presentation on world after covid 19 slideshare

Got any suggestions?

We want to hear from you! Send us a message and help improve Slidesgo

Top searches

Trending searches

26 templates

102 templates

15 templates

49 templates

cyber security

9 templates

386 templates

World After Coronavirus

It seems that you like this template, world after coronavirus presentation, premium google slides theme and powerpoint template.

Coronavirus too shall pass and we will live a bright new normal. Plenty of habits will change, and we’ll value the little things. To understand how the world will work after the pandemic, use this template to share your knowledge with your audience!

This presentation has been designed with a multi-purpose structure. It has an editorial style with minimalist layouts that combines black and white inspirational pictures of people with yellow to provide more contrast. The fonts used, like Abel, is specially designed for newspaper headlines and posters, which completes the editorial style and provides your presentation with a serious note.

Features of this template

• A minimalist template designed with a formal editorial style and inspirational pictures
• 100% editable and easy to modify
• 31 different slides to impress your audience
• Available in five colors: yellow, green, blue, pink and red
• Contains easy-to-edit graphics, maps and mockups
• Includes 500+ icons and Flaticon’s extension for customizing your slides
• Designed to be used in Google Slides and Microsoft PowerPoint
• 16:9 widescreen format suitable for all types of screens
• Includes information about fonts, colors, and credits of the free and premium resources used

What are the benefits of having a Premium account?

What Premium plans do you have?

What can I do to have unlimited downloads?

Don’t want to attribute Slidesgo?

Gain access to over 25600 templates & presentations with premium from 1.67€/month.

Are you already Premium? Log in

Available colors

Original Color

Related posts on our blog

How to Add, Duplicate, Move, Delete or Hide Slides in Google Slides

How to Change Layouts in PowerPoint

How to Change the Slide Size in Google Slides

Related presentations.

Premium template

Unlock this template and gain unlimited access

• Publications

Challenges and Opportunities in the Post-COVID-19 World

The COVID-19 crisis has affected societies and economies around the globe and will permanently reshape our world as it continues to unfold. While the fallout from the crisis is both amplifying familiar risks and creating new ones, change at this scale also creates new openings for managing systemic challenges, and ways to build back better. This collection of essays draws on the diverse insights of the World Economic Forum’s Global Risks Report Advisory Board to look ahead and across a broad range of issues – trade, governance, health, labour, technology to name a few – and consider where the balance of risk and opportunity may come out. It offers decision-makers a comprehensive picture of expected long-term changes, and inspiration to leverage the opportunities this crisis offers to improve the state of the world.

World Economic Forum reports may be republished in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Public License , and in accordance with our Terms of Use .

Further reading All related content

Will COVID-19 change how we think about migration and migrant workers?

Migrant workers are key to the pandemic response, but the focus on health security could have long-term implications for migrants and migration policy.

The COVID-19 pandemic is not a break for nature – let’s make sure there is one after the crisis

Nature is facing increased pressure due COVID-19 crisis – and to our health and our economy, governments must also prioritize healing our planet, too.

Infographic: How has the world changed since COVID-19?

One year ago, the World Health Organization (WHO) declared COVID-19 a pandemic. The microscopic coronavirus has, in one way or another, changed the lives of all 7.8 billion people on Earth.

While the long-term impact of this global health crisis may take years to understand, its immediate effect has already changed the world as we know it. In the following infographics, we break down the latest figures and reports to help you understand the pandemic’s global repercussions.

Keep reading

Amid global polarisation, the pandemic agreement encourages cooperation amid global polarisation, the pandemic ..., will the us unemployment rate continue at historic lows will the us unemployment rate continue ..., mexico’s teachers seek relief from pandemic-era spike in school robberies mexico’s teachers seek relief from ..., ‘a bad chapter’: tracing the origins of ecuador’s rise in gang violence ‘a bad chapter’: tracing the origins of ....

For each topic, we looked at the most complete and reliable datasets available on a global level. The numbers are often presented as averages across a country, so it is important to remember that averages may mask inequalities, especially when dealing with underreported areas or populations at risk.

Leading causes of death

At least 2.7 million people worldwide have died from COVID-19. While the leading global causes of death for 2020 have not been published yet, compared to 2019, COVID ranks among the top five biggest killers.

