Long COVID Incidence Proportion in Adults and Children Between 2020 and 2024: An EHR-Based Study From the RECOVER Initiative

DOI record: { "DOI": "10.1093/cid/ciaf046", "ISSN": [ "1058-4838", "1537-6591" ], "URL": "http://dx.doi.org/10.1093/cid/ciaf046", "abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Incidence estimates of post-acute sequelae of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) infection, also known as long COVID, have varied across studies and changed over time. We estimated long COVID incidence among adult and pediatric populations in 3 nationwide research networks of electronic health records (EHRs) participating in the RECOVER (Researching COVID to Enhance Recovery) Initiative using different classification algorithms (computable phenotypes).</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>This EHR-based retrospective cohort study included adult and pediatric patients with documented acute SARS-CoV-2 infection and 2 control groups: contemporary coronavirus disease 2019 (COVID-19)–negative and historical patients (2019). We examined the proportion of individuals identified as having symptoms or conditions consistent with probable long COVID within 30–180 days after COVID-19 infection (incidence proportion). Each network (the National COVID Cohort Collaborative [N3C], National Patient-Centered Clinical Research Network [PCORnet], and PEDSnet) implemented its own long COVID definition. We introduced a harmonized definition for adults in a supplementary analysis.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Overall, 4% of children and 10%–26% of adults developed long COVID, depending on computable phenotype used. Excess incidence among SARS-CoV-2 patients was 1.5% in children and ranged from 5% to 6% among adults, representing a lower-bound incidence estimation based on our control groups. Temporal patterns were consistent across networks, with peaks associated with introduction of new viral variants.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>Our findings indicate that preventing and mitigating long COVID remains a public health priority. Examining temporal patterns and risk factors for long COVID incidence informs our understanding of etiology and can improve prevention and management.</jats:p>\n </jats:sec>", "author": [ { "ORCID": "https://orcid.org/0000-0002-5685-9602", "affiliation": [ { "name": "Department of Population Health, New York University Grossman School of Medicine , New York, New York ,", "place": [ "USA" ] } ], "authenticated-orcid": false, "family": "Mandel", "given": "Hannah", "sequence": "first" }, { "ORCID": "https://orcid.org/0000-0003-2144-8480", "affiliation": [ { "name": "Department of Hematology and Medical Oncology, Emory University , Atlanta, Georgia ,", "place": [ "USA" ] } ], "authenticated-orcid": false, "family": "Yoo", "given": "Yun J", "sequence": "additional" }, { "affiliation": [ { "name": "Applied Clinical Research Center, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania ,", "place": [ "USA" ] } ], "family": "Allen", "given": "Andrea J", "sequence": "additional" }, { "affiliation": [ { "name": "Information Technologies and Services Department, Weill Cornell Medicine , New York, New York ,", "place": [ "USA" ] } ], "family": "Abedian", "given": "Sajjad", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-6183-9254", "affiliation": [ { "name": "Department of Population Health Sciences, Weill Cornell Medical College , New York, New York ,", "place": [ "USA" ] } ], "authenticated-orcid": false, "family": "Verzani", "given": "Zoe", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medicine, Brigham & Women's Hospital , Boston, Massachusetts ,", "place": [ "USA" ] } ], "family": "Karlson", "given": "Elizabeth W", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pediatrics and Child Health Institute, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey ,", "place": [ "USA" ] } ], "family": "Kleinman", "given": "Lawrence C", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-3792-1789", "affiliation": [ { "name": "Department of Population Health, New York University Grossman School of Medicine , New York, New York ,", "place": [ "USA" ] } ], "authenticated-orcid": false, "family": "Mudumbi", "given": "Praveen C", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0003-1897-6581", "affiliation": [ { "name": "Department of Pediatrics, Division of Infectious Diseases & Global Health, Yale University School of Medicine , New Haven, Connecticut ,", "place": [ "USA" ] }, { "name": "Department of Biostatistics, Yale University School of Public Health , New Haven, Connecticut ,", "place": [ "USA" ] } ], "authenticated-orcid": false, "family": "Oliveira", "given": "Carlos R", "sequence": "additional" }, { "affiliation": [ { "name": "Division of Critical Care Medicine, Nationwide Children's Hospital , Columbus, Ohio ,", "place": [ "USA" ] } ], "family": "Muszynski", "given": "Jennifer A", "sequence": "additional" }, { 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