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High-dimensional characterization of post-acute sequelae of COVID-19
Open accessPublished version of a preprint
Abstract
The acute clinical manifestations of COVID-19 have been well characterized 1,2, but the post-acute sequelae of this disease have not been comprehensively described. Here we use the national healthcare databases of the US Department of Veterans Affairs to systematically and comprehensively identify 6-month incident sequelae-including diagnoses, medication use and laboratory abnormalities-in patients with COVID-19 who survived for at least 30 days after diagnosis. We show that beyond the first 30 days of illness, people with COVID-19 exhibit a higher risk of death and use of health resources. Our high-dimensional approach identifies incident sequelae in the respiratory system, as well as several other sequelae that include nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain and anaemia. We show increased incident use of several therapeutic agents-including pain medications (opioids and non-opioids) as well as antidepressant, anxiolytic, antihypertensive and oral hypoglycaemic agents-as well as evidence of laboratory abnormalities in several organ systems. Our analysis of an array of prespecified outcomes reveals a risk gradient that increases according to the severity of the acute COVID-19 infection (that is, whether patients were not hospitalized, hospitalized or admitted to intensive care). Our findings show that a substantial burden of health loss that spans pulmonary and several extrapulmonary organ systems is experienced by patients who survive after the acute phase of COVID-19. These results will help to inform health system planning and the development of multidisciplinary care strategies to reduce chronic health loss among individuals with COVID-19.
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“This is typically referred to as a post-covid syndrome, characterized by several symptoms affecting quality of life (1–5).”
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Cites
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., et al. (2020) · JAMA · doi:10.1001/jama.2020.1585 · Cited by 20,148
La certeza de lo impredecible: Cultura Educación y Sociedad en tiempos de COVID19
Martínez González, M. (2020) · DSPACE System - Metalibrary (University of the Coast) · Cited by 18,463
Vincent, J. L., Moreno, R., Takala, J., Willatts, S., De Mendonça, A., Bruining, H., Reinhart, C. K., Suter, P. M., & Thijs, L. G. (1996) · Intensive Care Medicine · doi:10.1007/bf01709751 · Cited by 11,674
Vincent, J.-L., de Mendonca, A., Cantraine, F., Moreno, R., Takala, J., Suter, P. M., Sprung, C. L., Colardyn, F., & Blecher, S. (1998) · Critical Care Medicine · doi:10.1097/00003246-199811000-00016 · Cited by 3,463
Making Neighborhood-Disadvantage Metrics Accessible — The Neighborhood Atlas
Kind, A. J. H., & Buckingham, W. R. (2018) · New England Journal of Medicine · doi:10.1056/nejmp1802313 · Cited by 3,310
Management of post-acute covid-19 in primary care
Greenhalgh, T., Knight, M., A’Court, C., Buxton, M., & Husain, L. (2020) · BMJ · doi:10.1136/bmj.m3026 · Cited by 1,771
Negative Controls: A Tool for Detecting Confounding and Bias in Observational Studies
Lipsitch, M., Tchetgen Tchetgen, E., & Cohen, T. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181d61eeb · Cited by 1,583
A tutorial on propensity score estimation for multiple treatments using generalized boosted models
McCaffrey, D. F., Griffin, B. A., Almirall, D., Slaughter, M. E., Ramchand, R., & Burgette, L. F. (2013) · Statistics in Medicine · doi:10.1002/sim.5753 · Cited by 1,450
Balancing Covariates via Propensity Score Weighting
Li, F., Morgan, K. L., & Zaslavsky, A. M. (2016) · Journal of the American Statistical Association · doi:10.1080/01621459.2016.1260466 · Cited by 1,095
Thomas (2020) · doi:10.1001/jama.2020.7819 · Cited by 835
Cited by
Sorted by citations
Items 601–700 of 1,000
Targeting endothelial dysfunction and oxidative stress in Long-COVID
Trimarco, V., Izzo, R., Mone, P., Trimarco, B., & Santulli, G. (2022) · Pharmacological Research · doi:10.1016/j.phrs.2022.106451 · Cited by 12
“We fully agree with them on the fact that several factors need to be pondered in order to evaluate the risk of developing Long-COVID [1,2].”
