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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 Adult Broad Symptoms Risk Factors

Zang, C; Hou, Y; Schenck, EJ; et al., Communications Medicine

Some people develop new conditions or symptoms after a COVID infection, called Long COVID. This can lead to ongoing health problems. Researchers still don’t fully understand why some people get Long COVID while others do not. In this RECOVER study, researchers wanted to learn what increases someone’s risk of developing Long COVID after getting COVID. Researchers studied the electronic health records of 2.1 million people from New York and Florida who either had, or had not had, a COVID infection between March 2020 and November 2021. Using this data, they created a new computational model (a computer program that imitates how something works in real life) to help identify the things that Long COVID patients had in common. The researchers looked at whether these shared factors increased their risk of developing Long COVID. The model found that the people who were more likely to develop Long COVID if they had a severe first COVID infection, were underweight, or had other health problems, like cancer or liver disease. The results also show that computational models can help identify people who have a higher chance of developing different symptoms and types of Long COVID. This information is important because it can be used to help researchers find new ways to prevent, diagnose, and treat Long COVID.

Short Summary
EHR Pregnant Women Risk Factors

Bruno, AM; Zang, C; Xu, Z; et. al.RECOVER EHR CohortRECOVER Pregnancy Cohort, eClinicalMedicine

Little is known about Long COVID in pregnant women. This study looked at whether getting COVID while pregnant might increase the chances of getting Long COVID. Researchers from the RECOVER Patient-Centered Clinical Research Network (PCORnet) checked health records from 19 health systems across the US. They studied women ages 18–49 years old who had a test showing that they had a COVID infection between March 2020 and February 2022, and looked at 83,915 women who were not pregnant and 5,397 who were. Women who got COVID while pregnant were less likely to get Long COVID than those who weren’t pregnant. Pregnant women with COVID were more likely to develop certain conditions related to Long COVID, like an abnormal heartbeat. But they had a lower risk of getting other conditions, like malaise (feeling unwell). Overall, pregnant women with COVID had a lower chance of getting Long COVID in the 30 to 180 days after they first got sick.

The virus that causes COVID-19 can change over time, creating new virus types called variants. This study explored if problems related to Long COVID were different in people who were infected with different variants of COVID. Researchers looked at medical records from 2 databases in New York and Florida. They compared people who had the original type of COVID with those who had a variant called Delta, which was one of the main variants in 2021. The researchers found that some Long COVID conditions were more common in the people who had Delta. For example, some people infected with Delta developed clots in the blood vessels in their lungs. People who had Delta were also more likely to have stomach symptoms than people who were infected with the original type of COVID. Based on these findings, the researchers concluded that Long COVID symptoms can be different depending on which variant of COVID someone had.

Short Summary
Observational Pediatric

Gross, RS; Thaweethai, T; Rosenzweig, EB; et. al.RECOVER-Pediatric Consortium, 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 children. To do this, they are studying over 15,000 children and their caregivers in the US to understand how common Long COVID is in children and their caregivers; 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. This paper is important because it can show other scientists how to do their own research on Long COVID in children.

The researchers and study team running the RECOVER-NEURO clinical trial published a paper detailing the study’s design. RECOVER-NEURO is looking at 3 possible treatments for cognitive dysfunction, or brain fog, symptoms related to Long COVID. The possible treatments, also called study interventions, are BrainHQ (an interactive online brain training program), PASC-Cognitive Recovery (an online goal management training program), and transcranial direct current stimulation (a safe, noninvasive form of brain stimulation). The research team is using a variety of assessments, including brain function tests and participant surveys, to determine if these study interventions reduce brain fog symptoms and help people function better.

People with brain fog may have trouble thinking clearly, remembering things, or focusing on tasks, which can severely affect their daily functioning and quality of life. Results from this study will help the Long COVID community learn if BrainHQ, PASC-Cognitive Recovery, and transcranial direct current stimulation can be used to treat cognitive dysfunction symptoms related to Long COVID.

Short Summary
EHR Pediatric Risk Factors

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 New-onset and Pre-existing Conditions Risk Factors Viral Variants

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.

Short Summary
EHR Pediatric Vaccination

Wu, Q; Tong, J; Zhang, B; et al., Annals of Internal Medicine

This RECOVER study looks at how well and how long a COVID-19 vaccine, BNT162b2, works in children and teens. Researchers studied this before and during the wave of a new type of COVID, called Omicron. Researchers looked at the electronic health records from a group of children’s health systems across the country, known as PEDSnet. They checked 3 groups: teens ages 12–20 during the earlier Delta wave; and both children ages 5–11 and teens ages 12-20 during the Omicron wave. Researchers looked at data from more than 77,000 teenagers during Delta and over 167,000 kids and teens during Omicron. Some of these kids were vaccinated, and some were not. Researchers compared those who got the first dose of the BNT162b2 vaccine to those who didn't get any COVID vaccine. During Delta, researchers found that the vaccine stopped almost all the teenagers (98%) from getting sick. In the Omicron wave, the vaccine helped stop 74% of the kids and 86% of the teenagers from getting COVID. It also helped keep kids from getting really sick and needing to go to the hospital. Children and teens who got vaccinated were also less likely to have heart problems during Omicron. But they found that the vaccines didn’t work as well 4 months after the first dose. This information helps doctors better understand how to keep kids healthy when COVID is going around.

Short Summary
EHR Adult Pediatric Broad Symptoms

Zhang, Y; Romieu-Hernandez, A; Boehmer, TK; et al., BMC Infectious Diseases

This RECOVER study looked at why some people may have long lasting symptoms or new health problems after getting COVID-19. Researchers looked at the electronic health records of 3.7 million adults and children who were tested for COVID between March 2020 and May 2021. They compared the records of people who tested positive for COVID with people who did not.

The study found that both adults and children who were hospitalized with COVID were more likely to have at least 1 symptom in the months after getting COVID, like shortness of breath. They also found that adults who were hospitalized with COVID were more likely to have 3 or more symptoms, feel very tired, or develop a new health condition. Some of the conditions were diabetes, blood disorders, or diseases related to breathing. Even adults with COVID who were not hospitalized had a higher chance of certain symptoms or health issues compared to those who did not have COVID. This study is important because it shows that COVID can impact people’s health for a long time, even after their first infection is gone. These findings can help doctors and scientists better understand how to treat and care for people recovering from COVID.

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