COVID-19 Infection Prior to Omicron Variant Linked to Higher Risk of Developing Long COVID


There may be more than 200 symptoms associated with long COVID-19.

Long COVID-19 is a set of post-infection conditions that impact almost every tissue and organ, which may last for months or years after COVID-19 infection. A recent National Institutes of Health (NIH) study found that unvaccinated patients, or those who had COVID-19 prior to the spread of the 2021 Omicron strain, were more likely to have long or severe long COVID. The findings, which were published in JAMA, could be used to direct new treatment options, according to the authors.

Coronavirus pandemia concept, planet hologram. Image Credit: Adobe Stock - ImageFlow.

Image Credit: Adobe Stock - ImageFlow.

“All patients suffering from long COVID deserve the attention and respect of the medical field, as well as care and treatment driven by their experiences,” said David C. Goff, MD, PhD, director of the Division of Cardiovascular Sciences within the NIH, in a press release. “As treatments are developed, it will be important to consider the complete symptom profile.”

More than 11 million people in the United States have been infected with COVID-19. Currently, 6% of infected individuals may be suffering from long COVID, which could have more than 200 associated symptoms, according to the federal government’s Household Pulse survey.

“Americans living with long COVID want to understand what is happening with their bodies,” said ADM Rachel L. Levine, MD, Assistant Secretary for Health, in the press release.

The NIH Researching COVID to Enhance Recovery (NIH RECOVER) Initiative was created to understand how people recover from COVID-19, the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), and identify strategies to prevent and treat long COVID or the long-term effects from COVID-19.

The researchers assessed 9764 adults (8646 with COVID-19 and 1118 without) for 30-plus symptoms. There were 12 symptoms that characterized long COVID: post-exertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, heart palpitations, issues with sexual desire or capacity, loss of smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Certain symptoms also occurred together in a cluster.

Investigators observed that approximately 10% of the 2231 patients who got COVID-19 after Dec. 1, 2021, experienced long-term symptoms of COVID-19 or long COVID at 6 months. However, patients who had COVID-19 prior to Omicron, or who were unvaccinated at infection, had an even higher risk of long COVID. Further, the results suggest that reinfection was linked to long COVID frequency and severity.

The survey results are not final, and they will be compared against lab tests and imaging for accuracy. RECOVER is an ongoing initiative that will have more clinical trials. The researchers will enroll patients through 2023.

Study author Leora Horwitz, MD, director of the Center for Healthcare Innovation and Delivery Science, said that “this approach—which may evolve over time—will serve as a foundation for scientific discovery and treatment design.”


Pennington Biomedical Research Center. Large study provides scientists with deeper insight into long COVID symptoms. News Release. May 26, 2023. June 6, 2023.

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