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Working together to improve recovery

RECOVER Research Components

The RECOVER Initiative is a first-of-its-kind, patient-centered research initiative to understand, diagnose, prevent, and treat Long COVID.

Observational cohort studies, electronic health record (EHR) studies, pathobiology studies, and clinical trials form the core of RECOVER’s research. Each type of study uses a standardized research protocol (or study plan) so that RECOVER researchers can combine data from different research networks and locations.

Autopsy and Tissue Pathology Studies

RECOVER researchers do autopsies and tissue pathology studies of people who have died after having COVID-19. This includes people who did and did not have Long COVID. By doing these studies, researchers learn how and why Long COVID affects different parts of the body.

What is an autopsy?

An autopsy is a medical exam of a body after death. When RECOVER researchers do an autopsy, they carefully and respectfully look at the outside of the body to find any signs of health problems. They also do surgery to look at the inside of the body, like bones and organs. They also take small amounts of blood and tissue (called biosamples).

What is tissue pathology?

Tissue pathology is the study of tissue samples to learn how a disease affects different parts of the body. After taking tissue samples during an autopsy, RECOVER researchers use various tests to:

  • Understand how Long COVID damages different parts of the body
  • Learn why some people may be more likely to get Long COVID
  • Inform future efforts to prevent and treat Long COVID

Clinical Trials

RECOVER research findings are helping us understand who is at risk for Long COVID and how its symptoms can affect people’s health. Based on what they’ve learned so far, RECOVER researchers are conducting clinical trials. RECOVER clinical trials may help find ways to treat Long COVID symptoms.

In clinical trials, study participants take a drug, use a medical device, or try other therapies (called interventions) to see if these drugs, devices, or interventions improve their health.

What do the RECOVER clinical trials study?

RECOVER clinical trials study possible causes of Long COVID and possible treatments for Long COVID symptoms. The RECOVER team has developed a set of clinical trials based on what researchers are learning from RECOVER studies and conversations with people living with Long COVID. RECOVER clinical trials are studying multiple treatments across 5 focus areas:

  • Autonomic Dysfunction: Dizziness, fast heart rate, shortness of breath, upset stomach, or other changes in body functions that happen automatically
  • Cognitive Dysfunction: “Brain fog,” trouble thinking clearly, memory changes, slowed attention, and other symptoms related to brain function
  • Exercise Intolerance and Fatigue: Exhaustion or low energy that interferes with daily activities
  • Sleep Disturbances: Changes in sleep patterns or the ability to sleep
  • Viral Persistence: When the virus that causes COVID stays in the body and damages organs or affects the immune system

Learn more about current and upcoming RECOVER clinical trials.

Electronic Health Records

RECOVER researchers use real-world data from large groups of people to better understand the effects of Long COVID. One type of real-world data RECOVER researchers use are electronic health records (EHRs).

What are EHRs?

EHRs are digital versions of patients’ medical records. Each time a person gets healthcare, their doctor and other providers enter information into their EHR. A patient’s EHR typically includes their:

  • Demographic information, such as age, gender, and race
  • Current and past health problems and symptoms
  • Test results
  • Medicines and treatments

RECOVER follows strict data privacy rules to protect personal health information.

Where does RECOVER get EHRs and other health data?

RECOVER obtains EHRs from three large national healthcare networks within the United States. These networks contain more than 60 million patients’ EHRs, including more than 7 million people who’ve had COVID. RECOVER is also working with the National Institutes of Health’s (NIH) All of Us Research Program, which also has many health records. Together, these collections make up one of the largest sets of EHRs in the world.

Where can I learn more about EHR study findings?

RECOVER researchers are publishing EHR study results in scientific journals to share their findings with others. View easy-to-understand summaries of RECOVER’s EHR research.

Longitudinal Observational Cohort Studies

RECOVER researchers are studying large groups of people (called cohorts) over several years. Studying these cohorts will help us better understand:

  • Who gets Long COVID
  • Why people get Long COVID
  • What Long COVID symptoms people have
  • How Long COVID affects people’s health over time

These studies do not give treatments or medicines to participants or change their regular healthcare. Study participants keep living their lives as usual and share health information with researchers.

Who can participate in the observational cohort studies?

People of all ages take part in RECOVER observational studies. People also take part whether they’ve had COVID or not.

RECOVER researchers are studying two main cohorts:

  • Adults aged 26 and older, including pregnant people
  • Children and young adults aged 25 and younger

Learn more about RECOVER observational cohort studies.

What is the Collaborative Cohort of Cohorts for COVID-19 Research Initiative (C4R)?

The National Institutes of Health (NIH) supports many other observational studies of people with chronic (long-term) health conditions such as heart or lung diseases. Through a special project called the Collaborative Cohort of Cohorts for COVID-19 Research Initiative (C4R), RECOVER researchers are working with several of these studies to identify people who have had Long COVID. Because these studies started before the COVID pandemic, they can provide more information on how Long COVID develops and how it may affect chronic health conditions like diabetes, heart, or lung disease. Learn more about this special collaborative effort.

Where can I learn more about observational cohort study findings?

View easy-to-understand summaries of RECOVER observational cohort research.

Pathobiology Studies

RECOVER researchers collect biosamples from people with and without Long COVID to conduct pathobiology studies. The samples include blood, spit, stool (poop), urine (pee) or nose fluid.

Pathobiology studies can help researchers understand:

  • What happens in the body to cause Long COVID
  • Why some people get Long COVID while others don’t
  • Which treatments might work well

To date, RECOVER has funded more than 40 different pathobiology studies to understand how the virus that causes COVID affects the body and can lead to Long COVID. View the list of RECOVER pathobiology awards.

What are pathobiology studies?

During a pathobiology study, researchers look for biomarkers. A biomarker is any measurable sign, like an unusual blood test result, that can show someone has a health condition or is likely to develop a health condition. Doctors and scientists also use biomarkers to assess how well treatment works.

Whose samples are part of RECOVER pathobiology studies?

RECOVER-funded pathobiology studies use data and samples from several different sources. Researchers are also comparing the findings from pathobiology studies with the results of other RECOVER research, like EHR studies and tissue pathology studies. Comparing findings from different RECOVER research components helps researchers more quickly find ways to understand, treat, and prevent Long COVID.

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