An analysis of nearly two million private U.S. healthcare claims has found that one fourth of people with COVID-19 develop at least one lingering post-acute condition. 

The report, from consumer healthcare advocate Fair Health, identified the most common post-COVID conditions that continue 30 days or more following initial diagnosis. Particular attention was given to age and gender, mental health conditions, and death.

Among the findings:

  • Patients with all levels of COVID severity may exhibit post-acute conditions, including 50% of hospitalized patients, 27% of symptomatic but not hospitalized patients, and 19% of asymptomatic patients.
  • The five most common post-COVID conditions across all ages, from most to least common, were pain, breathing difficulties, hyperlipidemia (concentration of fats in the blood), malaise and fatigue, and hypertension.
  • Most post-COVID conditions evaluated were associated more with females than males. But 12 conditions were more commonly diagnosed in males, such as cardiac inflammation (with a 4% difference).
  • Among post-acute mental health conditions, anxiety was associated with the highest percentage of patients in all age groups. Depression was second, adjustment disorders third, and tic disorders fourth.

Little is yet known about these post-acute COVID-19 conditions or their causes, the authors noted. Theories include persistent immune activation, initial damage from the acute stage virus (such as slow-to-heal damage to nerve pathways), and the persistent presence of low-level virus, they reported.

This study is the largest to date on the subject, according to the authors. The full report is available here.