BackgroundInfluentialLong-term neurological sequelae of SARS-CoV-2 infection
(2022) · Nature Medicine · doi:10.1038/s41591-022-02018-4 · Cited by 14
Evaluation of the Hematological Patterns from Up to 985 Days of Long COVID: A Cross-Sectional Study
Galúcio, V. C. A., de Menezes, D. C., de Lima, P. D. L., Palácios, V. R. D. C. M., Vasconcelos, P. F. D. C., Quaresma, J. A. S., & Falcão, L. F. M. (2023) · Viruses · doi:10.3390/v15040879 · Cited by 14
Fankuchen, O., Lau, J. D., Rajan, M., Swed, B., Martin, P., Hidalgo, M. M., Yamshon, S., Pinheiro, L. C., & Shah, M. A. (2023) · American Journal of Clinical Oncology · doi:10.1097/coc.0000000000001005 · Cited by 12
“Long COVID 6 to 12 mo (excluding 78 died/LFU) 28 (16) 11, 23 3 (8.”
Morse, B., Kim, K. K., Xu, Z., Matsumoto, C. G., Schilling, L. M., Lucila Ohno-machado, A., Mak, S., & Keller, M. S. (2023) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocad058 · Cited by 12
SARS-CoV-2 Portrayed against HIV: Contrary Viral Strategies in Similar Disguise
Duerr, R., Crosse, K. M., Valero-Jimenez, A. M., & Dittmann, M. (2021) · Microorganisms · doi:10.3390/microorganisms9071389 · Cited by 12
Grape Phytochemicals and Vitamin D in the Alleviation of Lung Disorders
Santa, K. (2022) · Endocrine Metabolic & Immune Disorders - Drug Targets · doi:10.2174/1871530322666220407002936 · Cited by 12
Wilson, N., Grout, L. M., Summers, J. A., Nghiem, N., & Baker, M. G. (2021) · medRxiv · doi:10.1101/2021.06.25.21259556 · Cited by 12
Long-term effects on survivors with COVID-19
Yang, C., Zhao, H., & Tebbutt, S. J. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02323-0 · Cited by 12
Mental health in people with covid-19
Al‐Aly, Z. (2022) · BMJ · doi:10.1136/bmj.o415 · Cited by 12
Lau, B. M., Wentz, E., Ni, Z., Yenokyan, K., Coggiano, C., Mehta, S. H., & Duggal, P. (2022) · medRxiv · doi:10.1101/2022.12.07.22283203 · Cited by 12
Long-Term Persistence of COVID-Induced Hyperglycemia: A Cohort Study
Goel, V., Raizada, A., Aggarwal, A., Madhu, S., Kar, R., Agrawal, A., Mahla, V., & Goel, A. (2024) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.22-0695 · Cited by 11
SARS-CoV-2 antivirals and post-COVID-19 condition
Al‐Aly, Z. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(24)00436-5 · Cited by 11
Lesgards, J., Cerdan, D., & Perronne, C. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26167879 · Cited by 13
“Post-acute sequelae of COVID-19 (PASC) in the respiratory systems as well as in cardiovascular, nervous, immune, and other systems are also a field for long COVID to grow and worsen, especially in the absence of treatments during COVID episodes and after recovery [10,27].”
InfluentialBaumann, M. (2021) · Discover Mental Health · doi:10.1007/s44192-021-00002-x · Cited by 11
“4), it is of course important to consider if there have been infections in the local environment and if these have left consequences that have a psychological impact on the health of the caregivers or other important human [32, 33, 35, 36, 38, 82, 83].”
BackgroundLipták, P., Ďuríček, M., Rosoľanka, R., Žiačiková, I., Kocan, I., Uhrík, P., Grendár, M., Hrnciarova, M., Bucova, P., Galo, D., et al. (2022) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000002425 · Cited by 11
COVID-19 postacute care major organ damage: a systematic review
Greer, N., Bart, B. A., Billington, C. J., Diem, S. J., Ensrud, K. E., Kaka, A. S., Klein, M. A., Melzer, A. C., Reule, S. A., Shaukat, A., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-061245 · Cited by 11
Prognostic Performance of Cystatin C in COVID-19: A Systematic Review and Meta-Analysis
Matuszewski, M., Reznikov, Y. P., Pruc, M., Peacock, W. F., Navolokina, A. S., Juárez‐Vela, R., Jankowski, Ł., Rafique, Z., & Szarpak, Ł. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192114607 · Cited by 11
“Legend: CI: confidence interval; SD: standard deviation [21,24-2628,29,35,36,39,42].”
BackgroundCannata, F., Pinto, G., Chiarito, M., Maurina, M., Condello, F., Bombace, S., Villaschi, A., Novelli, L., Stankowski, K., Liccardo, G., et al. (2023) · Echocardiography · doi:10.1111/echo.15575 · Cited by 9
Chronic pain characteristics in COVID-19 survivors after an ICU stay. A cross-sectional study
Martinez, V., Dziadzko, M. A., Tamayo, J., Schitter, S., Guichard, L., Richeux, F., Roggerone, S., Branche, P., Schlaefflin, L., Nacto, Y., et al. (2023) · Anaesthesia Critical Care & Pain Medicine · doi:10.1016/j.accpm.2023.101267 · Cited by 11
“These results contrast with the frequency of post-COVID-19 sequelae reported in large cohort studies from extensive databases [31].”
