Long COVID science, research and policy
Abstract
Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling. The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion-equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis. Long COVID can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies, even threatening progress toward achieving the Sustainable Development Goals. Addressing the challenge of long COVID requires an ambitious and coordinated-but so far absent-global research and policy response strategy. In this interdisciplinary review, we provide a synthesis of the state of scientific evidence on long COVID, assess the impacts of long COVID on human health, health systems, the economy and global health metrics, and provide a forward-looking research and policy roadmap.
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The enduring and debilitating symptoms of long COVID have emerged as a significant public health concern.
“The enduring and debilitating symptoms of long COVID, associated with long-term recovery from SARS-CoV-2 infection have emerged as a significant public health concern in the aftermath of the global pandemic [1].”
From Evaluating the efficacy of repetitive anodal transcranial direct current stimulation on cognitive fatigue in long COVID: A randomized controlled trial (2025) · cites this paper as [1]
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Mapping the effectiveness and risks of GLP-1 receptor agonists
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- Authors
- Al-Aly, Z., Davis, H., McCorkell, L., Soares, L., Wulf-Hanson, S., Iwasaki, A., & Topol, E. J.
- Affiliations
- Patient-Led Research Collaborative (US)
- Howard Hughes Medical Institute (US)
- Scripps Research Institute (US)
- Venue
- Nature Medicine
- Published
- 2024-08
- Volume
- 30
- Issue
- 8
- Pages
- 2148-2164
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W4401461906
- Cited by
- 538
- References
- 14
- Citations by year
- 2026: 226 · 2025: 259 · 2024: 53
- FWCI
- 36.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › 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
- long COVID, viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation, dysbiosis, health system burden, global health policy, research roadmap
- MeSH terms
- COVID-19, SARS-CoV-2, Post-Acute COVID-19 Syndrome, Health Policy, Humans, Global Health, Biomedical Research
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