RECOVER Studies Identify Long Covid Disparities

Black and Hispanic Americans appear to experience more symptoms and health problems related to long Covid—a lay term that captures an array of health complications that persist after recovering from a Covid infection—than White people and are less likely to be diagnosed with the condition, according to new NIH-funded research.

The findings, from two different studies by NIH’s Researching Covid to Enhance Recovery (RECOVER) Initiative, add to a growing body of research aimed to better understand the complex symptoms and other issues associated with long Covid that millions have experienced.

In one analysis, published in the Journal of General Internal Medicine, researchers looked at the health records of 62,339 adults who received a positive Covid-19 test at one of five academic health centers in New York City, all between March 2020 and October 2021. They tracked the patients’ health for one to six months after the positive test and compared the findings to 247,881 adults who never had Covid.

In the months following infection, Black adults with severe disease were more likely than White adults to be diagnosed with diabetes and experience headaches, chest pain and joint pain, but less likely to have sleep disorders, cognitive problems or fatigue. Similarly, Hispanic adults who required hospital care were more likely than White adults to have headaches, shortness of breath, joint paint and chest pain, but less likely to have sleep disorders, cognitive problems or fatigue.

Similar patterns emerged among people with mild to moderate disease. Among patients who were not hospitalized, Black adults were more likely to have blood clots in their lungs, chest pain, joint pain, anemia or be malnourished. Hispanic adults were more likely than White adults to have dementia, headaches, anemia, chest pain and diabetes. Conversely, White adults were most likely to have conditions such as cognitive impairment (sometimes referred to as “brain fog”) and fatigue.

In the second study, which published in BMC Medicine, researchers analyzed data from the electronic health records of 33,782 adults and children who received a diagnosis for long Covid between October 2021 and May 2022 at one of 34 U.S. medical centers. 

Among the more striking findings: most of the patients were White, female, non-Hispanic and likely to live in areas with low poverty and greater access to health care. Given what researchers already knew about the disproportionate impact of Covid on people of color and economically disadvantaged populations, the findings stood out and suggest that not all patients who have long Covid are being diagnosed.