wei-Qi Wei, V Eric Kerchberger, Mark Weiner, Paul A Harris, Melissa Basford, Chris Lunt, Christopher G Chute, Richard A Moffitt, Melissa Haendel, N3C and RECOVER Consortia
Keywords: Not available
EHR Adult
Brannock, MD; Chew, RF; Preiss, AJ; et. al., Nature Communications
Published:
Journal: Nature Communications
Abstract: Long COVID, or complications arising from COVID-19 weeks after infection, has become a central concern for public health experts. The United States National Institutes of Health founded the RECOVER initiative to better understand long COVID. We used electronic health records available through the National COVID Cohort Collaborative to characterize the association between SARS-CoV-2 vaccination and long COVID diagnosis. Among patients with a COVID-19 infection between August 1, 2021 and January… Continue reading
Authors: M Daniel Brannock, Robert F Chew, Alexander J Preiss, Emily C Hadley, Signe Redfield, Julie A McMurry, Peter J Leese, Andrew T Girvin, Miles Crosskey, Andrea G Zhou, Richard A Moffitt, Michele Jonsson Funk, Emily R Pfaff, Melissa A Haendel, Christopher G Chute, N3C, RECOVER Consortia
Keywords: United States/epidemiology; Humans; Post-Acute COVID-19 Syndrome; COVID-19/epidemiology/prevention & control; COVID-19 Vaccines; Cohort Studies; SARS-CoV-2; Vaccination
EHR Adult
Summary
Khullar, D; Zhang, Y; Zang, C; et. al., Journal of General Internal Medicine
Published:
Journal: Journal of General Internal Medicine
Abstract: Compared to white individuals, Black and Hispanic individuals have higher rates of COVID-19 hospitalization and death. Less is known about racial/ethnic differences in post-acute sequelae of SARS-CoV-2 infection (PASC). Examine racial/ethnic differences in potential PASC symptoms and conditions among hospitalized and non-hospitalized COVID-19 patients. Retrospective cohort study using data from electronic health records. 62,339 patients with COVID-19 and 247,881 patients without COVID-19 in New… Continue reading
Authors: Dhruv Khullar, Yongkang Zhang, Chengxi Zang, Zhenxing Xu, Fei Wang, Mark G Weiner, Thomas W Carton, Russell L Rothman, Jason P Block, Rainu Kaushal
Keywords: Humans; COVID-19/complications; Ethnicity; Cohort Studies; Post-Acute COVID-19 Syndrome; SARS-CoV-2; Retrospective Studies; COVID-19 Testing; Minority Groups; New York City/epidemiology; Headache/diagnosis/epidemiology; Brain Diseases
Short Summary

RECOVER researchers wanted to learn more about racial and ethnic differences in Long COVID. Researchers used patients’ electronic health records (EHRs) to compare people who had COVID based on their race or ethnicity, whether they were hospitalized due to COVID, and whether they had any health problems related to Long COVID. They looked at data from over 60,000 adults from 5 healthcare systems.

The researchers found that Black and Hispanic adults were more likely to have symptoms of Long COVID compared to White adults – this was true for adults who were and were not hospitalized. The reason for these differences is unclear.

EHR Pediatric
Summary
Lorman, V; Rao, S; Jhaveri, R; et. al., JAMIA Open
Published:
Journal: JAMIA Open
Abstract: Post-acute sequalae of SARS-CoV-2 infection (PASC) is not well defined in pediatrics given its heterogeneity of presentation and severity in this population. The aim of this study is to use novel methods that rely on data mining approaches rather than clinical experience to detect conditions and symptoms associated with pediatric PASC. We used a propensity-matched cohort design comparing children identified using the new PASC ICD10CM diagnosis code (U09.9) ( = 1309) to children with ( = 6545)… Continue reading
Authors: Vitaly Lorman, Suchitra Rao, Ravi Jhaveri, Abigail Case, Asuncion Mejias, Nathan M Pajor, Payal Patel, Deepika Thacker, Seuli Bose-Brill, Jason Block, Patrick C Hanley, Priya Prahalad, Yong Chen, Christopher B Forrest, L Charles Bailey, Grace M Lee, Hanieh Razzaghi
Keywords: Not available
Short Summary

RECOVER researchers wanted to identify conditions and symptoms associated with Long COVID in children (also known as pediatric Long COVID). The researchers analyzed electronic health record (EHR) data to detect conditions and symptoms associated with pediatric Long COVID. The study identified multiple conditions and body systems associated with pediatric Long COVID related to many different organs, such as heart and lung problems. 

