Persistent physical and mental health impairments remained common up to 2.5 years after infection among nonhospitalized adults with long COVID, or post-COVID-19 condition (PCC), according to a cohort study published today in BMC Public Health.

Karolinska Institutet researchers followed up on 130 adults with PCC who were never hospitalized for acute COVID and were assessed at a specialized post-COVID clinic in Stockholm, Sweden. Participants underwent clinical evaluations at a median of 12 months and again at 30 months after infection to measure physical function, physical activity, mental health, and self-rated health. 

Data were collected from August 2020 to December 2024. Participants were predominantly middle-aged women who had been physically active before COVID infection, with no functional limitations.

Roughly half had shortness of breath 2.5 years on

Although some improvement occurred over time, impairments persisted across multiple domains. At 2.5 years, roughly half of participants demonstrated severe dyspnea (shortness of breath) and symptoms of moderate to severe depression, and 42% showed impaired lower-body strength on a one-minute sit-to-stand test. 

The researchers identified several factors at the 12-month assessment that were associated with poorer self-rated health at 2.5 years. These factors included impaired physical performance on the sit-to-stand test, low levels of physical activity, and symptoms of depression. Older age was also independently associated with worse self-rated health.

The findings suggest that recovery in nonhospitalized individuals may be slow and incremental, even years after infection. 

“Although most outcomes showed statistically significant improvements between assessments, the changes may not represent clinically meaningful improvement,” write the researchers. “These findings contribute to the understanding of the clinical course of PCC, suggest a slow improvement over time, and highlight the need for further research to better characterise recovery trajectories in this population.”

A new report from World Health Organization (WHO) estimates that broad use of improved seasonal influenza vaccines could prevent 6.6 to 18 billion additional influenza cases, 2.3 to 6.2 million deaths, and 21 to 57 million disability-adjusted life years (DALYs) globally between 2025 and 2050. 

The Full Value of Improved Influenza Vaccine Assessment, published in January, evaluates the health, economic, and policy impacts of next-generation influenza vaccines and identify barriers to their uptake. More effective and long-lasting flu vaccines would be an economic boon for most WHO member states, the report said. 

Cost savings for low- and middle-income countries 

The analysis shows that overall, the market size for seasonal influenza vaccines is large and will remain so for the foreseeable future, which ensures the commercial viability of the vaccines. Moreover, seasonal flu vaccines can be cost-saving or cost-effective in many countries when priced appropriately. 

 These vaccines have the potential to reduce the global burden of influenza significantly.

“By addressing key challenges in vaccine development, decision-making, market demand, health and economic impact, financial viability, and implementation, these vaccines have the potential to reduce the global burden of influenza significantly and to improve health outcomes, particularly in low- and middle-income countries,” the report said.