About half of people with long COVID saw meaningful improvement in their symptoms within three years of the infection that started their illness, Live Science reported. A study published Nov. 3 in Annals of Internal Medicine followed patients in the National Institutes of Health-funded RECOVER Adult Study, which has recruited thousands of U.S. adults who previously tested positive for COVID-19. The chance of improvement varied sharply by how the condition affected the body. Roughly 60 percent of patients whose predominant symptoms were changes in taste or smell had significantly improved three years after their first positive test. Less than 20 percent of those with a multisystem presentation, affecting the cardiac, nervous, and gastrointestinal systems, among others, had improved in that time.
Researchers scored patients on a 30-point 2024 LC Research Index meant to capture combinations of symptoms such as fatigue, brain fog, shortness of breath, and heart palpitations. Nearly 1,020 patients who scored more than 10 points were tracked with in-person appointments and symptom surveys every three months. Scientists marked patients as "improved" once they recorded scores of 10 or less at two consecutive visits. They found that 36 percent had improved two years after their inciting infection, and that the figure rose to 50 percent after three years. Index scores hit zero for 26 percent of participants after three years, meaning all of their symptoms were gone at the time of the survey. Co-author Harrison Reeder, a biostatistician at Massachusetts General Hospital, said he was careful not to describe those participants as "recovered," after input from the long COVID community, because symptoms can wax and wane and "recovery" implies a permanent resolution. The new study did not capture whether patients who improved later relapsed.
Men and women improved at similar rates, but adults under 46 were more likely to improve than older participants, and patients infected with Omicron variants were more likely to improve than those infected with earlier strains. In a previous study, RECOVER researchers had grouped participants into five subtypes: loss of smell or taste, chronic cough, brain fog, heart palpitations, and symptoms affecting multiple bodily systems. In the new analysis, patients in the last three groups were less likely to get better within three years. The multisystem group's rate was particularly low, at 19 percent.
Dr. Carmen Scheibenbogen, an immunologist at Charité University Medicine Berlin, said that group's progress resembles myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS, which often arises after an infection and similarly affects many systems. "It looks as if at least a major subgroup is suffering from ME-CFS," she said, noting that COVID-19 may have triggered the condition. Both she and Reeder said the subtypes should be considered in the design of future treatment trials. The verified finding is a three-year follow-up with a clear split by symptom pattern, not a claim that long COVID is mostly over, or that it never ends.