This research is important because these findings use a data-driven approach to detect several new or under-reported conditions and symptoms that should be studied further. Researchers believe that further study may reveal the biological processes that cause these Long COVID symptoms and conditions.

EHR Pediatric
Summary
Jhaveri, R; Webb, R; Razzaghi, H; et. al., Journal of the Pediatric Infectious Disease Society
Published:
Journal: Journal of the Pediatric Infectious Disease Society
Abstract: Using electronic health record data combined with primary chart review, we identified seven children across nine participant pediatric medical centers with a diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) managed exclusively as outpatients. These findings should raise awareness of mild presentations of MIS-C and the option of outpatient management.
Authors: Ravi Jhaveri, Ryan Webb, Hanieh Razzaghi, Julia Schuchard, Asuncion Mejias, Tellen D Bennett, Pei-Ni Jone, Deepika Thacker, Grant S Schulert, Colin Rogerson, Jonathan D Cogen, L Charles Bailey, Christopher B Forrest, Grace M Lee, Suchitra Rao, RECOVER consortium
Keywords: Humans; Child; Outpatients; Cohort Studies; Systemic Inflammatory Response Syndrome/diagnosis/therapy; COVID-19
Short Summary

RECOVER researchers explored Multisystem Inflammatory Syndrome in Children (MIS-C), a Long COVID symptom where there is inflammation (swelling) of multiple organ systems. Researchers looked to see if MIS-C can be identified and managed in the home (outpatient) instead of in the hospital (inpatient). 

An organ system is a collection of organs in your body dedicated to maintaining necessary functions. For example, your heart, arteries, and veins make up the Cardiovascular System--the system responsible for maintaining blood flow and delivering oxygen throughout the body.

Researchers were able to identify that in some patients, their MIS-C symptoms were mild enough to be treated at home and not require hospitalization. These results raise awareness that MIS-C can present in milder forms with the option to treat it at home if directed by a physician.

EHR Adult
Summary
Zang, C; Zhang, Y; Xu, J; et. al., Nature Communications
Published:
Journal: Nature Communications
Abstract: Recent studies have investigated post-acute sequelae of SARS-CoV-2 infection (PASC, or long COVID) using real-world patient data such as electronic health records (EHR). Prior studies have typically been conducted on patient cohorts with specific patient populations which makes their generalizability unclear. This study aims to characterize PASC using the EHR data warehouses from two large Patient-Centered Clinical Research Networks (PCORnet), INSIGHT and OneFlorida+, which include 11 million… Continue reading
Authors: Chengxi Zang, Yongkang Zhang, Jie Xu, Jiang Bian, Dmitry Morozyuk, Edward J Schenck, Dhruv Khullar, Anna S Nordvig, Elizabeth A Shenkman, Russell L Rothman, Jason P Block, Kristin Lyman, Mark G Weiner, Thomas W Carton, Fei Wang, Rainu Kaushal
Keywords: Humans; Post-Acute COVID-19 Syndrome; COVID-19/epidemiology; Electronic Health Records; SARS-CoV-2; Propensity Score
Short Summary

RECOVER researchers analyzed electronic health records (EHR) in order to define Long COVID. Researchers found up to 25 different symptoms that patients who had COVID were more likely to have than those who didn’t have COVID. The symptoms were related to many different organs, such as memory loss, hair loss, and feeling tired. They found that certain types of Long COVID symptoms were more likely to happen in patients who were older, had more severe COVID, or had more health problems before they had COVID.  

This research is important because the findings show that Long COVID affects many organs, and types of Long COVID symptoms differ between certain groups of patients. However, EHR findings are limited in that they can only look at data from the patients' past. In order to confirm these findings, future studies that follow patients' symptoms over time, into the future, are needed. 