Spera, F. R., Mistrulli, R., Salerno, L., Vannini, F., Muthukkattil, M. L., Falcetti, R., Segal, T. Y., Barbato, E., & Buonsenso, D. (2024) · Current Clinical Microbiology Reports · doi:10.1007/s40588-024-00217-w · Cited by 11
Síndrome pós-Covid-19: breve revisão sistemática / Long-Covid: brief systematic review
de Oliveira, R. D. C. S., Amaral, L. M. B., Silva, A. B. D., Brandão, A. S., Teixeira, F. T. B., Maia, L. C., Berni, L. C., Lopes, L. B. C., & Garcia, T. M. P. (2022) · Brazilian Journal of Health Review · doi:10.34119/bjhrv5n2-150 · Cited by 11
Identifying subtypes of Long COVID: a systematic review
Wang, B., Luo, X., Wu, M., Wang, Z., Zhang, J., Wang, Z., Shi, Q., Liu, J., Cao, W., Gu, X., et al. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103705 · Cited by 10
“Symptom capture bias may exist across different data sources, for instance, structured electronic health records (EHRs) may un-derreport subjective symptoms, 75 while survey-based data are susceptible to recall bias.”
Impact of Long-COVID on Health Care Burden: A Case Control Study
Valdivieso, B., Saurí, I., Philibert, J., Calderón, J. M., Gas, M.-E., Diaz, J., López-Hontangas, J. L., Navarro, D., Forner, M. J., & Redón, J. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12185768 · Cited by 16
“No new prescriptions were reported in the majority of publications [9].”
InfluentialCOVID-19-related cardiovascular disease risk due to weight gain: a nationwide cohort study
Lee, S. K., Lim, Y., Jeong, S., & Han, H. W. (2024) · European journal of medical research · doi:10.1186/s40001-023-01569-7 · Cited by 10
“A higher risk of death and incident CVD from 30 days after the diagnosis of COVID-19 until 4 months was found associated with COVID-19 [4, 5].”
BackgroundFan, Y., Liu, X., Guan, F., Hang, X., He, X., & Jin, J. (2024) · Viruses · doi:10.3390/v16010100 · Cited by 11
“…level of cognitive impairment and dementia in hospitalized [20,21] patients, and sequelae, such as mental health disorders and neurocognitive disorders in non-hospitalized [22] COVID-19 patients, and it is possible that SARS-CoV-2 infection may accelerate cognitive decline in AD patients [8,23,24].”
BackgroundSeverity of Postcovid Syndrome: A Systematic Review
Karaseva, A. A., Khudiakova, A. D., Garbuzova, E. V., Ragino, Y. I., & Логвиненко, И. И. (2024) · The Russian Archives of Internal Medicine · doi:10.20514/2226-6704-2023-13-6-422-435 · Cited by 10
LaVergne, S. M., Dutt, T. S., McFann, K., Baxter, B. A., Webb, T. L., Berry, K., Tipton, M., Stromberg, S., Sullivan, B. M., Dunn, J., et al. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1303971 · Cited by 10
Long COVID Characteristics and Experience: A Descriptive Study From the Yale LISTEN Research Cohort
Sawano, M., Wu, Y., Shah, R. M., Zhou, T., Arun, A. S., Khosla, P., Kaleem, S., Vashist, A., Bhattacharjee, B., Ding, Q., et al. (2024) · The American Journal of Medicine · doi:10.1016/j.amjmed.2024.04.015 · Cited by 11
Luo, D., Bai, M., Zhang, W. Y., & Wang, J. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1409723 · Cited by 10
Post-Acute Sequelae of Covid-19: A System-wise Approach on the Effects of Long-Covid-19
Umakanthan, S., Katwaroo, A. R., Bukelo, M. M., Shashidhar, B. G., Boralingaiah, P., Ranade, A. V., Rangan, P., Shashidhar, S., Kini, J. R., & Kini, G. (2024) · American Journal of Medicine Open · doi:10.1016/j.ajmo.2024.100071 · Cited by 12
“16 The SARS-COV-2 virus, beyond its well-known respiratory effects, also impacts multiple organs, including the gastrointestinal GI tract, resulting in sequelae such as nausea, vomiting, abdominal pain, anorexia, diarrhea, GI bleeding, acid reflux, and constipation.”
