400 million people worldwide suffer from Long Covid

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The world has had a huge long Covid problem since the start of the Sars-CoV-2 pandemic. More than 400 million people worldwide have been affected by these persistent and often severe complications. This has now been calculated by leading US scientists. They are calling for more efforts to tackle this problem.

“The cumulative global incidence of Long Covid is 400 million people. This has an annual economic impact of around one trillion US dollars minus – corresponding to around one percent of the global economy,” wrote Ziyad Al-Aly (Washington University in St. Louis/USA) and his co-authors, including the world-renowned cardiologist Eric Topol (Scripps Institute/San Diego), in “Nature Medicine” (https://doi.org/10.1038/s41591-024-03173-6). Ziyad Al-Aly published a similar review in the “New England Journal of Medicine” last Thursday.
High complexity
For example, the experts state in a timeline that patients after Sars-CoV-2 infection had already reported long-lasting health problems in March 2020. Just one month later, in March 2020, New York Times journalist Fiona Lowenstein wrote for the first time about the experiences of those affected. Patients organized self-help groups in the USA and literally invented the name “Long Covid”.

The experts discovered that long-term COVID-19 is incredibly complex: all age groups are affected. The cardiovascular, immune, nervous, and digestive systems can be affected just as much as the reproductive organs. “Brain fog,” cognitive disorders, lack of concentration, exhaustion, cardiac arrhythmia, lack of physical resilience, and many other physical and psychological problems are just some of the symptoms.
Things will certainly not end any time soon with the global spread of Sars-CoV-2. “The omicron variants of Sars-CoV-2 have been associated with a lower risk of Long Covid than the delta and pre-delta variants. The vaccines (before infection) and antiviral drugs (during the acute phase of infection) could reduce the risk of Long Covid. But even people who have not developed Long Covid syndrome after a first Sars-CoV-2 infection remain at risk of further infections,” the experts noted. A second infection could lead to Long Covid for the first time or exacerbate existing symptoms. According to the latest scientific findings, two infections cause an increased risk, and three infections are even higher.

One percent of children affected
As the authors explain, the estimates are conservative: In 2020, there were 65 million patients with Long Covid worldwide, rising cumulatively to 211 million people with this experience in 2021. In 2022, there were already 337 million people affected, compared to 409 million last year. Data from the USA, including large-scale health surveys in households and statistical evaluations in the UK, speak for themselves. The scientists: “Overall, the estimated prevalence of long Covid in the total population is around six to seven percent in adults and around one percent in children.”
The causes of Long-Term COVID-19 are also complex. The persistent presence of the virus in the body (not sufficiently eliminated by the immune system), dysregulation of the immune system, defects in the power plants of the cells (mitochondrial dysfunction), a tendency to thrombosis and inflammatory reactions, and much more apparently play a role. Subliminal chronic inflammation can maintain Long-Term COVID-19 in the long term.
According to the experts, there are no simple solutions: avoiding infections by wearing masks, etc., which also reduces infection rates almost automatically and the risk of Long Covid. “Covid-19 vaccines can sometimes reduce Long Covid in adults by 15 to 70 percent. It is unclear how much immediate treatment with antiviral medication in acute cases also reduces the risk of Long Covid. The experts’ criticism: “A large proportion of the Long Covid burden worldwide remains undiagnosed, especially in societies with fewer resources. Psychosomatic causes are also often wrongly suspected.”
Therefore, the healthcare system and society as a whole should address the problem intensively and comprehensively. The economic consequences also speak in favor of this. Al-Aly and his co-authors say, “According to the US Brookings Institute, between two and four million US citizens were unemployed due to Long COVID-19 in 2022.” Those affected in employment in the USA cut their working hours by a quarter to half.

According to the British think tank “Economist Impact,” calculations on the negative economic impact of Long Covid in 2024 are between 0.5 and 2.3 percent gross national product (GDP) minus for some major economies. Globally, a minus of around one percent can be assumed.