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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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49 Results

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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-19 with those who didn’t. The study found that kids who had COVID-19 were 25% more likely to have stomach issues, like belly pain, even after recovering from COVID-19. Specifically, 8.64% of kids who had COVID-19 experienced new stomach problems within a few months of having COVID-19 while only 6.85% of kids who didn’t have COVID-19 had stomach problems. This was true not only a few months after getting COVID-19 but also up to 2 years later. Doctors should be aware that kids who had COVID-19 might have more stomach problems. Knowing this can help doctors check for symptoms early and provide the right care.

Short Summary
EHR Adult Pediatric

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

Rao, S; Azuero-Dajud, R; Lorman, V; et al.; RECOVER EHR and RECOVER Pediatric Cohorts, eClinicalMedicine

This RECOVER study looked at whether some children were more likely to have long-term breathing or brain/nerve problems after having COVID-19. Researchers studied the electronic health records (EHRs) of 771,725 pediatric patients under the age of 21 across the US. They found that children under 5 years of age and Hispanic White children had a higher chance of having breathing problems linked to Long COVID. This was also true if they lived in low-income areas or had other breathing problems before getting COVID-19. Children ages 12–17 years old and non-Hispanic White children were more likely to have brain and nerve problems related to Long COVID, especially if they already had other problems related to the brain and nerves. These findings show that race and ethnicity may affect how children experience Long COVID. Factors like where children live and how easy it is for them to get healthcare could play a role in these differences. This research shows why it’s important to understand these factors, so all children can get the care they need after having COVID-19.

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-19 or had a positive COVID-19 test to those who never tested positive. The study found that children with COVID-19 were more likely to develop many health problems weeks or months after getting COVID-19 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-19 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-19 were more likely to experience cognitive symptoms (related to thinking, memory, or concentration) than Non-Hispanic White children with less severe COVID-19. In children with less severe COVID-19, 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-19 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.

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
EHR Adult

Tong, J; Li, L; Reps, JM; et al., Statistics in Medicine

This RECOVER study focused on a problem that happens when scientists study rare events. When scientists have very few cases of rare events to study, the usual ways of studying data can give misleading results. One way to fix this is to combine data from many hospitals or clinics so there are more cases to study. But, sharing detailed patient information raises concerns about privacy, so patient privacy must be protected when combining data from multiple healthcare centers.

In this study, RECOVER researchers created a new tool called ODAP-B, which combines information more accurately without sharing patient details. This is because it only needs a summary of patient data, not full health records. By using ODAP-B, researchers can better understand what increases the chance of a rare event happening while protecting patient privacy.

Short Summary
EHR Adult New-onset and Pre-existing Conditions Potential Treatments Risk Factors

Johnson, SG; Abedian, S; Stürmer, T; et al., Diabetes Care

Metformin is a drug that many doctors prescribe as treatment for type 2 diabetes mellitus (T2DM). Past studies have found that taking metformin before and while having COVID-19 helps lower the chances of getting very sick with COVID-19. These studies also found that taking metformin can lower the chance of a person being sick many months after getting COVID-19, 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.

Short Summary
EHR Pediatric Risk Factors

Zhou, T; Zhang, B; Zhang, D; et al., JAMA Network Open

This RECOVER study looked at how a child or young adult’s body weight, measured by body mass index (BMI), might impact their risk of developing Long COVID. Researchers studied medical records from over 172,000 children and young adults across 26 hospitals between March 2020 and May 2023. They found that children and young adults with obesity (a high BMI) were 25% more likely to have long-term health problems after getting COVID-19 than those with a healthy weight. The findings also show that children with severe obesity (a very high BMI) were about 42% more likely to experience these long-term problems. They also checked if these links were different for children and young adults, but did not find significant differences. This study highlights that the BMI of children and young adults before getting COVID-19 is an important factor in their risk for developing Long COVID.

Short Summary
EHR Adult Broad Symptoms

O'Neil, ST; Madlock-Brown, C; Wilkins, KJ; et al., NPJ Digital Medicine

In this RECOVER study, researchers wanted to find out which health conditions were common in people with long-term effects of COVID-19, known as Long COVID. They looked at the medical records of over 14 million patients who had and did not have COVID-19 using a method called topic modeling. Topic modeling is a method to find patterns in groups of documents. Researchers used topic modeling to look at lists of health problems that millions of patients faced over time, including before and after they had COVID-19. This allowed them to find the conditions that were more common in people with Long COVID. Researchers found that health problems related to the lungs, heart, brain, and immune system were more common in people with Long COVID compared to those who didn’t have Long COVID or had not had COVID-19. Common problems included chronic fatigue (feeling tired all the time), headaches, anxiety, and heart issues. They also found that some problems were more common in people of a certain age or sex (whether they are male or female). The study shows that Long COVID can affect many parts of the body and highlights how health problems can differ between groups. It also shows that age and sex can affect the chance of getting certain health conditions after COVID-19.

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