In 2019, 55.4 million people died across the globe. Heart disease killed the most people (8.9 million) followed by strokes (6.2 million) and lung disease (3.2 million). Collectively these are known as non-communicable diseases, meaning they are not transmitted between people. In contrast, the highly contagious coronavirus is a communicable disease.

The graphic below shows how one year of coronavirus deaths compares to the leading causes of death in 2019.

In the US, the country with the highest number of COVID-19 deaths, data from the Centers for Disease Control and Prevention shows that the coronavirus has killed more Americans in one year (540,000) than the flu has in the last 10 years combined (368,000).

Mental health

The WHO estimates that nearly one billion people worldwide are living with a mental disorder. In 2019, 703,000 people took their own lives , making suicide the 17th-most common cause of death. Despite that, countries spend only about 2 percent of their national health budgets on mental health.

The UN has warned that the COVID-19 pandemic will likely cause a long-term increase in the number and severity of mental health problems. The evidence regarding the mental health consequences of lockdowns and social distancing is still being studied. While we have no large-scale data on the effect COVID-19 has had on mental health globally, several smaller studies ( PDF ) indicate higher rates of anxiety and depression.

Below are five tips by Dr Devora Kestel , director of the Department of Mental Health and Substance Abuse at the WHO, on protecting our mental health.

Worldwide lockdowns

By definition, a pandemic is a worldwide spread of a disease. It is estimated that more than two-thirds of the world population has experienced lockdown measures, lasting from weeks to months.

According to data compiled by the Oxford COVID-19 Government Response Tracker, more than 100 countries and territories in 2021 have reintroduced stay-at-home orders with some exceptions such as for essential trips, daily exercise or grocery shopping.

The graphic below summarises the duration of nationwide lockdowns over 12 months (January 16, 2020 – January 15, 2021).

Trillions lost

According to World Bank estimates, the global economy shrank by 4.3 percent in 2020, wiping out trillions of dollars. Countries already facing economic hardship sank further into debt. A report by Oxfam International ( PDF ) estimates that it could take more than a decade for the world’s poorest to recover from the economic fallout of the pandemic.

On the upside, the World Bank expects the global economy to expand by 4 percent in 2021 with vaccine rollouts and investments leading the recovery.

The graphic below shows the effect COVID-19 had on the global economy. Every major economy except for China’s shrank over the course of 2020. Other countries that saw their gross domestic product (GDP) grow include Bangladesh (2 percent), Benin (2 percent), Burundi (0.3 percent), Egypt (3.6 percent), Ethiopia (6.1 percent), Ghana (1.1 percent), Guinea (5.2 percent), Guyana (23.2 percent), Ivory Coast (1.8 percent), Myanmar (1.7 percent), Nepal (0.2 percent), Niger (1 percent), South Sudan (9.3 percent), Tajikistan (2.2 percent), Tanzania (2.5 percent), Turkey (0.5 percent), Uzbekistan (0.6 percent) and Vietnam (2.8 percent).

This by no means suggests that these countries were better off after the coronavirus, several of them were projected to achieve even higher growth before the pandemic with otheried relying on lending to prop up their economies.

Global poverty and unemployment

The coronavirus has disproportionately affected the poor. For the first time in 20 years, global poverty is likely to increase significantly. The World Bank estimates the coronavirus has pushed between 119 and 124 million people into extreme poverty, making the total number of people living on less than $1.90 a day to 730 million, about 10 percent of the world’s population.

In 2020, 114 million people lost their jobs, according to the latest unemployment figures from the International Labour Organization (ILO). But official figures alone is not enough to measure joblessness. As the ILO points out, many more workers have fallen into “economic inactivity”, meaning they had to withdraw from the labour force. Many more may still be employed but operating with reduced working hours or pay cuts.

Women and younger workers have been among the hardest hit, prompting concerns over widening gender inequality and a lost generation of workers.

In addition, the  UN Development Programme has   warned that nearly half of all jobs in Africa could be wiped out due to the pandemic.

The rich got richer

A report ( PDF ) released by Oxfam International, a UK-based charity, said the pandemic hurt people living in poverty more than the rich. The most severely affected are women, Black people, African-descendants, Indigenous peoples, and historically marginalised and oppressed communities around the world, the report said.

To put that income inequality in perspective, a report ( PDF ) by Swiss Bank UBS, found that the world’s richest people got $3.9 trillion richer between March and December 2020. The 10 richest billionaires made $540bn during this time.

