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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 Risk Factors

Lorman, V; Rao, S; Jhaveri, R; et al., JAMIA Open

RECOVER researchers wanted to identify conditions and symptoms associated with Long COVID in children (also known as pediatric Long COVID). The researchers analyzed electronic health record (EHR) data to detect conditions and symptoms associated with pediatric Long COVID. The study identified multiple conditions and body systems associated with pediatric Long COVID related to many different organs, such as heart and lung problems. 

This research is important because these findings use a data-driven approach to detect several new or under-reported conditions and symptoms that should be studied further. Researchers believe that further study may reveal the biological processes that cause these Long COVID symptoms and conditions.

Research Summary
EHR Adult Health Disparities

Khullar, D; Zhang, Y; Zang, C; et al., Journal of General Internal Medicine

RECOVER researchers wanted to learn more about racial and ethnic differences in Long COVID. Researchers used patients’ electronic health records (EHRs) to compare people who had COVID based on their race or ethnicity, whether they were hospitalized due to COVID, and whether they had any health problems related to Long COVID. They looked at data from over 60,000 adults from 5 healthcare systems.

The researchers found that Black and Hispanic adults were more likely to have symptoms of Long COVID compared to White adults – this was true for adults who were and were not hospitalized. The reason for these differences is unclear.

RECOVER researchers wanted to find environmental risk factors of Long COVID by comparing the environment of people who had Long COVID to people who didn’t have Long COVID. Environmental risk factors are things about where a person lives that raise their chance of having a health condition, such as air pollution and poor housing conditions. The researchers looked at data from electronic health records (EHRs) of more than 100,000 people in the New York City area and Florida.  

The researchers found that people who lived in areas with higher levels of air pollution, more poverty, and less access to healthy food had a higher chance of getting Long COVID. People in the New York City area had different environmental risk factors than people in Florida. 

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

Zang, C; Zhang, Y; Xu, J; et al., Nature Communications

RECOVER researchers analyzed electronic health records (EHR) in order to define Long COVID. Researchers found up to 25 different symptoms that patients who had COVID were more likely to have than those who didn’t have COVID. The symptoms were related to many different organs, such as memory loss, hair loss, and feeling tired. They found that certain types of Long COVID symptoms were more likely to happen in patients who were older, had more severe COVID, or had more health problems before they had COVID.  

This research is important because the findings show that Long COVID affects many organs, and types of Long COVID symptoms differ between certain groups of patients. However, EHR findings are limited in that they can only look at data from the patients' past. In order to confirm these findings, future studies that follow patients' symptoms over time, into the future, are needed. 

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

Reddy, NV; Yeh, HC; Tronieri, JS; et al., Journal of Clinical and Translational Science

The relationship between COVID-19 and diabetes has captured the interest of many researchers. Some studies suggest that people may be more likely to develop type 2 diabetes after having COVID. The authors of this study tried to find out whether new diagnoses of type 2 diabetes are more common after having COVID. They did this by looking at electronic health records (EHRs), which are digital medical charts that have health data like doctor visits, lab results, and other health history. 

The researchers looked at the EHRs of people across the country who had COVID and were also diagnosed with type 2 diabetes within 6 months before or after having COVID. They found that the number of new diagnoses increased during the period when people had COVID, likely due to increased interaction with the healthcare system during that time. However, the average number of new diabetes diagnoses was about 83% lower in the 6 months after having COVID than in the 6 months before having COVID. This analysis could not explain whether having COVID makes people more likely to get diabetes, but it does include the unexpected finding that a diabetes diagnosis was less common months after having COVID.

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

Pfaff, ER; Madlock-Brown, C; Baratta, JM; et al., BMC Medicine

RECOVER researchers looked at the use of a code to diagnose Long COVID in electronic health records (EHRs). They used EHR data from over 8,000 people and compared people who had the ICD-10 code for Long COVID (which is U09.9) in their EHR on or after October 1, 2021. They also looked at other codes in their EHR for health conditions, symptoms, tests, and treatments within 60 days after their Long COVID diagnosis.

Researchers found that many doctors use the Long COVID code along with other codes. People with Long COVID had a mix of symptoms and other health conditions, tests, and treatments. This suggests there may be different types of Long COVID. The researchers concluded that for now, doctors should look at a person’s mix of symptoms and other health conditions to diagnose Long COVID.

Short Summary
EHR Adult

Reese, JT; Blau, H; Casiraghi, E; et al., eBioMedicine

In this study, RECOVER researchers used a computer program to identify possible types of Long COVID based on electronic health records (EHRs). They used the computer program to review EHRs of people diagnosed with Long COVID and group them based on patterns in their symptoms and health conditions.

The computer program found 6 different types of Long COVID, which were related to 1) many symptoms and health conditions with unusual lab test results, 2) the lungs, 3) the brain, 4) the heart, 5) pain and feeling weak and tired (fatigue), and 6) many symptoms and conditions with pain. Each type of Long COVID also differed based on health conditions people had before COVID and how severe their COVID infection was. This research could help identify people with different types of Long COVID to better diagnose and treat them and invite them to join research studies.

Research Summary
EHR Adult New-onset and Pre-existing Conditions Viral Variants

Zhang, H; Zang, C; Xu, Z; et al., Nature Medicine

RECOVER researchers wanted to learn if there are different types of Long COVID based on symptoms and health problems that often happen together. Researchers used data from electronic health records (EHRs) of about 35,000 people diagnosed with COVID. The EHRs were from 2 healthcare systems in PCORnet, the National Patient-Centered Clinical Research Network. They used a computer program to look for patterns in people’s new symptoms and health problems that started 30 to 180 days after having COVID.

The researchers found 4 main types of Long COVID based on symptoms and health problems that happen together. The 4 types of Long COVID are related to the 1) heart and kidneys, 2) breathing, sleep, and anxiety, 3) muscles and nerves, and 4) digestive tract and breathing. This research could help define types of Long COVID to give people more specific diagnoses and treatment plans.

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

Rao, S; Lee, GM; Razzaghi, H; et al., JAMA Pediatrics

RECOVER researchers used data in electronic health records (EHRs) from children’s hospitals that were a part of the National Pediatric Learning Health System Network (PEDSnet). Researchers looked for symptoms, health conditions, and medicines children had about 1 to 6 months after a COVID test. They compared children who did and didn’t have COVID to learn how many children who had COVID got Long COVID, and symptoms and health problems Long COVID causes in children.

The researchers learned that Long COVID is uncommon in children and happens in about 4% of children with COVID compared to in about 5% - 21% of adults with COVID. They also learned the Long COVID symptoms and health conditions that happen most often in children include changes in smell or taste hair loss, trouble breathing, and inflammation (swelling) in the heart or muscles.

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