The Current and Future Burden of Long COVID in the United States

Sarah M Bartsch^{1

2

3}, Kevin L Chin^{1

2

3}, Ulrich Strych⁴, Danielle C John^{1

2

5}, Tej D Shah^{1

2

3}, Maria Elena Bottazzi^{4

6}, Kelly J O'Shea^{1

2

3}, McKaylee Robertson⁷, Colleen Weatherwax^{1

2

3}, Jessie Heneghan^{1

2

3}, Marie F Martinez^{1

2

3}, Allan Ciciriello⁴, Sarah Kulkarni⁷, Kavya Velmurugan^{1

2

3}, Alexis Dibbs^{1

2

3}, Sheryl A Scannell^{1

2

3}, Yanhan Shen⁷, Denis Nash⁷, Peter J Hotez^{4

5}, Bruce Y Lee^{1

2

3

6}

Affiliations

¹ Public Health Informatics, Computational, and Operations Research, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
² Center for Advanced Technology and Communication in Health, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
³ Artificial Intelligence, Modeling, and Informatics for Nutrition Guidance and Systems Center, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
⁴ Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA.
⁵ Pandemic Response Institute, New York City, New York, USA.
⁶ Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA.
⁷ Institute for Implementation Science in Population Health, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.

PMID: 39842946
PMCID: PMC12247809 (available on 2026-01-22)
DOI: 10.1093/infdis/jiaf030

The Current and Future Burden of Long COVID in the United States

Sarah M Bartsch et al. J Infect Dis. 2025.

. 2025 Jul 11;231(6):1581-1590.

doi: 10.1093/infdis/jiaf030.

Authors

Affiliations

¹ Public Health Informatics, Computational, and Operations Research, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
² Center for Advanced Technology and Communication in Health, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
³ Artificial Intelligence, Modeling, and Informatics for Nutrition Guidance and Systems Center, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.
⁴ Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA.
⁵ Pandemic Response Institute, New York City, New York, USA.
⁶ Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA.
⁷ Institute for Implementation Science in Population Health, City University of New York Graduate School of Public Health and Health Policy, New York City, New York, USA.

PMID: 39842946
PMCID: PMC12247809 (available on 2026-01-22)
DOI: 10.1093/infdis/jiaf030

Abstract

Background: Long coronavirus disease (COVID), which affects an estimated 44.69-48.04 million people in the United States, is an ongoing public health concern that will persist as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread.

Methods: We developed a computational simulation model representing the clinical course, health effects, and associated costs of a person with long COVID.

Results: Simulations show that the average total cost of a long COVID case can range from $5084-$11 646 (assuming symptoms only last 1 year) with 92.5%-95.2% of these costs being productivity losses. Therefore, the current number of long COVID cases could cost society at least $2.01-$6.56 billion, employers at least $1.99-$6.49 billion in productivity losses, and third-party payers $21.0-$68.5 million annually (6%-20% probability of developing long COVID). These cases would accrue 35 808-121 259 quality-adjusted life-years (QALYs) lost and 13 484-45 468 disability-adjusted life-years (DALYs) and would rise as COVID-19 incidence increases.

Conclusions: The current health and economic burden of long COVID may already exceed that of a number of other chronic diseases and will continue to grow each year as COVID-19 cases increase. This could be a significant drain on businesses, third-party payers, the healthcare system, and society.

Keywords: cost; economic; long COVID; model; post-COVID conditions.

© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. M. E. B. and P. J. H. report they are co-inventors of a protein vaccine technology owned by their employer, Baylor College of Medicine (BCM), that was licensed nonexclusively and with no patent restrictions to several companies committed to advance vaccines for low- and middle-income countries. The co-inventors have no involvement in license negotiations conducted by BCM. Similar to other research universities, a long-standing BCM policy provides its faculty and staff, who make discoveries that result in a commercial license, a share of any royalty income. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

References

1. Ogunwole SU, Rabe MA, Roberts AW, Caplan Z. 2021. https://www.census.gov/library/stories/2021/08/united-states-adult-popul.... Accessed 19 December 2024.
1. National Center for Health Statistics . Long COVID: Household Pulse Survey, 2022–2024. 2024. https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm. Accessed 19 December 2024.
1. US Census Bureau . Exploring age groups in the 2020 census: data visualization select measures for the United States. 2023. https://www.census.gov/library/visualizations/interactive/exploring-age-.... Accessed 19 December 2024.
1. Centers for Disease Control and Prevention . Long COVID basics. https://www.cdc.gov/covid/long-term-effects/?CDC_AAref_Val. Accessed 5 December 2024.
1. Blanchflower DG, Bryson A. Long COVID in the United States. PLoS One 2023; 18:e0292672. - PMC - PubMed

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The Current and Future Burden of Long COVID in the United States

Affiliations

The Current and Future Burden of Long COVID in the United States

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous