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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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62 Results

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Short Summary
Observational Adult

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 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 with those who didn’t. The study found that kids who had COVID were 25% more likely to have stomach issues, like belly pain, even after recovering from COVID. Specifically, 8.64% of kids who had COVID experienced new stomach problems within a few months of having COVID while only 6.85% of kids who didn’t have COVID had stomach problems. This was true not only a few months after getting COVID but also up to 2 years later. Doctors should be aware that kids who had COVID might have more stomach problems. Knowing this can help doctors check for symptoms early and provide the right care.

Short Summary
Review Adult

Walters, KM; Clark, M; Dard, S; et al.; N3C and RECOVER Consortia, Journal of the American Medical Informatics Association

In this RECOVER study, researchers aimed to improve a large national database on COVID-19 patients from many hospitals to better answer research questions about Long COVID. They noticed that the current database was missing the details needed to study Long COVID properly. To fix this, researchers created clear, step-by-step instructions to help hospitals add specific details from patients’ electronic health records (EHRs) to data they submitted to RECOVER. These extra details included notes on patient visits to Long COVID clinics, hospital stays, living situations, jobs, and if they needed extra oxygen while in the hospital. By June 2024, 29 hospitals had added this more complete information to the data they submitted to RECOVER. Having the hospitals submit data this way made it easier for researchers to compare patient information from different places. This study shows that using clear and standard ways to collect data are important for big research studies. It also shows that researchers sometimes need more details to study difficult research questions, like those about the long-term effects of COVID.

Short Summary
EHR Pediatric Health Disparities Risk Factors

Zhang, D; Zhang, B; Wu, Q; et al., Nature Communications

This RECOVER study looked at how a child’s race or ethnicity might affect their chances of developing long-term health problems after getting COVID-19. Researchers studied data from 225,723 children and teens across 13 US hospitals and clinics from March 2020 to October 2022. They compared children who were diagnosed with COVID or had a positive COVID test to those who never tested positive. The study found that children with COVID were more likely to develop many health problems weeks or months after getting COVID than those who never had it. These problems included trouble breathing, feeling very tired (fatigue), and mental health problems.

Researchers also found that the chance of having these problems was different depending on a child's race or ethnicity. For example, Hispanic children with severe COVID were more likely to have hair loss after getting sick than Non-Hispanic White children with severe cases. Non-Hispanic Black children with less severe COVID were more likely to experience cognitive symptoms (related to thinking, memory, or concentration) than Non-Hispanic White children with less severe COVID. In children with less severe COVID, Asian American/Pacific Islander children were more likely to have more fever, chills, and respiratory symptoms (related to breathing) than Non-Hispanic White children. This study shows that long-term health problems in children and teens after COVID may be different between racial and ethnic groups. This can help doctors better understand and treat Long COVID in people who are more likely to get it.

Video
Observational Adult Risk Factors Viral Variants

Shah, DP; Thaweethai, T; Karlson, EW; et al.; RECOVER Consortium, JAMA Network Open

A RECOVER study looked at whether a person’s sex at birth affects their risk of developing Long COVID. To do this, researchers studied a large group of people enrolled in the RECOVER adult cohort. They found that females were more likely to have Long COVID symptoms than males. Among females, the risk of getting Long COVID changed based on age, pregnancy status during a COVID infection, and if they had gone through menopause. Researchers discovered that the risk of getting Long COVID was higher in females ages 40–54 years and females who had not gone through menopause. On the other hand, females who had already gone through menopause were not at a higher risk compared to males. More research is needed to understand why differences in sex at birth may put someone at higher risk of experiencing the long-term effects of COVID. Knowing this and understanding which hormones play a role in Long COVID risk could help researchers develop treatments and ways to prevent Long COVID.

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

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

A new 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. 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 in the study later developed ME/CFS, while only 0.6% of those who didn't have COVID got ME/CFS. These findings highlight the need for healthcare professionals to be aware that ME/CFS can develop after a COVID infection.  

Short Summary
EHR Pediatric Vaccination

Wu, Q; Zhang, B; Tong, J; et al.; RECOVER Consortium, eClinicalMedicine

This RECOVER study looked at how well the Pfizer COVID-19 vaccine, called BNT162b2, protected children and teens from long-term health problems after having COVID-19, also known as Long COVID. Researchers studied the electronic health records (EHRs) from more than 385,000 children and adolescents across 13 hospitals and clinics during the Delta and Omicron waves. In the Delta wave, researchers studied the EHRs of 112,590 adolescents ages 12 to 20. Of these, 88,811 adolescents were vaccinated before getting COVID-19. In the Omicron wave, they studied the EHRs of 188,894 children ages 5 to 11 years old, and 84,735 adolescents ages 12 to 20. Of these, 101,277 children, and 37,724 adolescents were vaccinated before getting COVID-19. In the Delta period, the researchers found that vaccinated adolescents were 95% less likely to develop Long COVID. In the Omicron period, the vaccine lowered the risk of Long COVID by 60% in children and 75% in adolescents. The study also showed that the vaccine’s main benefit in preventing Long COVID in children and adolescents came from preventing them from getting COVID-19 in the first place.

Short Summary
Pathobiology Broad Symptoms

Swank, Z; Borberg, E; Chen, Y; et al.; RECOVER consortium authors, Clinical Microbiology and Infection

RECOVER researchers studied how COVID affects people over time. They wanted to know if parts of the SARS-CoV-2 virus (which causes COVID-19), called antigens, stay in people's blood long after a COVID infection. They also wanted to see if these antigens are linked to Long COVID. Long COVID is when a person has 1 or more symptoms that last for at least 3 months after getting COVID. First, the researchers took blood samples from adults who had COVID. These samples were taken a few days after getting sick and up to 14 months later. Then, they looked for 3 types of antigens that are usually in the blood after having COVID: the S1 subunit of the spike protein, the nucleocapsid protein, and the full-length spike protein. The full-length spike protein was the most common antigen found in adults who had COVID, especially in those who had blood taken between 4 and 7 months after getting COVID.

The study also looked at 34 common Long COVID symptoms, like trouble breathing, muscle pain, and brain fog. Many participants said that they had at least 1 Long COVID symptom for 1 month or more after getting sick. In the group with the most common kinds of symptoms, 2 out of 5 people had antigens in their blood. In the group without symptoms, about 1 out of 5 people had antigens in their blood. This study shows that the 3 antigens researchers found might be linked to Long COVID. People with symptoms were twice as likely to have these antigens in their blood for a long time. The results also show that parts of the SARS-CoV-2 virus can stay in the blood for up to 14 months after an infection. This is true for people who have long-term symptoms. But, it is also true in some people who do not have long-term symptoms.

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