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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 Broad Symptoms

Lorman, V; Bailey, LC; Song, X; et al., PLOS Digital Health

This RECOVER study aimed to better understand how Long COVID affects kids in different ways. Researchers looked at the electronic health records (EHRs) of pediatric patients under the age of 21 who had signs of Long COVID. The study focused on children who were generally healthy and did not have serious long-term health problems before they got sick with COVID-19. Researchers used a special computer method to look for patterns of symptoms in children’s EHRs. This helped them find groups of kids who had similar health problems after having COVID-19, meaning that they had similar experiences with Long COVID. They found that more than half of the children in the study had heart, lung, and breathing problems related to Long COVID. Other common symptoms included muscle and joint pain, mood and thinking problems, stomach issues, headaches, and feeling tired. These findings give researchers a clearer picture of how Long COVID shows up in kids, which can guide future studies.

Short Summary
EHR Review Adult Pediatric Pregnant Women

Mandel, HL; Shah, SN; Bailey, LC; et al., Journal of Medical Internet Research

This RECOVER report looked at how using electronic health records (EHRs) to study Long COVID can be both helpful and challenging. EHRs are digital records with a patient’s health information. One good thing about using EHRs is that researchers can use computer programs to find people who might have Long COVID based on their symptoms. This can help researchers figure out what might increase the risk of getting Long COVID, like age and other health problems. EHRs also provide quick access to health records from many patients, which speeds up Long COVID research. A main problem with studying EHRs is that the information in them is not always complete or consistent because different medical providers enter it in different ways. This makes it harder for researchers to find patterns or other details they need to better understand Long COVID. Even with these challenges, the researchers explain that looking at EHRs can still help us better understand Long COVID and improve the lives of people with Long COVID.

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
Observational Adult Broad Symptoms Risk Factors

Geng, LN; Erlandson, KM; Hornig, M; et al., JAMA

Scientists updated a prior RECOVER study to explore Long COVID symptoms reported by participants in the RECOVER-Adult Observational Cohort Study. They compared symptoms in people who had COVID-19 to those who did not have COVID-19 to find the symptoms that were most different. The updated study included 13,647 participants, compared to 9,764 in the original, and added 8 new symptoms based on patient and community feedback. Symptoms that were most different between people with and without COVID-19 include post-exertional malaise, fatigue, brain fog, dizziness, palpitations, smell or taste change, thirst, chronic cough, chest pain, shortness of breath, and sleep apnea. In addition, this research update classifies Long COVID symptoms into 5 groups of symptoms called clusters. The previous study focused on 4 clusters. This study update is important because it highlights the wide range of symptoms experienced by people with Long COVID. Understanding these symptoms will help researchers study Long COVID and look for treatments.

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.

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Observational Adult Risk Factors Viral Variants

Shah, DP; Thaweethai, T; Karlson, EW; et al.; RECOVER Consortium, JAMA Network Open

A RECOVER study looked at whether a person’s sex at birth affects their risk of developing Long COVID. To do this, researchers studied a large group of people enrolled in the RECOVER adult cohort. They found that females were more likely to have Long COVID symptoms than males. Among females, the risk of getting Long COVID changed based on age, pregnancy status while having COVID-19, and if they had gone through menopause. Researchers discovered that the risk of getting Long COVID was higher in females ages 40–54 years and females who had not gone through menopause. On the other hand, females who had already gone through menopause were not at a higher risk compared to males. More research is needed to understand why differences in sex at birth may put someone at higher risk of experiencing the long-term effects of COVID-19. Knowing this and understanding which hormones play a role in Long COVID risk could help researchers develop treatments and ways to prevent Long COVID.

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.

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