BackgroundFollow-up assessment of the microvascular function in patients with long COVID
Romanowska‐Kocejko, M., Braczko, A., Jędrzejewska, A., Żarczyńska-Buchowiecka, M., Kocejko, T., Kutryb-Zając, B. A., & Hellmann, M. (2024) · Microvascular Research · doi:10.1016/j.mvr.2024.104748 · Cited by 10
Hsu, J. C., Saenkham, P., Huang, P., Octaviani, C. P., Drelich, A. K., Peng, B., & Tseng, C.-T. K. (2024) · Frontiers in Microbiology · doi:10.3389/fmicb.2024.1455462 · Cited by 10
Unraveling the SARS-CoV-2 spike protein long-term effect on neuro-PASC
Menezes, F., Palmeira, J. D. F., Oliveira, J. D. S., Argañaraz, G. A., Soares, C. R. J., Nóbrega, O. D. T., Ribeiro, B. M., & Argañaraz, E. R. (2024) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2024.1481963 · Cited by 10
Naiditch, H., Betts, M. R., Larman, H. B., Levi, M., & Rosenberg, A. Z. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1376654 · Cited by 10
“An increased burden of esophageal disorders, gastrointestinal disorders, and dysphagia was also seen, as was incident elevated alanine aminotransferase (ALT) levels (350).”
InfluentialLong COVID: General Perceptions and Challenges in Diagnosis and Management
Ozanic, K., Watanabe, A. S. A., Machado, A. B. F., da Silva, V. L., Dias, V. C., & Diniz, C. G. (2025) · COVID · doi:10.3390/covid5030041 · Cited by 10
Post-COVID Metabolic Fallout: A Growing Threat of New-Onset and Exacerbated Diabetes
Jouy, S. H., Tonchev, H., Mostafa, S. M., & Mahmoud, A. M. (2025) · Biomedicines · doi:10.3390/biomedicines13061482 · Cited by 11
“Notably, achieving effective glucose con-trol significantly reduces these biomarkers, suggesting that hyperglycemia exacerbates inflammatory and thrombotic responses independently of viral factors [65].”
Puta, C., Haunhorst, S., & Bloch, W. (2021) · Sports Orthopaedics and Traumatology · doi:10.1016/j.orthtr.2021.08.006 · Cited by 10
A Learning Health System Approach to Long COVID Care
Gustavson, A. M. (2022) · Federal Practitioner · doi:10.12788/fp.0288 · Cited by 10
Aby, E. S., Moafa, G. A. M., Latt, N. L., Sultan, M. T., Cacioppo, P. A., Kumar, S. R., Chung, R. T., Bloom, P. P., Gustafson, J. L., Daidone, M., et al. (2023) · Hepatology Communications · doi:10.1097/01.hc9.0000897224.68874.de · Cited by 10
“Early studies raised concern that patients who survived at least 30 days from the diagnosis of COVID-19 remain at higher long-term risk of death.[3,4] Evolving scientific evidence also suggests that those infected with COVID-19 can experience long-lasting debilitating symptoms, even months after being infected with CO…”
BackgroundKrysa, J. A., Buell, M., Manhas, K. P., Burns, K. K., Santana, M., Horlick, S., Russell, K., Papathanassoglou, E. D. E., & Ho, C. (2023) · Healthcare · doi:10.3390/healthcare11091309 · Cited by 11
Long COVID and its cardiovascular implications: a call to action
Al‐Aly, Z. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad723 · Cited by 11
Recurring SARS-CoV-2 variants: an update on post-pandemic, co-infections and immune response
Verma, A., Manojkumar, A., Dhasmana, A., Tripathi, M. K., Jaggi, M., Chauhan, S. C., Chauhan, D. S., & Yallapu, M. M. (2024) · Nanotheranostics · doi:10.7150/ntno.91910 · Cited by 11
“Different studies conducted on both the hospitalized and non-hospitalized patients shows high chances of major adverse cardiovascular events between a time period of 30 days to 4 months post-COVID-19 diagnosis (26,27).”
Khubchandani, J., Price, J. H., Sharma, S. K., Wiblishauser, M. J., & Webb, F. J. (2022) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2022.01.021 · Cited by 10
“Additional factors have also been proposed that could cause psychological distress among COVID-19 infection survivors such as fear of infecting family members, cost of care and not knowing outcome of illness, home confinement and quarantining, economic hardships and job loss due to disease, and other health complicati…”
A novel method to detect the early warning signal of COVID-19 transmission
Li, M., Ma, S., & Liu, Z. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07603-z · Cited by 11
A Review of Long COVID With a Special Focus on Its Cardiovascular Manifestations
Yousif, E., & Premraj, S. (2022) · Cureus · doi:10.7759/cureus.31933 · Cited by 10
“This is due to the fact that survivors of COVID-19 have now been reported to have a higher risk of mortality, and health loss due to a wide spectrum of pulmonary and extra-pulmonary manifestations [2].”
