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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 Pediatric

Zhang, D; Tong, J; Jing, N; et al., Journal of the American Medical Informatics Association

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.

Short Summary
Review Pediatric

Rao, S; Gross, RS; Mohandas, S; et al., Pediatrics

This paper talks about Long COVID in children. Long COVID is when a person still feels sick for at least 3 months after having COVID-19. This paper looks at how common it is, who gets it, what causes it, and what happens to children who have it. Researchers from the RECOVER study and other groups across the US looked at earlier studies about children and Long COVID. They put together what those studies found and think that up to 5.8 million children in the US might have Long COVID. The researchers talked about their plan for better understanding Long COVID by using RECOVER’s definition of Long COVID and what RECOVER has learned so far. Authors of this paper share that future research on Long COVID in children should do the following: 1) describe Long COVID symptoms and how they show up together in groups, 2) understand why some children get Long COVID and others don’t, 3) learn how symptoms come back when children get stressed or get COVID again, 4) find ways to stop hidden health problems from turning into long-term issues in adulthood, and 5) see if COVID vaccines can stop Long COVID from showing up. The authors of this paper also believe that more research should be done to find good treatments, test different medicines, and compare different ways to help children with Long COVID.

Long COVID may occur in people recovering from a COVID-19 infection and often includes symptoms related to the heart and lungs, which together are called the cardiopulmonary system. These symptoms, which include fatigue, shortness of breath, chest pain, cough, and reduced ability to do physical activity, can cause significant disability. This paper explores current knowledge about what causes Long COVID and how it affects the heart and lungs, in both adults and children. The authors also discuss how participants in the Researching COVID to Enhance RECOVERY (RECOVER) Initiative will help answer questions about the impact of Long COVID on the cardiopulmonary system. Understanding these causes and effects may help researchers discover new therapies for Long COVID symptoms. 

Short Summary
EHR Pediatric

Razzaghi, H; Forrest, CB; Hirabayashi, K; et. al., Pediatrics

Research shows that the COVID-19 vaccine lowers the chance of children getting sick from COVID. But it is not clear whether the COVID vaccine protects against Long COVID. RECOVER researchers did a study to look at how well vaccines work in protecting children, ages 5–17, against Long COVID. They studied data from a group of more than 1 million children. The vaccine was 42% effective in lowering the chance of getting Long COVID in kids ages 5–11 and 50% effective for kids ages 12–17. The vaccine works best against Long COVID within the first 6 months of getting it. After 6 months, it does not work as well, so getting the vaccine every year is important to prevent Long COVID. These results show that the COVID vaccine can help children 5 years and older to keep from getting very sick. While this study helps scientists understand how vaccines can protect against COVID, they still need to do more research to understand how they protect against Long COVID.

Short Summary
Tissue Pathology Adult

Troxel, AB; Bind, MC; Flotte, TJ; et. al. RECOVER Initiative Autopsy Group, PLOS ONE

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 using tissue samples from people who died after having COVID to answer questions about Long COVID. To do this, they are studying donated samples from deceased people across the US to understand 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 of someone who had Long COVID. This paper is important because it can show other scientists how to do their own research on Long COVID in people who have died.

Short Summary
Observational Pregnant Adult

Metz, TD; Clifton, RG; Gallagher, R; et. al.; RECOVER Initiative, PLOS ONE

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 pregnant people. To do this, they are studying 2,300 pregnant people and their babies in the US to understand how often pregnant people get Long COVID; 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. RECOVER researchers are also studying how COVID during pregnancy affects child development. This paper is important because it can show other scientists how to do their own research on Long COVID in pregnant people.

RECOVER researchers studied how multisystem inflammatory syndrome (MIS-C) looks different in a large group of children. The researchers looked at electronic health record (EHR) data from 8 children’s hospitals from March 2020 to September 2022. They studied 1,139 children who were patients hospitalized for MIS-C. The researchers divided the patients into 3 groups and used age, sex, location, symptoms, conditions, test results, and medications to look for patterns in these groups. Researchers then looked at how the groups were similar and how they changed over time. The study showed that MIS-C has a range of severity, from mild to medium and severe. This means that MIS-C symptoms can be different for each child. The researchers also found that there are fewer severe MIS-C cases now than there used to be. The study might not have included some children if they had symptoms like MIS-C but had a different illness, had Kawasaki disease when they were in the hospital (because of how similar the symptoms can be to MIS-C), or had mild MIS-C symptoms that did not bother them that much and may not have been written in their EHR. This study can help doctors better understand and treat MIS-C.

Short Summary
EHR Adult

Hill, EL; Mehta, HB; Sharma, S; et. al., BMC Public Health

An electronic health record, or EHR, is a digital file that contains information about a person’s healthcare. In this study, researchers studied anonymous EHR data from the National COVID Cohort Collaborative (N3C), a group of medical systems located across the United States. They compared a group of 8,325 people who had a Long COVID diagnosis or received healthcare at a Long COVID clinic to a group of 41,625 people who did not have Long COVID. The researchers found key differences between these 2 groups. They also identified risk factors that could make someone more likely to develop Long COVID, including being middle-aged (40 to 69 years old), being female, and having certain chronic (long-term) health conditions before they got COVID. Examples of these chronic health conditions were obesity and lung disease. More research is needed to better understand why and how the risk factors found in this study make someone more likely to develop Long COVID.

Researchers wanted to see if patients who had difficulty breathing while sleeping (Obstructive Sleep Apnea; OSA) were at higher risk for developing Long COVID compared to people without OSA. By comparing the electronic health record (EHR) data of COVID positive patients, researchers looked at the risk of developing Long COVID in patients with and without a previous diagnosis of OSA.

Researchers found that adults with a previous diagnosis of OSA had an increased chance of developing Long COVID when compared to patients that did not have a previous diagnosis of OSA.

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