Previous studies on post-COVID recovery have mainly focused on hospitalised patients or people receiving specialised care, limiting insight into recovery in the general population. Using longitudinal data from the Lifelines cohort, including health information collected before participants became infected with SARS-CoV-2, the UMCG researchers were able to compare participants' health before and after infection. This enabled them to distinguish post-COVID symptoms from pre-existing health complaints and measure recovery relative to each individual's pre-infection health status.
The researchers analysed data from 809 participants with post-COVID and followed them for an average of one year. Symptoms were assessed at 31 time points between March 2020 and October 2022, providing a detailed picture of recovery trajectories over time. Most recovery occurred within the first months after post-COVID developed, with improvement slowing substantially thereafter. Overall, the researchers estimated that 92% of participants with post-COVID returned to their pre-infection symptom levels during follow-up, although a substantial proportion continued to experience persistent symptoms long after infection.
The strongest predictor of prolonged illness was symptom burden at the onset of post-COVID. Participants with multiple persistent symptoms recovered more slowly than those with fewer symptoms, while younger adults recovered faster than older participants. Fatigue, memory problems, muscle pain, breathing difficulties and tingling sensations were among the symptoms associated with slower recovery.
The findings have implications for both clinical practice and future research. Early identification of patients with multiple persistent symptoms may help target follow-up care to those most at risk of prolonged illness. More broadly, the study provides robust population-based estimates that may help inform healthcare planning and the design of future studies on post-COVID and other post-infectious conditions.
Lifelines is a prospective, multi-generational cohort study and biobank that follows approximately 167,000 people in the north of the Netherlands. By combining biological samples with longitudinal health, lifestyle and environmental data, the cohort enables research across a wide range of diseases and healthy ageing. For this study, researchers used data from 31 COVID-19 questionnaires collected between March 2020 and October 2022.
The study was published in The Lancet Regional Health – Europe. Read the full publication:
