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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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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 Vaccination

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 Women

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 women. To do this, they are studying 2,300 pregnant women and their babies in the US to understand how often pregnant women 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 women.

Short Summary
EHR Pediatric Broad Symptoms New-onset and Pre-existing Conditions

Rao, S; Jing, N; Liu, X; et al., Scientific Reports

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 Risk Factors

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.

Long COVID patients, caregivers, and community members contribute to all parts of RECOVER, including scientific research. These chosen members of the community are known as RECOVER Representatives. This paper, written by a team of RECOVER Representatives and researchers, talks about why they chose to work together and how their partnership has improved the study. They summarize some of the impacts of Long COVID and highlight the roles that patient advocacy can play in research. They also discuss what progress has been made so far in studying Long COVID and what challenges lie ahead. The authors state that the result of Representatives working together with researchers on study design, ways to include patients, and sharing community concerns has set a new example for the design of future biomedical research studies.

Short Summary
EHR Adult Health Disparities New-onset and Pre-existing Conditions

Yoo, YJ; Wilkins, KJ; Alakwaa, F; et. al.; N3C and RECOVER Consortia, Clinical Journal of the American Society of Nephrology

Acute Kidney Injury (AKI) can happen when people get very sick with COVID-19. People in the hospital with COVID are more likely to die if they also get AKI. However, there is not enough research to understand how many people have had AKI since the start of the COVID pandemic or what increases the chances of getting AKI. In this RECOVER study, researchers looked at the electronic health records (EHRs) from 53 hospitals across the United States. They studied adults who were in the hospital with COVID between March 2020 and January 2022. To find out who had AKI, the researchers looked at blood tests that show how well the kidneys are working and diagnosis codes (what doctors use to say what’s wrong with the patient). To understand where people were getting sick, researchers split the country into 4 parts: Northeast, Midwest, South, and West. They also looked at different time periods during the pandemic. Out of 336,473 people in the study, 129,176 (38%) had AKI. People with AKI were also more likely to die than those without AKI. The South and the West had the most cases of AKI. Researchers found that AKI cases went down after the first big wave of COVID, but then went back up during the Delta and Omicron waves. This shows that different types of COVID might affect the kidneys differently. This study is important because it helps us understand how COVID can hurt people’s kidneys, and how it can change over time. It also helps us learn how COVID is linked to things like age, sex, race, and other health problems in different areas of the country.

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