EHR Adult
Summary
Zhang, Y; Hu, H; Fokaidis, V; et. al., Environmental Advances
Published:
Journal: Environmental Advances
Abstract: Post-acute sequelae of SARS-CoV-2 infection (PASC) affects a wide range of organ systems among a large proportion of patients with SARS-CoV-2 infection. Although studies have identified a broad set of patient-level risk factors for PASC, little is known about the association between "exposome"-the totality of environmental exposures and the risk of PASC. Using electronic health data of patients with COVID-19 from two large clinical research networks in New York City and Florida, we… Continue reading
Authors: Yongkang Zhang, Hui Hu, Vasilios Fokaidis, Colby Lewis V, Jie Xu, Chengxi Zang, Zhenxing Xu, Fei Wang, Michael Koropsak, Jiang Bian, Jaclyn Hall, Russell L Rothman, Elizabeth A Shenkman, Wei-Qi Wei, Mark G Weiner, Thomas W Carton, Rainu Kaushal
Keywords: Not available
Short Summary

RECOVER researchers wanted to find environmental risk factors of Long COVID by comparing the environment of people who had Long COVID to people who didn’t have Long COVID. Environmental risk factors are things about where a person lives that raise their chance of having a health condition, such as air pollution and poor housing conditions. The researchers looked at data from electronic health records (EHRs) of more than 100,000 people in the New York City area and Florida.  

The researchers found that people who lived in areas with higher levels of air pollution, more poverty, and less access to healthy food had a higher chance of getting Long COVID. People in the New York City area had different environmental risk factors than people in Florida. 

Review Adult
Summary
Bonilla, H; Peluso, MJ; Rodgers, K; et. al., Frontiers in Immunology
Published:
Journal: Frontiers in Immunology
Abstract: Although most individuals recover from acute SARS-CoV-2 infection, a significant number continue to suffer from Post-Acute Sequelae of SARS-CoV-2 (PASC), including the unexplained symptoms that are frequently referred to as long COVID, which could last for weeks, months, or even years after the acute phase of illness. The National Institutes of Health is currently funding large multi-center research programs as part of its Researching COVID to Enhance Recover (RECOVER) initiative to understand… Continue reading
Authors: Hector Bonilla, Michael J Peluso, Kathleen Rodgers, Judith A Aberg, Thomas F Patterson, Robert Tamburro, Lawrence Baizer, Jason D Goldman, Nadine Rouphael, Amelia Deitchman, Jeffrey Fine, Paul Fontelo, Arthur Y Kim, Gwendolyn Shaw, Jeran Stratford, Patricia Ceger, Maged M Costantine, Liza Fisher, Lisa O'Brien, Christine Maughan, John G Quigley, Vilma Gabbay, Sindhu Mohandas, David Williams, Grace A McComsey
Keywords: United States; Humans; COVID-19; SARS-CoV-2; Post-Acute COVID-19 Syndrome; Virus Diseases; Motivation
Short Summary

RECOVER researchers reviewed ongoing, planned, and potential future treatment options for Long COVID, based on our current understanding of the biological causes of Long COVID symptoms and conditions. The purpose of this study is to help guide future research by summarizing the current state of the science as a call for urgent and efficient research to help the millions who continue to suffer from Long COVID around the world.

Researchers identified a number of studies that attempted to treat the various symptoms and conditions of Long COVID that may be useful to consider or incorporate when designing a larger research project aimed at treating the underlying biological cause of those symptoms and conditions.

EHR Adult
Reddy, NV; Yeh, HC; Tronieri, JS; et. al., Journal of Clinical and Translational Science
Published:
Journal: Journal of Clinical and Translational Science
Abstract: Long-term sequelae of severe acute respiratory coronavirus-2 (SARS-CoV-2) infection may include increased incidence of diabetes. Here we describe the temporal relationship between new type 2 diabetes and SARS-CoV-2 infection in a nationwide database. We found that while the proportion of newly diagnosed type 2 diabetes increased during the acute period of SARS-CoV-2 infection, the mean proportion of new diabetes cases in the 6 months post-infection was about 83% lower than the 6 months… Continue reading
Authors: Neha V Reddy, Hsin-Chieh Yeh, Jena S Tronieri, Til Stürmer, John B Buse, Jane E Reusch, Steven G Johnson, Rachel Wong, Richard Moffitt, Kenneth J Wilkins, Jeremy Harper, Carolyn T Bramante, N3C and RECOVER Consortiums
Keywords: Not available
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