Who Is Most Likely to Get Long COVID? Patient Data May Tell

Kara Grant

March 27, 2023

Editor's note: Find the latest long COVID news and guidance in Medscape's Long COVID Resource Center.

Good news and bad news on the long COVID front: Certain groups of people – like women, smokers, and those who had severe COVID-19 infections – are at a higher risk of long COVID, a review of more than 800,000 patients has found. 

That's the bad news. Yet, researchers also found that patients who had at least two doses of the COVID vaccine had a significantly lower risk of getting long COVID down the line. 

"Not only is it important to recognize which individuals may be at high risk of developing PCC [post−COVID-19 condition] and to offer follow-up care; it is imperative to plan population-level public health measures," wrote lead author Vassilios Vassiliou, PhD, a professor of cardiac medicine at the University of East Anglia in Norwich, England, and his team. 

The research, published in the journal  JAMA Internal Medicine , combined 41 previously published articles that included information from 860,783 patients. The review uncovered a slew of demographic traits that were significantly linked to long COVID, including female sex, being over 40 years old, smoking, having a high body mass index (BMI), and hospitalization due to a COVID-19 infection. 

Long COVID, as defined by the World Health Organization, is the continuation of COVID symptoms or the start of new symptoms at least 3 months after initial infection.

Having other conditions – like anxiety, depression, asthma, diabetes, and being immunocompromised – were also connected to a higher likelihood of getting long COVID, researchers reported. 

That cisgender women are at a higher risk of long COVID falls in line with previous analyses, suggesting that hormones might play a role "in perpetuating the hyperinflammatory status of the acute phase of COVID-19 even after recovery." 

The same goes for previous studies on vaccination status and long COVID risk – like much of the previous research on the subject, vaccinations were found to have a protective effect on long COVID. 

But long COVID – all the ways it presents itself, how widespread it is, and what we can do about it – still remains somewhat of a mystery, even 3 years into the pandemic. 

"While this and other data on vaccines suggest that there are factors that can reduce the risk of long COVID, nothing as of yet can completely eliminate the risk of long COVID. The only guarantee against long COVID is not to get COVID," said Stanford University primary care professor Linda Geng, MD, PhD. 

"Furthermore, we still do not have any effective therapy established for the millions who already have long COVID, and we urgently need randomized controlled trials to help provide those answers," she said.


JAMA Internal Medicine: "Risk Factors Associated With Post−COVID-19 Condition: A Systematic Review and Meta-analysis."


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