In a comprehensive 265-page report, the National Academies of Sciences, Engineering and Medicine has acknowledged the severity and persistence of long COVID, shedding light on the damaging impacts it continues to inflict on millions of Americans. The report, drafted by a committee of 14 doctors and researchers, highlights the extensive range of symptoms associated with long COVID, affecting individuals across all age groups and demographic backgrounds.

According to data cited in the report from 2022, it is estimated that nearly 18 million adults and almost 1 million children in the United States have experienced long COVID at some point. These figures indicate that about 8.9 million adults and 362,000 children were affected by the condition at the time of the survey. While the prevalence of long COVID decreased in 2023, recent trends have shown a rise in cases, albeit for reasons that remain unclear. As of January, data indicates that nearly 7% of adults in the United States continue to battle long COVID.

One significant challenge in addressing long COVID is the absence of a standardized diagnostic approach and definitive treatment methods. The National Academies emphasized the need for tailored rehabilitation programs that cater to the complex needs of individual patients. The report also advised doctors not to require a positive coronavirus test for diagnosing long COVID. Troublesome symptoms such as brain fog and chronic fatigue were highlighted as impairments that may hinder individuals' ability to return to work, making them potentially eligible for disability payments, even if their symptoms do not fit within the Social Security Administration's current disability categories.

Moreover, the report recognized that the risk of developing long COVID is higher for individuals who experienced more severe illness during their initial coronavirus infection. Hospitalized patients were found to be two to three times more likely to develop long COVID. However, the report also emphasized that even individuals who initially had mild COVID-19 symptoms can develop long COVID with severe health effects. The majority of long COVID cases, in fact, are seen among those who had a mild course of the illness.

Notably, women were found to be twice as likely as men to develop long COVID. Other risk factors included inadequate vaccination, preexisting medical conditions or disabilities, and smoking. Although children have a lower likelihood of developing long COVID compared to adults, some children experience persistent or intermittent symptoms that adversely impact their quality of life and hinder their participation in school, sports, and social activities.

Recovery from long COVID varies from person to person, with evidence suggesting that symptoms may diminish after a year. However, there have also been indications that recovery may plateau after the first year. Given the diverse nature of long COVID and its impact on multiple body systems, individualized approaches to managing the condition are necessary. Gradual return-to-work plans may be advised, particularly for those experiencing post-exertional malaise, which involves depleted energy or setbacks after physical or mental exertion. Employers may need to provide accommodations, such as frequent breaks or remote work options, for returning employees.

The report highlights that long COVID shares similarities with other chronic conditions such as myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia, and postural orthostatic tachycardia syndrome. However, the biological cause of long COVID symptoms remains unclear, with theories suggesting inflammation, remnants of the virus, and immune system dysregulation as potential factors.

The report also underscores how equity issues exacerbate the challenges faced by individuals with long COVID. Economic disparities, discrimination based on race or ethnicity, geographical limitations, and educational barriers all contribute to greater obstacles in accessing proper diagnosis, treatment, and support. Such individuals may encounter skepticism regarding their symptoms, face difficulties taking time off from work, and have limited access to specialized long COVID clinics and programs.

The National Academies' thorough examination of long COVID provides a valuable resource for healthcare professionals, policymakers, and affected individuals in understanding the scope and complexities of this condition. It underscores the urgent need for continued research, improved diagnostic approaches, and targeted support systems to address the multifaceted challenges presented by long COVID.