The diagnosis of long COVID varies throughout the nation, indicating the rate of the disorder varies by region, a study of U.S. veterans shows.
In some areas, including Florida, less than 4 percent of veterans who had COVID ended up with long COVID, while in parts of Texas, nearly 1 in 4 ended up with it.
The new study was published in JAMA Network Open on Dec. 8.
In the study, the research team from institutions such as the Veterans Affairs (VA) Puget Sound Health Care System, the University of Washington, and Harvard Medical School looked through COVID test results and found 388,980 American veterans who tested positive for the virus between Oct. 1, 2021, and Jan. 31, 2023. The study aimed to determine what factors caused individuals to have an increased risk of developing long COVID.
Results indicated that, on average, 5 percent of the veterans had developed long COVID 12 months after initial infection. The research team also noted that older veterans, women, Hispanics or Latinos, patients who required hospitalization within 30 days of COVID-19 infection (especially if they were on a ventilator), and unvaccinated people were at an increased risk of developing long COVID.
Latino/Hispanic veterans reported having long COVID at nearly twice the rate of non-Hispanics or Latinos (8.48 percent versus 4.94 percent). American Indians or Alaska Natives also reported a high risk, with 6.52 percent of those who tested positive for the virus reporting they came down with long COVID.
The research team found that the older a patient was, the more likely they were to report having long COVID. Just 4.28 percent of veterans between the ages of 18 and 49 reported having long COVID, while 6.04 percent between the ages of 75 and 79 reported it. The percentage continued to increase for each age bracket (6.52 percent for veterans between 80 and 84, 7.16 percent for ages 85 and 89, and 7.39 percent for those 90 and older).
Long-COVID Diagnosis Varies by Region
Of utmost curiosity to the research team was that long-COVID diagnoses varied greatly throughout the country. Along with the variances in diagnostic rates in Florida and Texas, the research team noted the diagnostic rate for long COVID in Vancouver, Washington (Northwest VA Center) was 6.71 percent. Other VA region rates for long COVID included the following:
- Great Lakes region (includes Wisconsin and Illinois): 6.48 percent.
- Rocky Mountain region (including Colorado, Montana, Oklahoma, Utah, and Wyoming): 5.37 percent.
- Heartland region (includes Kansas and Missouri): 4.32 percent.
“Marked differences by geographic region … may reflect local screening and care practices,” the research team wrote.
Why Does Long COVID Exist?
Researchers believe long COVID results from the virus remaining inside an infected person’s body after initial symptoms have dissipated. Some research indicates the virus establishes “viral reservoirs” unaffected by white blood cells. These reservoirs can erupt—much like a geyser—and reactivate the virus when inflammation occurs or by other triggers.
Other potential causes of long COVID revolve around theories regarding a person’s immune system. Specifically, scientists think that the white blood cells or antibodies responsible for attacking viruses fail to respond appropriately when the COVID-19 virus presents itself.
Long COVID is a debilitating disorder affecting up to 65 million people worldwide. According to the study, there have been as many as 200 symptoms recorded, including fatigue, shortness of breath, and myriad cognitive dysfunction issues. Long COVID is diagnosed when initial symptoms persist beyond four weeks of initial COVID diagnosis. Typically, a person with long COVID will experience problems related to their lungs, heart, mental health, kidneys, and digestion.
Understanding that long COVID is diagnosed at different rates throughout the country can help establish better protocols for this budding and debilitating disorder. The research team noted that “in the future, accurate and consistent documentation” of the diagnostic code for long COVID is necessary.