Your Chance of Full Recovery From Long-Covid is Only About 50-50 Within 3 Months

Shin

The chances of long-Covid recovery also become slimmer with female sex, obesity, older age, and more severe Covid-19.

When SARS-CoV-1 emerged 20 years ago in China, no one anticipated the disease could cause long-SARS. When SARS-CoV-2 — the causative agent of Covid-19 — appeared 3 years ago, barely anyone anticipated it could cause long-Covid. Same coronavirus family, the same oversight.

Back then, about 40% of SARS survivors were found to have persistent fatigue two years later, of which 27% met the criteria for chronic fatigue syndrome. About 13% of SARS survivors still had impaired lung function 15 years later.

Now, how long might long-Covid last?

Due to an overabundance of long-Covid studies in the literature, I will only select and discuss studies of sufficient quality, such as having adequate sample sizes and follow-up time and, crucially, little sampling bias. Briefly, I keyed in (long-covid OR post-covid-19 syndrome) AND recover* into PubMed and derived and screened 438 papers as of 2 April 2022.

I also won’t be discussing the prevalence of long-Covid here as I already did elsewhere: “Current Long-COVID Statistics Are Missing the Background Prevalence” and “Your Lifetime Risk of Severe Long-Covid Is Likely <5%.”

1. Data from the U.S.

Using the TriNetX research network containing data from 59 healthcare organizations, mainly from the U.S., Taquet et al. analyzed data of those who had Covid-19 (273,618 patients; mean age of 46 years; 57% women).

They did find that Covid-19 patients were 1.6-times more likely to develop at least one persistent symptom than influenza patients, but I’ll not emphasize so much on prevalence here.

Focusing on symptom trajectory, there was a downward trend in long-Covid prevalence from the first 90 days to the next 90 days (90–180 days):

  • Anxiety or depression: from 22.8% to 15.5% (32% decrease).
  • Abnormal breathing: from 18.7% to 7.9% (58% decrease).
  • Abdominal symptoms: from 15.6% to 8.3% (47% decrease).
  • Fatigue or malaise: from 12.8% to 5.9% (54% decrease).
  • Chest or throat pain: from 12.6% to 5.7% (55% decrease).
  • Other pain symptoms: from 11.6% to 7.2% (38% decrease).
  • Headache: from 8.7% to 4.6% (47.1% decrease).
  • Cognitive symptoms: from 7.9% to 4% (49% decrease).
  • Muscle pain: from 3.2% to 1.5% (53% decrease).

So, if you have got long-Covid symptoms soon after getting Covid-19, you have about a 50% chance of recovering within the first 3 months.

2. Data from the U.K.

The U.K. Office of National Statistics (ONS) has tracked over 20,000 Covid-19 survivors as of April 2021 and come up with the nice figure below, where the chances of recovery stand at 33-43% within the first 3 months.

Specifically, about 21% had symptoms at 5-week post-Covid, which dropped to 14% at 12-week and 12% at 16–18-week. That’s a 33% and 43% decrease from 5-week to 12-week and 16–18-week, respectively.

But this analysis has no control group to gauge how high is the background prevalence. So, the prevalence of long-Covid herein has not been deducted from the background and is likely overestimated to some extent.

3. Data from Spain

Fernández-de-las-Peñas et al. randomly recruited 1,563 previously hospitalized Covid-19 patients from five hospitals in Spain (mean age of 61 years; 46% women), interviewing them at 8.4-month and 13.2-month after hospitalization about their symptoms.

Results showed that:

  • 19% of patients reported no symptoms at 8.4-month post-hospitalization, which rose to 32% at 13.2-month (a 68% increase in recovery rate).
  • 48% of survivors reported ≥3 long-Covid symptoms at 8.4-month post-hospitalization, which dropped to 25% at 13.2-month (a 48% decrease in symptom prevalence).

Again, this study has no control group, so its long-Covid prevalence number still has to be deducted from the background prevalence. That said, at least this study informs that the chances of full and partial long-Covid recovery within 8 months are 68% and 48%, respectively.

What’s brilliant about this study is the random sampling, which other cohort studies rarely do. Random sampling minimizes sampling bias and ensures that the sample size is representative of the target population, which, in the case of this study, is previously hospitalized Covid-19 patients.

