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Research Summaries

Discover what the latest science from RECOVER 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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114 Results

In this RECOVER study, researchers looked at the relationship between a young person’s weight and their health after getting COVID-19. Researchers reviewed the electronic health records (EHRs) of over 139,000 children and young adults, ages 5–20 years, across the US. They grouped participants based on their body mass index (BMI). BMI is a number that helps show whether someone is at a healthy weight, is overweight, has obesity, or has severe obesity based on their height and weight. The researchers checked if any new health problems were added to participants’ EHRs between 1 and 6 months after getting COVID-19. The study found that children and young adults with severe obesity were much more likely to develop health problems after getting COVID-19. These included problems related to the heart, like high blood pressure, and stomach problems, like diarrhea and heartburn. The researchers also checked whether participants had mental health issues after getting COVID-19. Those results were less clear and may have been due to other factors. This study is important because it shows that doctors should be thinking about the weight of children and young adults affected by COVID-19. If a child is overweight or has obesity and gets COVID-19, doctors should monitor their heart and stomach health to make sure they receive the care they need. 


This RECOVER study looked at whether COVID-19 was linked to a higher risk for dyslipidemia (unusual levels of fats or cholesterol in the blood) or a high body mass index (BMI) in children and young adults. BMI is a number that helps show if someone's weight is in the healthy range for their height. A higher BMI can be a sign that a person may be overweight or have obesity. Researchers looked at the electronic health records (EHRs) of over one million children and young adults, from birth to age 21, across 25 different children’s hospitals in the US. Researchers followed the health of children and young adults for up to 6 months after they got COVID-19 for the first time and compared them to a group of children and young adults who did not get COVID-19. Researchers found that children and young adults who got COVID-19 were about 24% more likely to develop dyslipidemia and 15% more likely to develop a high or unhealthy BMI than those who never had COVID-19. These findings are important because they show that COVID-19 may be linked to a higher risk of health problems related to blood fats and weight. These findings also highlight the need for closer follow-up of children and young adults during their recovery from COVID-19.  


Short Summary
Observational Pediatric

Rhee, KE; Thaweethai, T; Pant, DB; et al., JAMA Pediatrics

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.


Short Summary
Pathobiology

Aid, M; Boero-Teyssier, V; McMahan, K; et al., Nature Immunology

In this study, researchers used RECOVER data and blood samples to learn more about the biological mechanisms (changes in the body) that can lead to the development of Long COVID symptoms.

The researchers analyzed health information and blood samples collected between 2020 and 2021 from a group (cohort) of 142 people not taking part in RECOVER studies. This cohort included people who did and did not have COVID-19 as well as people experiencing symptoms of Long COVID. To ensure the accuracy (validate) their findings from the study of the 2020-2021 cohort, researchers compared them to findings from a different cohort that also included people without COVID-19, people with COVID-19, and people with Long COVID. The people in this cohort also took part in a RECOVER clinical trial between 2022 and 2024.  

Researchers performed multiple tests on blood samples collected from both cohorts and combined those analyses with health data collected from cohort members. The combined test results and health data suggest that Long COVID is associated with changes to the body’s immune system. Among people taking part in the study, the most important of these changes were chronic (long-lasting) inflammation and T cell exhaustion. While inflammation can indicate that the immune system is overreacting and even attacking healthy parts of the body, T cell exhaustion means the immune system has a reduced ability to fight off infections like SARS-CoV-2, the virus that causes COVID-19. Evidence of inflammation and T cell exhaustion appeared in multiple types of blood sample analysis data, including data about how individual immune cells behave and how a person’s body creates the proteins it needs to repair damage. Researchers also found that people who experienced inflammation during an initial (acute) SARS-CoV-2 infection were most likely to develop symptoms of Long COVID like pain, cough, brain fog, and fatigue.  

The findings suggest that the immune system may stay activated, and sometimes in a weakened state, for a long time after a person has had COVID. These findings are important because they could inform future studies on diagnosing and treating Long COVID.


This RECOVER paper combined research findings, patient experiences, and possible explanations about how the body works to understand how different germs and health factors might play a role in Long COVID. Researchers looked at how having a viral, bacterial, or fungal infection before, during, or after COVID-19 might make someone more likely to develop Long COVID. The combined information suggests that these infections can confuse the immune system, making it attack healthy cells or cause problems to the body’s organs. For example, the stress of fighting SARS-CoV-2, the virus that causes COVID-19, might “wake up” old viruses that were dormant (asleep or inactive) in the body, which can make a person sicker or more likely to develop Long COVID. This paper is important because it shows that Long COVID is complex and may involve different germs that change the body’s responses to infection. By learning more about these connections, researchers hope to find better ways to test for and treat Long COVID in everyone.


Video
Observational Adult

Thaweethai, T; Donohue, SE; Martin, JN; et al., Nature Communications

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.


Research Summary
Clinical Trial Adult

Knopman, DS; Koltai, D; Laskowitz, D; et al., JAMA Neurology

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.


Short Summary
EHR Adult

Hawkins, KL; Dandachi, D; Verzani, Z; et al., Clinical Infectious Diseases

This RECOVER study looked at whether people with Human Immunodeficiency Virus (HIV) are more likely to get Long COVID after having COVID-19. HIV is a virus that attacks the body’s immune system. Researchers used electronic health records (EHRs) from 2 nationwide research networks of people ages 21 and older who had COVID-19. They divided them into 2 groups: people with HIV and people without HIV. Researchers used 2 methods to find people in the groups who might have Long COVID. One used a computer system that looked for Long COVID symptoms in medical records. The other looked for official diagnosis codes that doctors enter when they think someone has Long COVID. They found that people with HIV may have a slightly higher risk of being diagnosed with Long COVID when looking for Long COVID symptoms in medical records. However, they found that there was no clear link between having HIV and receiving the official diagnosis code for Long COVID. This suggests that Long COVID may be missed in people with long-term health problems like HIV.


Short Summary
EHR Adult

Vekaria, V; Thiruvalluru, RK; Verzani, Z; et al., JAMA Network Open

In this RECOVER study, researchers wanted to find out if adults with a serious mental illness (SMI)—like major depression, schizophrenia, or bipolar disorder—were more likely to develop Long COVID. To do this, researchers looked at the electronic health records (EHRs) of more than 1.6 million adults across the US. They found that adults with an SMI had a higher chance of developing Long COVID than adults without an SMI. This may be because SMIs can cause stress and problems with a person’s immune system, which could make them more likely to develop long-lasting symptoms after having COVID-19. Among adults with an SMI, higher rates of Long COVID were seen in older people, non-Hispanic Black and Hispanic people, people with public health insurance, people with other long-term illnesses like heart disease or diabetes, and people who were hospitalized after they got COVID-19 for the first time. This study is important because it shows that healthcare teams should look at SMIs in addition to other risk factors to help prevent and treat Long COVID.