Long COVID and the Military: A Current Research Landscape, Knowledge Gaps, and Future Directions

Area of Science:

• Military Health
• Infectious Disease Epidemiology
• Post-COVID Conditions

Background:

• Post-COVID conditions (PCC), or Long COVID, present a significant threat to military readiness.
• This review examines the epidemiology and impact of Long COVID in military service members and beneficiaries.
• It identifies research gaps and proposes a roadmap for Military Health System (MHS)-based studies.

Purpose of the Study:

• To highlight the impact and epidemiology of Long COVID in military populations.
• To characterize the threat of Long COVID to military readiness.
• To propose a research roadmap for MHS-based studies on Long COVID.

Main Methods:

• A narrative review approach was employed.
• Searches included MEDLINE (PubMed), MHS conference abstracts and websites, and clinicaltrials.gov.
• Bibliographies of relevant published articles were also reviewed.

Main Results:

• Studies indicate medically attended and self-reported post-acute symptoms in military personnel across cardiorespiratory, neurocognitive, and mental health domains.
• An association between SARS-CoV-2 infection and fitness in young adult service members has been noted.
• The ongoing prevalence, morbidity, and functional impact of Long COVID in current military populations remain unclear, with all identified studies having limitations.

Conclusions:

• Significant research exists on Long COVID risks and risk factors in active-duty personnel, particularly from the early pandemic.
• Future research should prioritize defining Long COVID for active duty, and studies to delineate, treat, and prevent its impact on health and fitness.
• Findings may inform understanding of post-acute sequelae from other infectious diseases relevant to military health and future pandemic preparedness.