BackgroundGoretzki, S., Brasseler, M., Dogan, B., Hühne, T., Bernard, D., Schönecker, A., Steindor, M., Gangfuss, A., Marina, A. D., Felderhoff-Müser, U., et al. (2023) · Viruses · doi:10.3390/v15020579 · Cited by 10
“Symptom clusters that have been reported in adult medicine (neurological, abdominal, respiratory) were calculated and the number of present symptoms for each cluster was counted [12,14].”
BackgroundHalaçlı, B., & Topeli, A. (2021) · TURKISH JOURNAL OF MEDICAL SCIENCES · doi:10.3906/sag-2106-306 · Cited by 11
“Another study [18] from the United States Department of Veterans Affairs electronic database, comparing COVID-19 patients who survived but did not require hospitalization with non-COVID outpatients demonstrated that patients with COVID-19 had increased risk of mortality (hazard ratio:1.”
ResultLong Covid and the ghost of nursing theory
Maxwell, E., & Radford, M. (2021) · Journal of research in nursing · doi:10.1177/17449871211037473 · Cited by 10
Frailty and Disability: Predictors or Outcomes or Both in Post COVID-19*
O’Malley, P. A. (2022) · Critical Care Medicine · doi:10.1097/ccm.0000000000005502 · Cited by 10
“Another rare article also exploring frailty in relationship to Long-COVID emerged in the European literature less than a month ago.”
BackgroundInfluentialPersistent alveolar type 2 dysfunction and lung structural derangement in post-acute COVID-19Preprint
Rendeiro, A. F., Ravichandran, H., Kim, J., Borczuk, A., Elemento, O., & Schwartz, R. E. (2022) · medRxiv · doi:10.1101/2022.11.28.22282811 · Cited by 9
“Recent studies of health records have tallied the cumulative burden of PASC symptoms, revealing increased risk for developing comorbidities systemically, in a manner dependent on the severity of the acute phase of disease 11 .”
Vaivode, K., Saksis, R., Litvina, H. D., Niedra, H., Spriņģe, M. L., Krūmiņa, U., Kloviņš, J., & Rovīte, V. (2024) · Current Issues in Molecular Biology · doi:10.3390/cimb46010029 · Cited by 7
“Risk factors for developing long-term COVID-19 are still being defined, but evidence suggests that factors such as disease severity, age, and certain comorbidities may influence the likelihood of experiencing these prolonged effects [4].”
BackgroundInvestigating viral and autoimmune T cell responses associated with post-acute sequelae of COVID-19
Williams, G. P., Yu, E. D., Shapiro, K., Wang, E. W., Freuchet, A., Frazier, A., Arlehamn, C. S. L., Sette, A., & Antunes, R. D. S. (2024) · Human Immunology · doi:10.1016/j.humimm.2024.110770 · Cited by 9
Daodu, T. B., Rugel, E. J., & Lear, S. A. (2024) · CJC Open · doi:10.1016/j.cjco.2024.03.003 · Cited by 10
Identification of the needs of individuals affected by COVID-19
Stanley, H. B., Pereda‐Loth, V., Mantel, M., Rouby, C., Daudé, C., Aguera, P., Fornoni, L., Hummel, T. R., Weise, S., Mignot, C., et al. (2024) · Communications Medicine · doi:10.1038/s43856-024-00510-1 · Cited by 9
“Selected verbatim responses can be found in Supplementary Notes 6.”
InfluentialDermatological complications due to post‑COVID‑19 syndrome: A systematic review
Figueroa, B. C., Rojas, W. M., & Jiménez, D. (2024) · Medicine International · doi:10.3892/mi.2024.208 · Cited by 9
Subphenotypes of Long COVID and the clinical applications of probiotics
Lim, H. X., Khalid, K., Abdullah, A., Lee, L., & Ali, R. A. R. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2025.117855 · Cited by 9
Foreman, L. M., Child, B., Saywell, I., Collins‐Praino, L. E., & Baetu, I. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106067 · Cited by 12
de Melo, B. P., da Silva, J. A. M., Rodrigues, M. A., Palmeira, J. D. F., Saldanha‐Araújo, F., Argañaraz, G. A., & Argañaraz, E. R. (2025) · Viruses · doi:10.3390/v17050617 · Cited by 10
Label efficient phenotyping for Long COVID using electronic health records
Hong, C., Wen, J., Zhang, H. G., Panickan, V. A., Yang, D. Y., Chen, A. W., Xiong, X., Wang, X., Morris, M. M., Morini, S., et al. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01617-y · Cited by 9
“…employ other surrogate features such as earlier SARS-CoV-2 infections 19 – 21 , clinical terms and symptomsassociatedwithLongCOVID 14,20,22 – 25 , SNOMEDclinicalterms 12 , records of Long COVID clinic visits 26 , and online survey data 27 , along with diverse algorithms such as rule-based…”
Sliwa, K. S., Singh, K., Nikhare, K., Kondal, D., Raspail, L., Jain, M., Akter, S., Talukder, S. H., Kato, T., Bertagnolio, S., et al. (2025) · Global Heart · doi:10.5334/gh.1452 · Cited by 9
“Evidence so far suggests that the severity of acute COVID-19 illness is the most common risk predictor for long COVID (3).”