Many of the world’s richest men, including Elon Musk (US), Zhong Shanshan (China) and Mukesh Ambani (India), saw their wealth more than double since the pandemic was declared.

1.7 billion students out of school

In 2020, school and university closures disrupted the education of more than 1.7 billion students from 188 countries, or about 99 percent of the world’s student population, according to UNESCO.

Today, nearly 900 million students, more than half the world’s student population, continue to face heavy education disruptions, ranging from school closures in 29 countries to reduced or part-time classes in 68 others, according to the latest data from UNESCO.

While online schooling played allowed classes to continue virtually, the UN estimates that nearly 500 million children, especially in poorer countries or rural areas, have been excluded from remote learning due to a lack of technology or policies.

Oxfam estimates that the pandemic will reverse the last 20 years of global progress on girls’ education, further increasing poverty and inequality.

Worst year for air travel

In 2019, more than 4.5 billion passengers took 38 million flights worldwide. With lockdowns and quarantines for most of 2020, many cancelled or postponed travel plans.

International passenger demand in 2020 dropped by 75.6 percent compared to 2019, according to the International Air Transport Association.

Global flight-tracking service Flightradar24 also recorded a 42-percent dip in commercial flights from 2019. Many airlines were forced to operate cargo-only flights to keep supermarket shelves stocked and online orders fulfilled.

Lockdowns from space

On the left are images taken pre-lockdown, contrasted with lockdown images taken in March 2020 to show the pandemic’s effect had on cities worldwide. Unprecedented lockdowns emptied streets, disrupted travel and slowed economic activity – temporarily slashing air pollution.

Below we see how Mecca, Wuhan and Venice all saw a sharp decline in visitors a few weeks into the pandemic. See satellite images from more cities here .

Pollution levels

In the first weeks of COVID lockdowns, there were reports of clearer and less polluted skies. For example, residents of Venice, Italy, reported clear running water in its normally bustling canals for the first time in years.

However, this seems to have been short-lived. A recent report by the International Energy Agency found that while global energy-related CO2 emissions fell overall by 5.8 percent in 2020 – the largest annual percentage decline since World War II – the latest data shows global CO2 pollution bounced back to pre-COVID levels.

Professor Ralph Keeling, head of the Scripps CO2 programme, explained the situation back in May 2020: “People might be surprised to hear that the response to the coronavirus outbreak has not done more to influence CO2 levels. The build-up of CO2 is a bit like trash in a landfill. As we keep emitting, it keeps piling up.”

• Work & Careers
• Life & Arts
• Currently reading: Yuval Noah Harari: the world after coronavirus | Free to read
• How to save the human race from extinction
• Tips for working from home — in style
• Alain de Botton: how to travel from your sofa
• Beyond the mud hut: the return of raw-earth architecture
• Farmed fishing is the future — but can it be sustainable?
• Uncovering London’s hidden property wealth

Yuval Noah Harari: the world after coronavirus | Free to read

• Yuval Noah Harari: the world after coronavirus | Free to read on x (opens in a new window)
• Yuval Noah Harari: the world after coronavirus | Free to read on facebook (opens in a new window)
• Yuval Noah Harari: the world after coronavirus | Free to read on linkedin (opens in a new window)
• Yuval Noah Harari: the world after coronavirus | Free to read on whatsapp (opens in a new window)

Yuval Noah Harari

Simply sign up to the Life & Arts myFT Digest -- delivered directly to your inbox.

Humankind is now facing a global crisis. Perhaps the biggest crisis of our generation. The decisions people and governments take in the next few weeks will probably shape the world for years to come. They will shape not just our healthcare systems but also our economy, politics and culture. We must act quickly and decisively. We should also take into account the long-term consequences of our actions. When choosing between alternatives, we should ask ourselves not only how to overcome the immediate threat, but also what kind of world we will inhabit once the storm passes. Yes, the storm will pass, humankind will survive, most of us will still be alive — but we will inhabit a different world. 

Many short-term emergency measures will become a fixture of life. That is the nature of emergencies. They fast-forward historical processes. Decisions that in normal times could take years of deliberation are passed in a matter of hours. Immature and even dangerous technologies are pressed into service, because the risks of doing nothing are bigger. Entire countries serve as guinea-pigs in large-scale social experiments. What happens when everybody works from home and communicates only at a distance? What happens when entire schools and universities go online? In normal times, governments, businesses and educational boards would never agree to conduct such experiments. But these aren’t normal times. 

