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Sharing our progress toward recovery

Research Summaries

Discover what the latest science from the RECOVER Initiative means for our ability to understand, diagnose, prevent, and treat Long COVID.

This page contains descriptions of findings from RECOVER research studies. These descriptions use plain language and a format that is easy to understand.

If you want to learn more about the scientific discoveries described here, you can also browse and search the complete list of RECOVER Publications.

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Short Summary
EHR Adult Pediatric Broad Symptoms Risk Factors

Mandel, H; Yoo, YJ; Allen, AJ; et al., Clinical Infectious Diseases

This RECOVER study looked at how common Long COVID is in adults and children across the US. Researchers compared people who had COVID-19 to those who didn’t. They used data from 3 nationwide research networks that collect electronic health records (EHRs). Since there is no single definition for Long COVID yet, each network created its own working definition. These were based on earlier studies and symptoms that are commonly seen in people with Long COVID. Researchers then checked how many people had those symptoms between 1 and 6 months after having COVID-19. Findings were generally similar across the 3 networks. They found that about 4 out of every 100 children, and between 10 and 26 out of every 100 adults, developed Long COVID, depending on the definition of Long COVID used. The rates of Long COVID also changed over time, likely linked to new versions of the virus. Understanding how common Long COVID is and how this changes over time can help researchers learn who is most likely to get Long COVID.

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Observational Pediatric Broad Symptoms Risk Factors

Gross, RS; Thaweethai, T; Salisbury, AL; et al., JAMA Pediatrics

This paper builds on an earlier RECOVER study about Long COVID symptoms in school-age children (ages 6 to 11 years old) and teenagers (ages 12 to 17 years old). In this study, RECOVER researchers focused on two younger age groups that they did not study before, including infants and toddlers (ages 0 to 2 years old) and preschool-age children (ages 3 to 5 years old). The study compared symptoms in children who had COVID-19 in the past with those who never had it. Researchers created new tools to help figure out which young children were most likely to have Long COVID based on their age group and symptom patterns. The symptoms that were most likely to be signs of Long COVID in infants and toddlers were poor appetite for a long period of time, trouble sleeping, coughing, and stuffy nose. For preschool-age children, the most likely signs were daytime tiredness, sleepiness or low energy, and coughing. Children with these symptoms often had worse overall health, lower quality of life, and delays in development. The tools from this study can be used in future studies to better understand Long COVID in young children and develop ways to care for them. This study is important because it shows that Long COVID symptoms in young children are different from those in older children and adults.

Short Summary
Observational Adult Broad Symptoms

Kulik (née Ditzenberger), GL; Zheng, T; Jolley, SE; et al., Physical Therapy

This RECOVER study looked at how COVID-19 can impact people’s physical abilities. Researchers looked at 3 groups of adults in the RECOVER study: people who never had COVID-19, people who had COVID-19 in the last 3 months, and people who had COVID-19 more than 3 months ago. They wanted to know if people who had COVID-19 were more likely to have trouble with daily activities like walking, climbing stairs, or getting in and out of a chair compared to those who never had COVID-19. To measure physical ability, participants were asked to sit in a chair and stand up as many times as they could in 30 seconds. This study didn't find big differences in physical abilities between the groups, but those who had severe COVID-19 and long-lasting symptoms faced more challenges. This study is important because the findings show that COVID-19 may have long-term impacts on physical function.

Short Summary
EHR Adult Broad Symptoms New-onset and Pre-existing Conditions

Powers, JP; McIntee, TJ; Bhatia, A; et al., Communications Medicine

This RECOVER study looked at the similarities and differences between Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in electronic health records (EHRs). Both illnesses can make people feel exhausted for long periods of time. Researchers studied the EHRs of 6.5 million adults and found some similarities between people who had diagnoses of either Long COVID or ME/CFS. Problems like trouble breathing, feeling very tired, and difficulty focusing were seen in the EHRs of both people with Long COVID diagnoses and those with ME/CFS diagnoses. But there were also some differences. People with a diagnosis of Long COVID were more likely to have problems with their heart and lungs in their EHRs. People with a diagnosis of ME/CFS were more likely to have pain, trouble sleeping, and problems with mood or thinking in their EHRs. Researchers looked at the symptoms listed in people’s EHRs, regardless of diagnosis. They found that about half the people with symptoms that looked like Long COVID also had symptoms that looked like ME/CFS. This research is important because Long COVID and ME/CFS can look similar. That means people with either illness may benefit from some of the same treatments.