Ivković, V., Anandh, U., Bell, S., Kronbichler, A., Soler, M. J., & Bruchfeld, A. N. (2025) · Nature Reviews Nephrology · doi:10.1038/s41581-025-00997-4 · Cited by 9
Multisystem involvement is common in post-COVID-19 syndrome
(2022) · Nature Medicine · doi:10.1038/s41591-022-01838-8 · Cited by 9
Aschman, T., & Stenzel, W. (2022) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001101 · Cited by 9
Aden, D., Zaheer, S., Kumar, R., Raj, S., Khan, T., & Varshney, S. (2022) · Pathology - Research and Practice · doi:10.1016/j.prp.2022.154144 · Cited by 9
Peiris, S., Nates, J. L., Toledo, J., Ho, Y.-L., Sosa, O., Stanford, V., Aldighieri, S., & Revéiz, L. (2022) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2022.142 · Cited by 9
Síndrome da COVID longa: uma revisão integrativa
Nunes, M. D. C., Alves, O. N., de Santana, L. C., & Nunes, L. T. D. (2022) · Research Society and Development · doi:10.33448/rsd-v11i13.35990 · Cited by 9
Teng, L., Song, X., Zhang, M., Han, Y., Ge, C., Chang, W., & Shen, Z. (2023) · Journal of Medical Virology · doi:10.1002/jmv.28477 · Cited by 10
“At follow‐up in the same study, 36% of those with residual kidney disease at discharge had recovered, but 14% of those who recovered before discharge had recurrent kidney disease.5 An obvious example is AKI patients hospitalized for COVID‐19, of which 47% still have a renal injury at discharge.13 In another study, 35%…”
BackgroundInfluentialLong COVID-19 renal disease: A present medical need for nephrology
de Francisco, A. M., & Fresnedo, G. F. (2023) · Nefrología (English Edition) · doi:10.1016/j.nefroe.2023.03.011 · Cited by 9
“A study from the USA using Veterans Health Administration (VHA) electronic health records to perform a comprehensive assessment of prolonged COVID-19 found that COVID-19 increased the risk of CKD and that this risk was higher among those with severe illness.(30)”
MethodSARS-CoV-2 spread to endocrine organs is associated with obesity: an autopsy study of COVID-19 cases
Poma, A. M., Basolo, A., Alì, G., Bonuccelli, D., Stefano, I. D., Conti, M., Mazzetti, P., Sparavelli, R., Vignali, P., Macerola, E., et al. (2023) · Endocrine · doi:10.1007/s12020-023-03518-0 · Cited by 9
Cost-effectiveness of therapeutics for COVID-19 patients: a rapid review and economic analysis
Metry, A., Pandor, A., Ren, S., Shippam, A., Clowes, M., Dark, P. M., McMullan, R., & Stevenson, M. (2023) · Health Technology Assessment · doi:10.3310/nafw3527 · Cited by 9
Proteomic Evolution from Acute to Post-COVID-19 Conditions
Mohammed, Y., Tran, K. C., Carlsten, C., Ryerson, C. J., Wong, A. W., Lee, T., Cheng, M. P., Vinh, D. C., Lee, T. C., Winston, B. W., et al. (2023) · Journal of Proteome Research · doi:10.1021/acs.jproteome.3c00324 · Cited by 8
Multiplexed optofluidic laser immunosensor for sensitive and rapid detection of biomarkers
Liu, Y., Zhang, Y., Wang, C., Wang, C., Zhang, K., Yang, X., Peng, G.-D., Liu, S., Wang, Z., Rao, Y.-J., et al. (2023) · Sensors and Actuators B Chemical · doi:10.1016/j.snb.2023.135198 · Cited by 9
Anxiety in post-covid-19 syndrome – prevalence, mechanisms and treatment
Burkauskas, J., Branchi, I., Pallanti, S., & Domschke, K. (2023) · Neuroscience Applied · doi:10.1016/j.nsa.2023.103932 · Cited by 13
Bielecka-Dabrowa, A. M., Sakowicz, A., Gryglewska-Wawrzak, K., Kapusta, J., Banach, M., Jankowski, P., & Chudzik, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13061559 · Cited by 10
“Written informed consent has been obtained from the patient(s) to publish this paper.”
