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What are the latest estimates of long COVID prevalence and risk factors by age and health status (2025 data)?
Executive summary
Recent 2025 reporting and studies show wide disagreement on long COVID prevalence: some meta-analyses through 2024 reported pooled prevalence estimates as high as ~36% globally (through May 2024), while health agencies describe lower but still substantial burdens—millions affected in the U.S.—and localized studies report very low detected prevalences (2.4 per thousand) depending on methods and population sampled [1] [2] [3].
1. Prevalence estimates: wildly divergent numbers driven by methods
Estimates of how common long COVID is vary dramatically across the literature: a pooled analysis of many studies reported a global prevalence around 36% (95% CI 33–40%) through May 2024, while reviews of 2024–2025 studies found individual-study estimates ranging from under 3% up to 80%, reflecting differences in case definitions, follow-up time, and sampling strategies [1]. By contrast, a population-based primary‑care study in the Barcelona metropolitan area detected a much lower prevalence of 2.4 per thousand (0.24%) in its registered population, noting important limitations that likely underestimate true incidence such as early test shortages and discontinued testing [3].
2. Definitions and timing matter: who counts as “long COVID”?
Agencies and researchers use different definitions and instruments—WHO’s post‑COVID condition definition (symptoms ≥3 months) and symptom‑index tools used in RECOVER or healthcare databases produce different caseloads; follow-up intervals (months vs. years) and whether studies require laboratory‑confirmed infection versus suspected infection also shift estimates substantially [2] [4] [1].
3. Age and children: lower but non‑zero prevalence; reinfections matter
Children are reported to have lower prevalence than adults in many sources, but they are not risk‑free. CDC and reporting cited by news outlets estimate at least ~1.3% of people under 18 in the U.S. have had long COVID (on the order of one million children), and a RECOVER analysis found a doubling of long‑COVID risk in children after a second infection, underscoring reinfections’ role in risk [5] [2]. Available sources do not mention a full age‑stratified 2025 global prevalence table; age trends are described qualitatively [1] [5].
4. Health status and comorbidities: established risk gradients
Multiple reviews and public‑health pages identify higher age, female sex, more severe acute infection, and underlying medical conditions as consistent risk factors for long COVID; vaccination lowers risk in many analyses. The CDC emphasizes higher risk among people 65+ and those with comorbidities, and pooled meta‑analyses identify unvaccinated status (OR ~2.1), pre‑Omicron infections (OR ~1.74), and female sex (OR ~1.56) among the stronger risk correlates [2] [1] [6].
5. Social determinants and inequities: social risk can multiply risk
A large RECOVER‑related analysis described by Mass General Brigham and ScienceDaily found that economic instability, food insecurity, limited healthcare access, and other social‑risk factors were associated with two‑ to threefold higher long‑COVID risk, indicating that socioeconomic conditions substantially modify population risk beyond clinical factors [7].
6. Variants, vaccination and reinfection: shifting landscape through 2025
Studies pooled through 2024–2025 show infections from pre‑Omicron variants carried higher long‑COVID risk than some Omicron infections, and vaccination reduces risk in many—but not all—analyses; reinfections increase cumulative risk [1] [5]. Updated vaccine formulations in 2024–2025 were described as durable against severe outcomes, which indirectly matters to long‑COVID risk because preventing severe acute disease lowers subsequent risk [8].
7. Why estimates differ and what that means for interpretation
Differences in surveillance (routine testing stopped in many places), case ascertainment (self‑report vs. EHRs vs. population registries), symptom lists, and follow‑up length drive the spread of prevalences from fractions of a percent to tens of percent; the Barcelona study explicitly warns its detected prevalence likely undercounts cases due to test and surveillance limitations, while meta‑analyses aggregate heterogeneous studies that may inflate pooled prevalence [3] [1]. Journalistic reporting and agency pages highlight that “millions” are affected but give little standardization across datasets [2] [9].
8. Practical takeaways for clinicians, policymakers and the public
Treat long COVID as a persistent public‑health challenge: target vaccination and prevention (to reduce severe disease and infections), improve surveillance to get reliable age‑ and comorbidity‑stratified rates, and address social determinants that triple risk for some groups [8] [2] [7]. Available sources do not mention a single agreed global 2025 prevalence by detailed age and health‑status strata; instead, policymakers must weigh multiple, sometimes conflicting, data streams [1] [3].
Limitations and transparency note: this analysis uses only the provided sources; where specific 2025 age‑ and comorbidity‑stratified prevalence tables are not present in those sources, I state that such granular figures are not found in current reporting [1] [3].