Short Summary
EHR Pediatric Broad Symptoms

Lorman, V; Bailey, LC; Song, X; et al., PLOS Digital Health

This RECOVER study aimed to better understand how Long COVID affects kids in different ways. Researchers looked at the electronic health records (EHRs) of pediatric patients under the age of 21 who had signs of Long COVID. The study focused on children who were generally healthy and did not have serious long-term health problems before they got sick with COVID-19. Researchers used a special computer method to look for patterns of symptoms in children’s EHRs. This helped them find groups of kids who had similar health problems after having COVID-19, meaning that they had similar experiences with Long COVID. They found that more than half of the children in the study had heart, lung, and breathing problems related to Long COVID. Other common symptoms included muscle and joint pain, mood and thinking problems, stomach issues, headaches, and feeling tired. These findings give researchers a clearer picture of how Long COVID shows up in kids, which can guide future studies.

Short Summary
EHR Pregnant Women Risk Factors

Zang, C; Guth, D; Bruno, AM; et al., Nature Communications

This RECOVER study looked at whether pregnancy made it more or less likely to get Long COVID. Researchers compared the electronic health records (EHRs) of pregnant women who had COVID-19 during pregnancy to those of non-pregnant women of the same age who also had COVID-19. They found that even though many pregnant women got Long COVID, they were less likely to get it than non-pregnant women their age who had COVID-19. But, certain risk factors increased the chances of Long COVID among pregnant women. These included identifying as Black, being age 35 or older, having COVID-19 earlier in pregnancy, being overweight, and having other health conditions. This study shows that even though many pregnant women have Long COVID, they are less likely to get it than women who are not pregnant.

Video
Observational Adult Broad Symptoms New-onset and Pre-existing Conditions

Vernon, SD; Zheng, T; Do, H; et al., Journal of General Internal Medicine

This RECOVER study found that adults who had COVID-19 were more likely to develop a condition called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) compared to those who didn’t have COVID-19. ME/CFS can be very severe and similar to many forms of Long COVID. Even small amounts of effort can lead to days or weeks of physical and mental exhaustion in people with ME/CFS. Researchers studied about 13,000 RECOVER participants and found that 4.5% of people who had COVID-19 in the study later developed ME/CFS, while only 0.6% of those who didn't have COVID-19 got ME/CFS. These findings highlight the need for healthcare professionals to be aware that ME/CFS can develop after having COVID-19.

Short Summary
EHR Review Adult Pediatric Pregnant Women

Mandel, HL; Shah, SN; Bailey, LC; et al., Journal of Medical Internet Research

This RECOVER report looked at how using electronic health records (EHRs) to study Long COVID can be both helpful and challenging. EHRs are digital records with a patient’s health information. One good thing about using EHRs is that researchers can use computer programs to find people who might have Long COVID based on their symptoms. This can help researchers figure out what might increase the risk of getting Long COVID, like age and other health problems. EHRs also provide quick access to health records from many patients, which speeds up Long COVID research. A main problem with studying EHRs is that the information in them is not always complete or consistent because different medical providers enter it in different ways. This makes it harder for researchers to find patterns or other details they need to better understand Long COVID. Even with these challenges, the researchers explain that looking at EHRs can still help us better understand Long COVID and improve the lives of people with Long COVID.

Short Summary
EHR Pediatric Broad Symptoms

Zhang, D; Stein, R; Lu, Y; et al.; Researching COVID to Enhance Recovery (RECOVER) Initiative, JAMA Network Open

This RECOVER study looked at whether children and teens who had COVID-19 were more likely to have stomach problems later. To do this, researchers compared electronic health record (EHR) data from over 1.5 million US children and teens who had COVID-19 with those who didn’t. The study found that kids who had COVID-19 were 25% more likely to have stomach issues, like belly pain, even after recovering from COVID-19. Specifically, 8.64% of kids who had COVID-19 experienced new stomach problems within a few months of having COVID-19 while only 6.85% of kids who didn’t have COVID-19 had stomach problems. This was true not only a few months after getting COVID-19 but also up to 2 years later. Doctors should be aware that kids who had COVID-19 might have more stomach problems. Knowing this can help doctors check for symptoms early and provide the right care.

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