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Trends in long COVID among US adults, 2022-2024
Xiaoli Jia1,2, Jingjing Wang3, Xiaomeng Cui1,2
1Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Importance:
Long COVID poses a significant public health challenge. However, population-level trends and associated factors in the general US population during the post-pandemic era are not fully characterized.
Objective:
To analyze trends in long COVID prevalence among US adults from 2022 to 2024, identify associated demographic and socioeconomic factors, and assess its impact on daily activities.
Design Setting And Participants:
We analyzed data from three cycles (2022-2024) of the National Health Interview Survey, a repeated cross-sectional, nationally representative survey. COVID-19 infection, long COVID, and daily activity limitation were determined through participant self-report. Daily activity limitation was assessed in 2023-2024. Multivariable Poisson regression identified factors associated with: (1) long COVID history and (2) significant activity limitation among those with current symptoms. All analyses incorporated survey weights to produce nationally representative estimates. Data analysis was conducted in October 2025.
Results:
The study included 88,731 adults (median age 47 years; 51.4% female and 48.6% male; 61.7% non-Hispanic White, 17.6% Hispanic, 11.8% non-Hispanic Black, and 8.9% non-Hispanic other). In the overall population, the prevalence of ever long COVID increased from 7.0% (95% CI, 6.6-7.3%) in 2022 to 8.4% (95% CI, 8.0-8.8%) in 2023, plateauing at 8.3% (95% CI, 7.9-8.7%) in 2024, while for current long COVID the prevalence remained stable (3.4% [95% CI, 3.1-3.6%] in 2022, 3.6% [95% CI, 3.3-3.9%] in 2023, and 3.3 [95% CI, 3.1-3.6%] in 2024). Among adults with prior COVID-19 infection, prevalence of both ever and current long COVID declined significantly, from 17.7 to 13.7% and from 8.6 to 5.5%, respectively. Long COVID was more common among women, adults in middle age (35-64 years), Hispanic or non-Hispanic White individuals, those who were widowed/separated/divorced, people with lower educational attainment, and individuals with incomes below the federal poverty threshold. Among those with current long COVID, 19.8% reported significant activity limitation, and this limitation was more common among older adults and individuals with lower incomes.
Conclusions And Relevance:
From 2022 to 2024, long COVID continued to impose a substantial public health burden, with clear demographic and socioeconomic disparities. These findings underscore the necessity for continued surveillance and targeted support for high-risk groups.
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