Long COVID prevalence varies widely across US states, CDC study finds

By Dr. Sushama R. Chaphalkar, PhD.Feb 18 2024Reviewed by Susha Cheriyedath, M.Sc.

In a recent study published in the CDC journal MMWR Morbidity and Mortality Weekly Report, researchers investigated the prevalence of long coronavirus disease 2019 (long COVID) among adults across the United States of America (USA). They found that the prevalence of long COVID varied among the states and territories, ranging from 1.9% in the Virgin Islands to 10.6% in West Virginia.

Notes from the Field: Long COVID Prevalence Among Adults — United States, 2022. Image Credit: Donkeyworx / Shutterstock

Background

Long COVID or post-COVID refers to various health issues that persist after acute COVID-19, including neurological and respiratory symptoms, as well as fatigue. About 6.9% of adults in the USA reportedly suffered from long COVID in 2022. However, the current lack of data from states and territories hinders targeted public health responses. The Association of State and Territorial Health Officials and Council of State and Territorial Epidemiologists have also highlighted this gap. The Centers for Disease Control and Prevention (CDC) in the USA conducted a nationwide study to estimate the prevalence of long COVID among adults to address this need.

About the study

The CDC utilized data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey of non-institutionalized adults in the USA aged 18 years and older. This cross-sectional, population-based survey employed random digit dialing of phones (cellular and landline) for sampling and gathering information on age, sex, COVID-19 history, and long COVID symptoms lasting at least three months. Prevalence estimates, standardized to the 2020 USA Census Bureau population, were calculated for all adults across states and territories. Weights specific to gender were applied to individuals aged 18–44 years, 45–64 years, and ≥65 years. Analysis was conducted using a Statistical Analysis System (SAS)-callable SUDAAN (short for Survey Data Analysis) while considering the complex survey design.

Results and discussion

The national prevalence of long COVID among non-institutionalized adults in the USA was found to be 6.4%, with estimates ranging from 1.9% in the Virgin Islands to 10.6% in West Virginia. Seven states surpassed a prevalence of 8.8%. Variations were observed across regions, with lower prevalence in the Pacific and New England and higher prevalence in the South, West, and Midwest. Limitations of the study include the lack of data on treatment during acute COVID illness, time since illness, symptom duration or severity, and vaccination status in some jurisdictions.

Conclusion

In conclusion, the present study fills a crucial gap by providing insights into the prevalence of long COVID, highlighting the need for continued monitoring of state- and territory-level data to inform healthcare planning and policy decisions. The findings highlight the importance of addressing the healthcare needs of individuals with long COVID and identifying geographic disparities to promote health equity through targeted interventions.