In this time of crisis, we face two particularly important choices. The first is between totalitarian surveillance and citizen empowerment. The second is between nationalist isolation and global solidarity. 

Under-the-skin surveillance

In order to stop the epidemic, entire populations need to comply with certain guidelines. There are two main ways of achieving this. One method is for the government to monitor people, and punish those who break the rules. Today, for the first time in human history, technology makes it possible to monitor everyone all the time. Fifty years ago, the KGB couldn’t follow 240m Soviet citizens 24 hours a day, nor could the KGB hope to effectively process all the information gathered. The KGB relied on human agents and analysts, and it just couldn’t place a human agent to follow every citizen. But now governments can rely on ubiquitous sensors and powerful algorithms instead of flesh-and-blood spooks. 

In their battle against the coronavirus epidemic several governments have already deployed the new surveillance tools. The most notable case is China. By closely monitoring people’s smartphones, making use of hundreds of millions of face-recognising cameras, and obliging people to check and report their body temperature and medical condition, the Chinese authorities can not only quickly identify suspected coronavirus carriers, but also track their movements and identify anyone they came into contact with. A range of mobile apps warn citizens about their proximity to infected patients. 

About the photography

The images accompanying this article are taken from webcams overlooking the deserted streets of Italy, found and manipulated by Graziano Panfili, a photographer living under lockdown

This kind of technology is not limited to east Asia. Prime Minister Benjamin Netanyahu of Israel recently authorised the Israel Security Agency to deploy surveillance technology normally reserved for battling terrorists to track coronavirus patients. When the relevant parliamentary subcommittee refused to authorise the measure, Netanyahu rammed it through with an “emergency decree”.  

You might argue that there is nothing new about all this. In recent years both governments and corporations have been using ever more sophisticated technologies to track, monitor and manipulate people. Yet if we are not careful, the epidemic might nevertheless mark an important watershed in the history of surveillance. Not only because it might normalise the deployment of mass surveillance tools in countries that have so far rejected them, but even more so because it signifies a dramatic transition from “over the skin” to “under the skin” surveillance. 

Hitherto, when your finger touched the screen of your smartphone and clicked on a link, the government wanted to know what exactly your finger was clicking on. But with coronavirus, the focus of interest shifts. Now the government wants to know the temperature of your finger and the blood-pressure under its skin. 

The emergency pudding

One of the problems we face in working out where we stand on surveillance is that none of us know exactly how we are being surveilled, and what the coming years might bring. Surveillance technology is developing at breakneck speed, and what seemed science-fiction 10 years ago is today old news. As a thought experiment, consider a hypothetical government that demands that every citizen wears a biometric bracelet that monitors body temperature and heart-rate 24 hours a day. The resulting data is hoarded and analysed by government algorithms. The algorithms will know that you are sick even before you know it, and they will also know where you have been, and who you have met. The chains of infection could be drastically shortened, and even cut altogether. Such a system could arguably stop the epidemic in its tracks within days. Sounds wonderful, right?

The downside is, of course, that this would give legitimacy to a terrifying new surveillance system. If you know, for example, that I clicked on a Fox News link rather than a CNN link, that can teach you something about my political views and perhaps even my personality. But if you can monitor what happens to my body temperature, blood pressure and heart-rate as I watch the video clip, you can learn what makes me laugh, what makes me cry, and what makes me really, really angry. 

It is crucial to remember that anger, joy, boredom and love are biological phenomena just like fever and a cough. The same technology that identifies coughs could also identify laughs. If corporations and governments start harvesting our biometric data en masse, they can get to know us far better than we know ourselves, and they can then not just predict our feelings but also manipulate our feelings and sell us anything they want — be it a product or a politician. Biometric monitoring would make Cambridge Analytica’s data hacking tactics look like something from the Stone Age. Imagine North Korea in 2030, when every citizen has to wear a biometric bracelet 24 hours a day. If you listen to a speech by the Great Leader and the bracelet picks up the tell-tale signs of anger, you are done for.

You could, of course, make the case for biometric surveillance as a temporary measure taken during a state of emergency. It would go away once the emergency is over. But temporary measures have a nasty habit of outlasting emergencies, especially as there is always a new emergency lurking on the horizon. My home country of Israel, for example, declared a state of emergency during its 1948 War of Independence, which justified a range of temporary measures from press censorship and land confiscation to special regulations for making pudding (I kid you not). The War of Independence has long been won, but Israel never declared the emergency over, and has failed to abolish many of the “temporary” measures of 1948 (the emergency pudding decree was mercifully abolished in 2011). 

