That's the primary conclusion of a new study that tracked over 1,000 patients with long COVID, a chronic condition that can emerge after an infection with the SARS-CoV-2 virus. Among the patients, the chance of improvement varied sharply depending on how the condition affected their bodily systems.
This latter group had symptoms that affected their cardiac, nervous and gastrointestinal systems, among others. An expert told Live Science that the condition resembled myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which often arises after an infection and similarly impacts a wide range of bodily systems.
The patients in the study were enrolled in the long-term RECOVER Adult Study. Funded by the National Institutes of Health, the project has recruited thousands of adults across the United States who previously tested positive for COVID-19.
Nearly 1,020 patients met this requirement and were tracked over time; they had in-person appointments and filled out symptom surveys every three months. Scientists marked patients as "improved" once they recorded LCRI scores of 10 or less at two consecutive visits. They found that 36% of the participants had improved two years after their inciting COVID-19 infection, and that figure rose to 50% after three years.
Reeder said he was careful to avoid describing the participants as "recovered." This decision was influenced by input from the long COVID community to the RECOVER Adult Study, he said. They highlighted that their symptoms can wax and wane, whereas "recovery" implies a permanent resolution. The new study didn't capture, for example, whether individual patients who recorded meaningful improvement later relapsed.
The researchers analyzed which SARS-CoV-2 strain was associated with the most long COVID cases, controlling for patient vaccination status. (Image credit: koto_feja via Getty Images)ME/CFS and long COVID
Some of the starkest differences in improvement rates were seen between patients with different symptoms.
Loss of smell or tasteChronic coughBrain fogHeart palpitationsSymptoms affecting multiple bodily systems
In the new study, patients in the last three groups were less likely to get better within three years. The final group's rate was particularly low, at just 19%.
"It looks as if at least a major subgroup is suffering from ME-CFS," Scheibenbogen said, noting that COVID-19 may have triggered their condition. "This is a disease which is triggered by different infections, but in the end, the disease [itself] is very similar," she said.
The team's new findings highlight the need for clinical trials to test possible treatments for long COVID. Both Scheibenbogen and study co-author Harrison Reeder, a biostatistician at Massachusetts General Hospital, said these subtypes would be important to consider in the design of these potential trials.
Related storiesThe multisystem subgroup, Reeder said, "might be a group where an effective intervention can make a bigger difference than people who stand to potentially have a higher chance of improvement regardless."
"There's a lot of work to do in RECOVER and in the world of long COVID research," Harrison said. "There's a lot of opportunity."
This article is for informational purposes only and is not meant to offer medical advice.
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