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Updated: Jun 17, 2025

Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Long COVID science, research and policy
Ziyad Al-Aly1,2, Hannah Davis3, Lisa McCorkell3
1VA St. Louis Health Care System, Saint Louis, MO, USA. zalaly@gmail.com.
Insights
Long COVID, a complex condition affecting 400 million globally, has severe health and economic impacts. A coordinated global research and policy strategy is urgently needed to address this multisystem disorder.
Area of Science:
- Multidisciplinary science
- Infectious disease
- Public health
Background:
- Long COVID is a complex, multisystem disorder following SARS-CoV-2 infection.
- It affects approximately 400 million individuals globally, causing severe disability.
- The economic impact is estimated at $1 trillion annually, impacting global economies.
Purpose of the Study:
- To synthesize current scientific evidence on Long COVID.
- To assess the multifaceted impacts of Long COVID on health, economies, and global metrics.
- To propose a future research and policy roadmap for addressing Long COVID.
Main Methods:
- Interdisciplinary review of scientific literature.
- Analysis of Long COVID's impact on individual health, healthcare systems, and economies.
- Synthesis of current understanding of mechanistic pathways.
Main Results:
- Long COVID involves multiple mechanistic pathways: viral persistence, immune and mitochondrial dysfunction, and microbiome dysbiosis.
- The condition poses significant threats to individual well-being, health systems, and progress toward Sustainable Development Goals.
- Current global research and policy responses are insufficient.
Conclusions:
- Addressing Long COVID requires a coordinated global research and policy strategy.
- Effective management of Long COVID is crucial for individual health, economic stability, and global health security.
- Further research into mechanistic pathways and effective interventions is essential.
Abstract:
Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling. The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion-equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis. Long COVID can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies, even threatening progress toward achieving the Sustainable Development Goals. Addressing the challenge of long COVID requires an ambitious and coordinated-but so far absent-global research and policy response strategy. In this interdisciplinary review, we provide a synthesis of the state of scientific evidence on long COVID, assess the impacts of long COVID on human health, health systems, the economy and global health metrics, and provide a forward-looking research and policy roadmap.
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