Even when infections from coronavirus are down to zero, some data-hungry governments could argue they needed to keep the biometric surveillance systems in place because they fear a second wave of coronavirus, or because there is a new Ebola strain evolving in central Africa, or because . . . you get the idea. A big battle has been raging in recent years over our privacy. The coronavirus crisis could be the battle’s tipping point. For when people are given a choice between privacy and health, they will usually choose health.

The soap police

Asking people to choose between privacy and health is, in fact, the very root of the problem. Because this is a false choice. We can and should enjoy both privacy and health. We can choose to protect our health and stop the coronavirus epidemic not by instituting totalitarian surveillance regimes, but rather by empowering citizens. In recent weeks, some of the most successful efforts to contain the coronavirus epidemic were orchestrated by South Korea, Taiwan and Singapore. While these countries have made some use of tracking applications, they have relied far more on extensive testing, on honest reporting, and on the willing co-operation of a well-informed public. 

Centralised monitoring and harsh punishments aren’t the only way to make people comply with beneficial guidelines. When people are told the scientific facts, and when people trust public authorities to tell them these facts, citizens can do the right thing even without a Big Brother watching over their shoulders. A self-motivated and well-informed population is usually far more powerful and effective than a policed, ignorant population. 

Consider, for example, washing your hands with soap. This has been one of the greatest advances ever in human hygiene. This simple action saves millions of lives every year. While we take it for granted, it was only in the 19th century that scientists discovered the importance of washing hands with soap. Previously, even doctors and nurses proceeded from one surgical operation to the next without washing their hands. Today billions of people daily wash their hands, not because they are afraid of the soap police, but rather because they understand the facts. I wash my hands with soap because I have heard of viruses and bacteria, I understand that these tiny organisms cause diseases, and I know that soap can remove them. 

But to achieve such a level of compliance and co-operation, you need trust. People need to trust science, to trust public authorities, and to trust the media. Over the past few years, irresponsible politicians have deliberately undermined trust in science, in public authorities and in the media. Now these same irresponsible politicians might be tempted to take the high road to authoritarianism, arguing that you just cannot trust the public to do the right thing. 

Normally, trust that has been eroded for years cannot be rebuilt overnight. But these are not normal times. In a moment of crisis, minds too can change quickly. You can have bitter arguments with your siblings for years, but when some emergency occurs, you suddenly discover a hidden reservoir of trust and amity, and you rush to help one another. Instead of building a surveillance regime, it is not too late to rebuild people’s trust in science, in public authorities and in the media. We should definitely make use of new technologies too, but these technologies should empower citizens. I am all in favour of monitoring my body temperature and blood pressure, but that data should not be used to create an all-powerful government. Rather, that data should enable me to make more informed personal choices, and also to hold government accountable for its decisions. 

If I could track my own medical condition 24 hours a day, I would learn not only whether I have become a health hazard to other people, but also which habits contribute to my health. And if I could access and analyse reliable statistics on the spread of coronavirus, I would be able to judge whether the government is telling me the truth and whether it is adopting the right policies to combat the epidemic. Whenever people talk about surveillance, remember that the same surveillance technology can usually be used not only by governments to monitor individuals — but also by individuals to monitor governments. 

The coronavirus epidemic is thus a major test of citizenship. In the days ahead, each one of us should choose to trust scientific data and healthcare experts over unfounded conspiracy theories and self-serving politicians. If we fail to make the right choice, we might find ourselves signing away our most precious freedoms, thinking that this is the only way to safeguard our health.

We need a global plan

The second important choice we confront is between nationalist isolation and global solidarity. Both the epidemic itself and the resulting economic crisis are global problems. They can be solved effectively only by global co-operation. 

First and foremost, in order to defeat the virus we need to share information globally. That’s the big advantage of humans over viruses. A coronavirus in China and a coronavirus in the US cannot swap tips about how to infect humans. But China can teach the US many valuable lessons about coronavirus and how to deal with it. What an Italian doctor discovers in Milan in the early morning might well save lives in Tehran by evening. When the UK government hesitates between several policies, it can get advice from the Koreans who have already faced a similar dilemma a month ago. But for this to happen, we need a spirit of global co-operation and trust. 

