LONG COVID: Answers Emerge on How Many People Improve

Studies are shedding light on recovery rates as well as on the prevention and treatment of this complex condition. More than three years after the global spread of the SARS-CoV-2 virus, it is estimated that over 65 million people are still living with the often devastating effects of Long Covid. Scientists are still struggling to understand this complex condition.

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How Many People with Long Covid Improve?

In a study published in May, researchers followed 1,106 adults who had contracted the SARS-CoV-2 virus before vaccines were available. After six months, 22.9% of them still had symptoms. This number decreased to 18.5% after one year and to 17.2% after two years. “After the first year, it stabilizes,” says study co-author Tala Ballouz, an epidemiologist at the University of Zurich in Switzerland. “You are more likely to recover during the first year, and after a year, it becomes truly a chronic condition.”

In another study published in May, epidemiologist Unnur Anna Valdimarsdóttir from the University of Iceland in Reykjavik and her colleagues reported that one-third of people who had Long Covid at six months post-infection no longer had it at nine months.

Can Long Covid Be Treated or Prevented?

There is now considerable evidence that vaccination reduces the risk of Long Covid. In a meta-analysis from March, people who had received two doses of the vaccine were significantly less likely to develop the condition compared to unvaccinated individuals. However, there are several drugs that appear promising for preventing Long Covid. One of these is metformin, a standard treatment for type 2 diabetes. In a study published in June, Carolyn Bramante, a specialist in obesity medicine at the University of Minnesota in Minneapolis, and her colleagues followed 1,126 overweight or obese individuals who had contracted COVID-19. By day 300 of the study, 6.3% of those who had received metformin during the acute phase of the illness had persistent COVID-19, compared to 10.4% of those who had received a placebo. Ballouz says the results are “promising,” but need to be replicated in other groups.

Meanwhile, a study published in March found that the antiviral Paxlovid—a combination of the drugs nirmatrelvir and ritonavir—reduced the risk of Long Covid if administered during the acute phase. This result is “equally promising,” says Ballouz. This study also needs to be replicated, she notes, as the study participants were mostly men.

But preventive agents will not help those who already have the condition, which could affect “10% of infected people,” according to a review published in January. Similarly, the WHO estimates that the prevalence is 10-20%. “The real benefit would be finding a therapy that works once people are diagnosed with Long Covid,” says Ballouz.