4. Data from the Netherlands

In the Netherlands, Wynberg et al. enrolled 192 Covid-19 survivors — of which 29% had mild, 42% had moderate, 16% had severe, and 12% had critical Covid-19 — in a one-year follow-up study about symptom persistence.

Results revealed that:

  • At 12-week post-Covid, 31%, 64%, and 87% of survivors of mild, moderate, and severe/critical Covid-19 developed long-Covid, respectively. (Again, these numbers did not factor in the background prevalence).
  • Among survivors of mild Covid-19, the median time to full recovery was 63 days, although 16% still had long-Covid at one-year post-Covid (a 48% decrease from 31% at 12-week).
  • Among survivors of moderate Covid-19, the median time to full recovery was 232 days, but 49.5% still had long-Covid at one-year post-Covid (a 23% decrease from 64% at 12-week).
  • Among survivors of severe Covid-19, the median time to full recovery was not mentioned, and 53.5% still had long-Covid one year later (a 38.5% decrease from 87% at 12-week).

So, this study showed that chances of long-Covid recovery decrease with more severe Covid-19: from 48% chance in mild Covid-19 patients to 23–39% chance in moderate-to-severe Covid-19 patients in 3 months.

Moreover, this study found that long-covid recovery was 35% slower in women than men and 38% slower in obese than non-obese adults after adjusting for age, sex, and medical comorbidity confounding variables.

This study also produced the figure below, where we can see that long-Covid recovery is rare after 5–6 months. In other words, past the 5–6-month mark, a long-Covid patient may never recover as the recovery trend line is stagnating rather than declining.

https://img.particlenews.com/image.php?url=3aCYAy_0ezda2um00
Percentages of participants who still had long-Covid over the course of one year. Dashed red line: 12-week mark.Wynberg et al. (2022).

5. Data from Italy

In a 9-month follow-up study from Italy, Righi et al. examined the risk factors and recovery patterns of long-Covid patients among 465 Covid-19 survivors (46% females, mean age of 56 years; 51% hospitalized).

Results were as follows:

  • At 1-month, 42% reported persistent symptoms, which dropped to 20% at 9-month (a 52% decrease).
  • Older age of >50 years, ICU stay, and >4 initial Covid-19 symptoms independently upped the risk of long-Covid at 9-month by 2–2.5-fold.
  • Before Covid-19, 90% of survivors reported excellent physical health, which fell to 24% during Covid-19 and rose back to 82% at 9-month post-Covid (a 73% decrease, followed by a 71% increase).

Similar to the above findings, this study informed that the chances of long-Covid recovery stand at roughly 50–70% from 1-month to 9-month, which decrease with older age and more severe Covid-19. But most of the long-Covid cases in this study are likely mild since 82% out of 90% reported re-attaining their physical health at 9-month post-Covid.

This study also plotted the recovery lines for certain long-Covid symptoms — cough (blue), breathlessness (green), fatigue (orange), and muscle pain (light blue) — showing, again, a similar stagnating pattern past the 4–6-month (120–180-day) mark after Covid-19:

https://img.particlenews.com/image.php?url=46zclC_0ezda2um00
The recovery stagnates at 4-month for cough (blue) and myalgia (light blue) and 6-month for breathlessness (green) and fatigue (orange).Righi et al. (2022).

Key points

Synthesizing these studies tells us that about 50% and 70% of people with long-Covid symptoms recover within 3 and 9 months, respectively.

If recovery didn’t happen within these time frames, long-Covid could very well persist for over a year and possibly for years to come, judging from data on patients with long-SARS and chronic fatigue syndrome.

Chances of long-Covid recovery also become slimmer with female sex (1.35-times), obesity (1.38-times), older age (2.5-times), and more severe Covid-19 (2.4-times). Past the 5–6-month mark after getting Covid-19, chances of long-Covid recovery are even much slimmer, based on the stagnating recovery line from the U.K., the Netherlands, and Italy data.

Even though the risk of getting long-Covid may be small — since it depends on catching Covid-19 first — chances long-Covid recovery are not so great. So, ultimately, long-Covid is not to be underestimated.

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MSc Biology student | 5x first-author academic papers | 100+ articles on coronavirus | Freelance medical writer

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