Risk of kidney and liver diseases after COVID‐19 infection: A systematic review and meta‐analysis
Pan, B., Wang, X., Lai, H., Vernooij, R. W. M., Deng, X., Ma, N., Li, D., Huang, J., Zhao, W., Ning, J., et al. (2024) · Reviews in Medical Virology · doi:10.1002/rmv.2523 · Cited by 9
“9 In a large cohort study 10 with 47,780 participants, rates of multiorgan dysfunction including chronic kidney diseases and liver diseases after discharge were raised in individuals with COVID ‐ 19.”
BackgroundThe causal role of gut microbiota in susceptibility of Long COVID: a Mendelian randomization study
Li, Z., Xia, Q., Feng, J., Chen, X., Wang, Y., Ren, X., Wu, S., Yang, R., Li, J., Liu, Y., et al. (2024) · Frontiers in Microbiology · doi:10.3389/fmicb.2024.1404673 · Cited by 9
Reduced olfactory bulb volume accompanies olfactory dysfunction after mild SARS-CoV-2 infection
Petersen, M., Becker, B., Schell, M., Mayer, C., Naegele, F. L., Petersen, E. L., Twerenbold, R., Thomalla, G., Cheng, B., Betz, C. S., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-64367-z · Cited by 11
Freudenberg‐Hua, Y., Makhnevich, A., Li, W., Liu, Y., Qiu, M., Marziliano, A. M., Carney, M. T., GREENWALD, B. S., Kane, J. M., Diefenbach, M. A., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.841326 · Cited by 9
“With regard to other variables found to be associated with post-COVID dementia, we confirmed the previously reported association between delirium and post-COVID dementia (4, 5).”
ResultPhysiological Network Is Disrupted in Severe COVID-19
Barajas‐Martínez, A., Mehta, R., Ibarra‐Coronado, E., Fossión, R., Martínez‐Garcés, V. J., Arellano, M. R., Alvarez, I. A. G., Bautista, Y. V. M., Bello‐Chavolla, O. Y., Ramírez-Pedraza, N., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.848172 · Cited by 9
Maranducă, M. A., Tănase, D. M., Cozma, C. T., Dima, N., Clim, A., Pînzariu, A. C., Șerban, D. N., & Șerban, I. L. (2022) · Pharmaceutics · doi:10.3390/pharmaceutics14091906 · Cited by 12
“The risk for progression of CKD was evident even in COVID-19 patients who did not require hospitalization; expectedly, risk was highest among the admissions to critical care unit [192].”
Backgroundde Oliveira, T. C. P., Gardel, D. G., Ghetti, A. T. A., & Lopes, A. J. (2022) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2022.105797 · Cited by 9
“Patients recovering from COVID-19 have a higher incidence of negative health indicators, including worse functional status, and may need additional clinical support such as physical and mental health rehabilitation services (Al-Aly et al., 2021).”
Zhao, J., Zhu, J., Huang, C., Zhu, X., Zhu, Z., Wu, Q., & Yuan, R. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.1035151 · Cited by 9
Bernas, S. N., Baldauf, H., Real, R. G. L., Sauter, J., Markert, J., Trost, S., Tausche, K., Behrends, U., Schmidt, A. H., & Schetelig, J. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13587 · Cited by 8
Cohen, A. B., McAvay, G., Geda, M. E., Chattopadhyay, S., Lee, S., Acampora, D., Araujo, K. L. B., Charpentier, P. A., Gill, T. M., Hajduk, A. M., et al. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18146 · Cited by 9
What Long COVID investigators can learn from four decades of ME/CFS research
Jason, L. A., Natelson, B. H., Bonilla, H. F., Sherif, Z. A., Vernon, S. D., Verduzco‐Gutierrez, M., O’Brien, L., & Taylor, E. C. (2023) · Brain Behavior and Immunity Integrative · doi:10.1016/j.bbii.2023.100022 · Cited by 9
Ambalavanan, R., Snead, R. S., Marczika, J., Kozinsky, K., & Aman, E. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20196836 · Cited by 13
Maxwell, E. (2021) · BMJ · doi:10.1136/bmj.n1173 · Cited by 9
Lokugamage, A. U., Simpson, F. K., & Chew-Graham, C. A. (2021) · BMJ · doi:10.1136/bmj.n1579 · Cited by 9
Health Care Costs Following COVID-19 Hospitalization Prior to Vaccine Availability
Khan, T., Tsipas, S., Wozniak, G. D., Kirley, K., & Mainous, A. G. (2023) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2023.230069r1 · Cited by 8
Wang, J., Zhang, H., Ma, J., Gu, L., & Li, X. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1500020 · Cited by 8
“The prevalence of stroke may be underestimated due to the cardiovascular effects of COVID-19 sequelae (1, 4).”
