Over 2 million likely had long COVID-19 in England, study estimates

By | June 26, 2021

A new study projects more than 2 million adults in England likely experienced persistent symptoms in the months following COVID-19 infection, or so-called long COVID.

Researchers affiliated with Imperial College London released findings Thursday, stemming from over half a million people in England who participated in several rounds of the Real-Time Assessment of Community Transmission-2 (REACT-2) study, which invited random samples of adults to take surveys from September to February. 

“Long COVID, describing the long-term sequelae after SARS-CoV-2 infection, remains a poorly defined syndrome. There is uncertainty about its predisposing factors and the extent of the resultant public health burden, with estimates of prevalence and duration varying widely,” authors prefaced.

The survey, funded by the Department of Health and Social Care in England, compiled data on demographics, suspected COVID-19, viral tests, underlying health conditions, COVID-19 symptoms and severity, and duration of some 29 listed symptoms.

Nearly 20% of respondents self-reported COVID-19, according to a weighted prevalence, and 37.7% of some 76,100 people reported experiencing one or more persistent symptoms, with about 15% reporting three or more symptoms lasting for over 12 weeks. 


“Estimates [of weighted population prevalence] ranged from 5.8% of the population experiencing one or more persistent symptoms post-COVID-19 (corresponding to over 2 million adults in England), to 2.2% for three or more persistent symptoms (just under a million adults in England), and 1.7% with one or more symptoms lasting at least 12 weeks in people who reported severe COVID-19 symptoms affecting their daily life at the time of their illness,” authors wrote.

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What’s more, the researchers found the risk of persistent symptoms was higher among women and increased with age. Additional risk factors included obesity, smoking, vaping and hospitalization for COVID-19. Low income was also tied to a higher proportion of long COVID cases, or 51% versus 28.7% for respondents with high income.

Some of the most common persistent symptoms included tiredness (co-occurring with muscle aches and sleep issues) and respiratory-related symptoms, like shortness of breath and chest pain.

“Clinicians need to be aware of the differing manifestations of Long COVID which may require tailored therapeutic approaches,” authors wrote.


Researchers attributed a “comparatively high estimate” of people affected with long COVID to the many symptoms under study, some of which are non-specific to COVID and occur frequently. But researchers said the survey asked “only about symptoms that related to a confirmed or suspected episode of COVID-19, and not to symptoms more generally,” and a further sensitivity analysis limited symptoms to 15 associated with a positive COVID-19 test, like loss of smell or taste, tiredness and shortness of breath. 

“We have identified significant ongoing morbidity among people post COVID-19, with a substantial proportion experiencing persistent symptoms lasting 12 weeks or more. Managing the long term sequelae of SARS-CoV-2 infection in the population will remain a major challenge for health services in the next stage of the pandemic,” authors concluded.

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