Research Summaries

This RECOVER study looked at whether social determinants of health (SDOH) affect the risk of children developing Long COVID after having COVID-19. SDOH are the conditions in the places where people live, learn, work, and play that can affect health, such as safety or access to food, education, and healthcare. Researchers looked at survey data from more than 4,500 children. The surveys included questions about family income, access to food, school life, and how children are treated by others. The study found that children whose families struggled to pay for basic needs, like housing and food, were much more likely to have Long COVID. However, children in families who always had access to food, even if they struggled to pay for other things, were less likely to have Long COVID. This study also found that children who felt they were treated worse than others or parents who did not have enough support from friends and family had a higher chance of Long COVID. This RECOVER study is important because it shows that access to food and a supportive community may play a key role in protecting children from developing Long COVID.

This RECOVER publication summarizes what scientists know so far about how having different infections other than COVID-19 (called co-infections) may affect the development of Long COVID. These co-infections include those that a person may have had before COVID-19, infections that became active again during or after COVID-19, and new infections that may happen after having COVID. After reviewing existing studies, researchers found that differences in the type and timing of these co-infections make it difficult to fully understand their role in Long COVID. They note that co-infections could make Long COVID more severe, or COVID could cause other infections to worsen, depending on the infection, timing, and many other factors. The publication highlights the need for continued, coordinated research efforts, including longitudinal studies like RECOVER, to understand how co-infections may impact the development of Long COVID and the mechanisms leading to those impacts.

In this RECOVER study, researchers wanted to find out how Long COVID symptoms change over 15 months. To do this, researchers studied 3,659 adults who had COVID-19 before joining the RECOVER study or while they were enrolled. Researchers found that Long COVID does not look the same in everyone. Instead, people’s Long COVID symptoms usually fell into 1 of 8 different patterns over time. While most people felt better after recovering from COVID-19, about 1 in 20 participants had symptoms of Long COVID that lasted throughout the entire study. About 3 in 25 participants with Long COVID had symptoms that came and went. Other participants did not have Long COVID symptoms early on but started having health problems many months after having COVID-19. These findings show that doctors should continue monitoring patients for a long time after they have COVID-19 because their symptoms can stay, come and go, or start several months after getting sick. Understanding these patterns will help researchers find better ways to prevent and treat Long COVID in different groups of people.

The RECOVER-NEURO Cognitive Dysfunction (BrainHQ, PASC-CoRE, & tDCS) clinical trial tested 3 non-drug treatments to see if they improved thinking, focus, and memory for people with Long COVID. The 3 treatments included:

1. An interactive online brain training program called BrainHQ.
2. A virtually delivered, small group cognitive rehabilitation program called PASC-Cognitive Recovery or PASC-CoRE.
3. A cap that provided a non-invasive form of brain stimulation via electrical current called transcranial direct current stimulation or tDCS.

A unique aspect of RECOVER-NEURO was its decentralized design, enabling 328 adults across 22 U.S. sites to participate in this research despite living with Long COVID symptoms. The participants completed most study activities remotely during a 10-week study period. Some participants were assigned to a treatment group and received one of the three active treatments (BrainHQ, PASC-CoRE plus BrainHQ, or tDCS-active plus BrainHQ). Other participants were assigned to a comparison group and received either the BrainHQ active comparator or tDCS-comparator plus BrainHQ. Researchers found that all of the treatment groups and comparison groups reported similar results in their improvement in thinking, focus, and memory. All participants reported some improvement over time and many said they felt better overall after they completed their assigned treatment, even though no one treatment outperformed other groups, including the comparison groups.

This RECOVER study looked at whether the COVID-19 vaccine could help protect teenagers ages 12–17 from developing Long COVID. Researchers studied 1,231 teenagers enrolled in RECOVER who had confirmed COVID-19. Some were vaccinated before they got COVID-19 (724 teenagers), and some were not (507 teenagers). Researchers made sure the 2 groups were similar in terms of sex, date when they got COVID-19, and when they joined the study to make comparisons fair. They found that teenagers who were vaccinated in the 6 months before getting COVID-19 for the first time were about one-third less likely to get Long COVID. This study is important because it shows that COVID-19 vaccines, which were previously found to prevent getting COVID-19, can also protect against developing Long COVID in young people. 

This RECOVER study looked at whether pregnant women who had the Omicron type of COVID-19 were more likely to have Long COVID than women who were not pregnant when they had the Omicron type of COVID-19. Researchers studied the symptom surveys and study visits of more than 2,400 RECOVER pregnancy participants, ages 18–45, to see if being pregnant while having COVID-19 impacted the risk of developing Long COVID. They found that about 10.2% of the participants who had COVID-19 while pregnant later got Long COVID, compared with 10.6% of the those who were not pregnant at the time of infection. This suggests that there was no real difference in the chance of getting Long COVID based on whether someone was pregnant or not when they got COVID-19. This study is important because it helps researchers better understand the risk of developing COVID-19 based on whether or not someone is pregnant.

In this RECOVER study, researchers wanted to find out if natural language processing (NLP) could be used to identify Long COVID symptoms in children. NLP is a tool that can help find details in electronic health records (EHRs) beyond what is usually looked at in EHRs, such as diagnosis or billing codes (known as standard EHR data). Researchers used an NLP tool to look for 25 signs of Long COVID in children: 21 symptoms (like pain or extreme tiredness) and 4 types of daily life challenges (such as trouble with school). They compared children who had been diagnosed with Long COVID to those who had COVID-19 but did not develop Long COVID. The NLP tool analyzed more than 48,000 doctors’ notes within the EHRs of more than 10,000 children across 12 hospitals. Researchers found that the NLP tool identified almost all 25 symptoms much more often in the children who had Long COVID. The NLP tool also often identified patients’ symptoms that were not recognized when researchers only looked at standard EHR data. The study shows that using NLP to read EHR notes can help researchers better understand the symptoms and daily challenges that children with Long COVID experience when compared to looking only at codes and medication lists. This supports the idea that NLP should be used when doing scientific studies that need to identify children with Long COVID.