Văruț, R. M., Popescu, A. I. S., Găman, S., Niculescu, C. E., Niculescu, Ș. A., Dop, D., Stepan, M. D., Ionovici, N., Singer, C. E., & Popescu, C. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17030355 · Cited by 8
“Antidepressants were prescribed very often before SARS-CoV-2 [9], and during the COVID-19 pandemic, usage increased [10].”
Marasco, G., Hod, K., Colecchia, L., Cremon, C., Barbaro, M., Cacciari, G., Falangone, F., Kagramanova, A., Bordin, D., Drug, V., et al. (2025) · United European Gastroenterology journal · doi:10.1002/ueg2.70005 · Cited by 9
“Interestingly, the increased rates and severity of constipation in patients with pre‐existing IBS/FD are consistent with previous findings [21].”
A multidimensional network of factors associated with long COVID in the French population
Coste, J., Delpierre, C., Robineau, O., Rushyizekera, M., Richard, J., Alleaume, C., Gallay, A., Tebeka, S., Steichen, O., Lemogne, C., et al. (2025) · Communications Medicine · doi:10.1038/s43856-025-00846-2 · Cited by 8
“The fi nal models obtained at each stage based on the alternative de fi nitions of PCC and in participants infected within the past year provided very similar results to those of the main analysis (Supplementary data fi les 3 – 7).”
Ono, B. E., Izaías, J. E., Sales, A. O., Rodrigues, T. S., Nunes, C. S., Niec, J., Rocha, N. G., Rocha, H. N. M., Texeira, G. F., Rodrigues, A. G., et al. (2025) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00055.2025 · Cited by 8
The immunological impact of revaccination in a hybrid-immune world
Bausch-Jurken, M. T., & Alter, G. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1588259 · Cited by 11
“Long COVID, or post-acute sequelae of COVID-19, includes a myriad of complications affecting multiple organ systems, which, beyond 30 days after COVID-19 diagnosis, cause a substantial burden of health loss and increased risk of mortality (12).”
Căliman-Sturdza, O. A., Gheorghita, R. E., Lobiuc, A., Filip, R., Șoldănescu, I., Mangul, S., & Dimian, M. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2642510 · Cited by 11
The effectiveness and safety of the use of antithrombotic therapy in COVID-19
Lobastov, K. V., Porembskaya, О. Y., & Schastlivtsev, I. (2021) · Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) · doi:10.21518/1995-1477-2021-18-2 · Cited by 8
Post COVID-19 burden: focus on the short-term condition
Yang, F., Pang, B., Jin, X., Chen, Z., Pang, W., Liu, Q., Zhang, J., & Zhang, B. (2022) · Acupuncture and Herbal Medicine · doi:10.1097/hm9.0000000000000036 · Cited by 8
Allado, E., Poussel, M., Hamroun, A., Moussu, A., Kneizeh, G., Hily, O., Temperelli, M., Corradi, C., Koch, A., Albuisson, É., et al. (2022) · Healthcare · doi:10.3390/healthcare10112154 · Cited by 8
Metadata
- Authors
- Al-Aly, Z., Xie, Y., & Bowe, B.
- Affiliations
- VA St. Louis Health Care System (US)
- Venue
- Nature
- Published
- 2021-04-22
- Volume
- 594
- Issue
- 7862
- Pages
- 259-264
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W3153493739
- Cited by
- 1,518
- References
- 46
- Citations by year
- 2026: 95 · 2025: 170 · 2024: 268 · 2023: 365 · 2022: 391 · 2021: 228
- FWCI
- 149.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature (publishedVersion)
- Research Square (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Society of Nephrology
- McDonnell Center for Systems Neuroscience
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- post-COVID-19 sequelae, long COVID, COVID-19 mortality, health resource utilization, pulmonary sequelae, neurocognitive disorders, mental illness, metabolic disorders, cardiovascular disease, gastrointestinal diseases, fatigue, musculoskeletal pain, anemia, medication use, laboratory abnormalities, disease severity, intensive care unit admission, veterans
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Post-Acute COVID-19 Syndrome, Female, Hospitalization, Humans, Influenza, Human, Male, Outpatients, Risk, Time Factors, United States, United States Department of Veterans Affairs, Cohort Studies, Databases, Factual, Electronic Health Records, Datasets as Topic
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