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.
Metformin is a drug that many doctors prescribe as treatment for type 2 diabetes mellitus (T2DM). Studies in the past have found that taking metformin before and during a COVID-19 infection helps lower the chances of getting very sick with COVID. These studies also found that taking metformin can lower the chance of a person being sick many months after getting COVID, which is called Long COVID. In this study, RECOVER researchers were interested in understanding if people with diabetes who were on different medications got Long COVID or died. They looked at electronic health records (EHRs), or computer-based versions of patient health records, for 88,342 adults with T2DM. The study looked at 2 groups. The first group used metformin to control their diabetes, while the second group used other medications to control their diabetes. The researchers found that the chances of getting Long COVID or dying were a little bit lower in the group that took metformin compared to the group taking other medications. Since being on metformin may help only a little bit with Long COVID for adults with T2DM, people taking diabetes medications do not need to change their treatment plans unless told by their doctor.
Many research centers have general formal guidelines about whether and how employees can participate in research studies. However, these guidelines don’t always discuss the risks and benefits of researchers, staff, and community partners enrolling in studies they are involved in, which can create ethical questions. It is very important to consider these ethical questions for studies that aim to enroll large numbers of diverse participants.
All authors of this article are part of the Researching COVID to Enhance Recovery (RECOVER) Initiative, a large study enrolling participants at multiple locations across the country. They used what they learned from RECOVER to address what’s currently missing from existing policy and ethics papers by creating a set of guidelines for how research studies can enroll researchers, staff, and community partners. The authors conclude that people should not be excluded from participating in their own research studies if certain requirements are met and there are rules to ensure everyone’s safety.
The RECOVER Initiative did a study to see how often pregnant women get Long COVID. The study looked at 1,502 pregnant participants. Participants took surveys about Long COVID symptoms around 10 months after they first got COVID. About 9% of them reported having Long COVID symptoms. The most common symptoms participants had were feeling very tired, especially after physical or mental activity, or being tired all the time. Some participants had stomach and gut problems. RECOVER researchers also found that people were more likely to get Long COVID if they needed extra oxygen while sick with COVID; had trouble paying bills; or had other health problems before COVID, such as obesity, depression, or anxiety. Future research will focus on whether having COVID while pregnant changes the chance of developing Long COVID. Researchers will compare this to people who got COVID when they were not pregnant.
This RECOVER study is one of the first of its kind to look at Long COVID symptoms in children across age groups. Researchers for this study also developed a new research tool to help identify children who were most likely to have Long COVID. The study asked about prolonged or long-lasting symptoms in both school-age children (ages 6 to 11 years old) and teenagers (ages 12 to 17 years old) and compared these symptoms between those with and without a history of a COVID infection. The symptoms that were most likely to identify school-age children with Long COVID were trouble with memory or focusing, back or neck pain, stomach pain, headache, fears, refusing to go to school, skin rashes, trouble sleeping, nausea or vomiting, and lightheadedness or dizziness. The symptoms that were most likely to identify teenagers with Long COVID included change or loss of smell or taste, bone, muscle or joint pain, back or neck pain, feeling tired all day or after walking, having low energy, trouble with memory or focusing, headache, and lightheadedness or dizziness. These study findings show Long COVID symptoms can affect almost every organ system in the body. It also showed that while many of the symptoms between the two age groups were similar, there were differences. Understanding why these differences occur can help create future Long COVID treatments for children that are age-group specific. Read the Research Q&A
Little is known about Long COVID in pregnant women. This study looked at whether getting COVID while pregnant might increase the chances of getting Long COVID. Researchers from the RECOVER Patient-Centered Clinical Research Network (PCORnet) checked health records from 19 health systems across the US. They studied women ages 18–49 years old who had a test showing that they had a COVID infection between March 2020 and February 2022, and looked at 83,915 women who were not pregnant and 5,397 who were. Women who got COVID while pregnant were less likely to get Long COVID than those who weren’t pregnant. Pregnant women with COVID were more likely to develop certain conditions related to Long COVID, like an abnormal heartbeat. But they had a lower risk of getting other conditions, like malaise (feeling unwell). Overall, pregnant women with COVID had a lower chance of getting Long COVID in the 30 to 180 days after they first got sick.
The virus that causes COVID-19 can change over time, creating new virus types called variants. This study explored if problems related to Long COVID were different in people who were infected with different variants of COVID. Researchers looked at medical records from 2 databases in New York and Florida. They compared people who had the original type of COVID with those who had a variant called Delta, which was one of the main variants in 2021. The researchers found that some Long COVID conditions were more common in the people who had Delta. For example, some people infected with Delta developed clots in the blood vessels in their lungs. People who had Delta were also more likely to have stomach symptoms than people who were infected with the original type of COVID. Based on these findings, the researchers concluded that Long COVID symptoms can be different depending on which variant of COVID someone had.
A COVID-19 infection can lead to new symptoms or symptoms that do not go away. This condition is called Long COVID. RECOVER researchers are working to answer questions about Long COVID in children. To do this, they are studying over 15,000 children and their caregivers in the US to understand how common Long COVID is in children and their caregivers; how the body changes when someone has Long COVID; what makes some people more likely to develop Long COVID, such as where a person lives and their age, race, and sex; and what happens in the body that might cause Long COVID. This paper is important because it can show other scientists how to do their own research on Long COVID in children.
The researchers and study team running the RECOVER-NEURO clinical trial published a paper detailing the study’s design. RECOVER-NEURO is looking at 3 possible treatments for cognitive dysfunction, or brain fog, symptoms related to Long COVID. The possible treatments, also called study interventions, are BrainHQ (an interactive online brain training program), PASC-Cognitive Recovery (an online goal management training program), and transcranial direct current stimulation (a safe, noninvasive form of brain stimulation). The research team is using a variety of assessments, including brain function tests and participant surveys, to determine if these study interventions reduce brain fog symptoms and help people function better.
People with brain fog may have trouble thinking clearly, remembering things, or focusing on tasks, which can severely affect their daily functioning and quality of life. Results from this study will help the Long COVID community learn if BrainHQ, PASC-Cognitive Recovery, and transcranial direct current stimulation can be used to treat cognitive dysfunction symptoms related to Long COVID.
Doctors keep patient information in computer files called electronic health records (EHRs). RECOVER researchers can use these records to learn more about Long COVID, which is when someone feels sick for a long time after having COVID-19. But studying these records is not easy. It can be hard to get certain information from EHRs, when things that might explain why some people get Long COVID happen at different times. It can also be hard to put information from many hospitals together in one place and can cost a lot of money. In this study, RECOVER researchers made a new tool called ODACoR, which stands for “one-shot distributed algorithms for competing risks model.” This tool was used to look at the EHRs of 6.5 million kids and teens from 8 children’s hospitals. Researchers found that ODACoR was able to find information about things that could make children and teens more likely to get Long COVID. ODACoR could also combine information from different hospitals, which did not always work with old ways of studying health information. This tool gave the same results as if all the hospitals had shared all their information in one place, which is hard to do. This study is important because it can help doctors study other kinds of health problems using information from many hospitals.
