More than one in 10 US adults reported that a preexisting health condition or concern got worse following a COVID-19 infection, according to a survey published last week on the preprint server medRxiv. Participants who reported worsening preexisting conditions also said they experienced challenges managing symptoms, completing daily activities, and accessing care.
Long COVID is often described as new-onset symptoms that follow a COVID infection, but the condition also includes exacerbation of preexisting conditions.
For the study, which has not yet been peer-reviewed, researchers led by a team from Eagle Global Scientific in Huntsville, Alabama, analyzed data from 2,227 adults who completed health questionnaires three, six, and 12 months after having COVID. Participants hailed from Arizona, Indiana, the Bronx, and north and northeastern Philadelphia, and data were collected from July 2023 to January 2025. Roughly 94% of respondents reported having at least one underlying condition before contracting COVID.
Worsening respiratory problems lead the list
Of all the participants, 263 (11.8%) said COVID had made at least one health condition or concern worse. When the researchers analyzed participants’ written descriptions of their worsened conditions, they found that nearly 32% reported a worsening respiratory concern, including asthma, chronic obstructive pulmonary disease (COPD), cough, and shortness of breath.
Approximately 20% described worsening concerns in a general category that included symptoms like fatigue, headache, hair loss, and chills, and nearly 15% reported worsening musculoskeletal problems, chiefly body aches and pains. Anxiety and depression were among other frequently reported concerns, with nearly 12% saying these symptoms got worse after COVID infection.
A very small number of respondents reported worsening symptoms related to endocrine conditions, including diabetes (three respondents) and thyroid concerns like hypothyroidism and Hashimoto’s (three).
Worsening conditions warrant more research
Most previous research has focused on new-onset conditions following COVID infection. “It is important to gather qualitative information on worsening conditions to better understand patients’ experiences and barriers to better health,” write the researchers. “The intersection between pre-existing conditions and Long COVID highlights distinct challenges with respect to symptom management, healthcare navigation, and participation in social and work settings.”
The intersection between pre-existing conditions and Long COVID highlights distinct challenges with respect to symptom management, healthcare navigation, and participation in social and work settings.
The findings suggest that more research is warranted and that follow-up with healthcare providers may benefit those with worsened pre-existing conditions following COVID infection.
“With the continued transmission of SARS-CoV-2 leading to new infections and reinfections, it will be important to continue assessing the long-term outcomes of those who experience exacerbated symptoms following their infection,” conclude the researchers.
