New Report Reviews Evidence on Long COVID Diagnosis, Risk, Symptoms, and Functional Impact for Patients

A new report from the National Academies of Sciences, Engineering, and Medicine presents conclusions about Long COVID diagnosis, symptoms, and impact on daily function — including that Long COVID can cause more than 200 symptoms, and that a positive COVID-19 test is not necessary to make a Long COVID diagnosis.

Since the onset of the COVID-19 pandemic in 2020, many individuals infected with the virus have continued to experience lingering symptoms for months or even years following acute infection. In a 2022 survey, 3.4 percent of U.S. adults and 1.3 percent children reported they were experiencing Long COVID symptoms at the time of the survey.

The new report says that some health effects of Long COVID, including chronic fatigue and post-exertional malaise, cognitive impairment (sometimes referred to as “brain fog”), and autonomic dysfunction, can impair an individual’s ability to work or attend school for six months to two years or more after COVID-19 infection. It can be difficult to clinically assess these health effects, or to determine their severity and effect on a person’s ability to function. They also may not be captured in the Social Security Administration’s Listing of Impairments, which is used as an initial screening step in determining disability.

Even patients with a mild case of COVID-19 can go on to develop Long COVID with severe health effects. Risk factors for poor functional outcomes from Long COVID include being female, lack of or inadequate vaccination against COVID-19, preexisting disability or comorbidities, and smoking. A greater number of or more severe Long COVID symptoms are correlated with decreased quality of life, physical functioning, and ability to work or perform in school.

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