In the days ahead, each one of us should choose to trust scientific data and healthcare experts over unfounded conspiracy theories and self-serving politicians

Countries should be willing to share information openly and humbly seek advice, and should be able to trust the data and the insights they receive. We also need a global effort to produce and distribute medical equipment, most notably testing kits and respiratory machines. Instead of every country trying to do it locally and hoarding whatever equipment it can get, a co-ordinated global effort could greatly accelerate production and make sure life-saving equipment is distributed more fairly. Just as countries nationalise key industries during a war, the human war against coronavirus may require us to “humanise” the crucial production lines. A rich country with few coronavirus cases should be willing to send precious equipment to a poorer country with many cases, trusting that if and when it subsequently needs help, other countries will come to its assistance. 

We might consider a similar global effort to pool medical personnel. Countries currently less affected could send medical staff to the worst-hit regions of the world, both in order to help them in their hour of need, and in order to gain valuable experience. If later on the focus of the epidemic shifts, help could start flowing in the opposite direction. 

Global co-operation is vitally needed on the economic front too. Given the global nature of the economy and of supply chains, if each government does its own thing in complete disregard of the others, the result will be chaos and a deepening crisis. We need a global plan of action, and we need it fast. 

Another requirement is reaching a global agreement on travel. Suspending all international travel for months will cause tremendous hardships, and hamper the war against coronavirus. Countries need to co-operate in order to allow at least a trickle of essential travellers to continue crossing borders: scientists, doctors, journalists, politicians, businesspeople. This can be done by reaching a global agreement on the pre-screening of travellers by their home country. If you know that only carefully screened travellers were allowed on a plane, you would be more willing to accept them into your country. 

Unfortunately, at present countries hardly do any of these things. A collective paralysis has gripped the international community. There seem to be no adults in the room. One would have expected to see already weeks ago an emergency meeting of global leaders to come up with a common plan of action. The G7 leaders managed to organise a videoconference only this week, and it did not result in any such plan. 

In previous global crises — such as the 2008 financial crisis and the 2014 Ebola epidemic — the US assumed the role of global leader. But the current US administration has abdicated the job of leader. It has made it very clear that it cares about the greatness of America far more than about the future of humanity. 

This administration has abandoned even its closest allies. When it banned all travel from the EU, it didn’t bother to give the EU so much as an advance notice — let alone consult with the EU about that drastic measure. It has scandalised Germany by allegedly offering $1bn to a German pharmaceutical company to buy monopoly rights to a new Covid-19 vaccine. Even if the current administration eventually changes tack and comes up with a global plan of action, few would follow a leader who never takes responsibility, who never admits mistakes, and who routinely takes all the credit for himself while leaving all the blame to others. 

If the void left by the US isn’t filled by other countries, not only will it be much harder to stop the current epidemic, but its legacy will continue to poison international relations for years to come. Yet every crisis is also an opportunity. We must hope that the current epidemic will help humankind realise the acute danger posed by global disunity. 

Humanity needs to make a choice. Will we travel down the route of disunity, or will we adopt the path of global solidarity? If we choose disunity, this will not only prolong the crisis, but will probably result in even worse catastrophes in the future. If we choose global solidarity, it will be a victory not only against the coronavirus, but against all future epidemics and crises that might assail humankind in the 21st century. 

Yuval Noah Harari is author of ‘Sapiens’, ‘Homo Deus’ and ‘21 Lessons for the 21st Century’

Copyright © Yuval Noah Harari 2020

Follow  @FTLifeArts on Twitter to find out about our latest stories first. Listen to our culture podcast,  Culture Call , where editors Gris and Lilah dig into the trends shaping life in the 2020s, interview the people breaking new ground and bring you behind the scenes of FT Life & Arts journalism. Subscribe on  Apple ,  Spotify , or wherever you listen.

Read more about the impact of coronavirus

• The latest figures as the outbreak spreads
• Containing coronavirus: lessons from Asia
• How dangerous is the coronavirus and how does it spread?

Subscribers can  use myFT to follow the latest ‘coronavirus’ coverage

Letters in response to this article:

So, Prof Harari, who am I supposed to trust? / From Justin Evans

Let’s be the good ancestors our descendants deserve / From Lord Bird (Crossbench) and others

Promoted Content

Explore the series.

Follow the topics in this article

• Life & Arts Add to myFT
• Health Add to myFT
• Audio articles Add to myFT
• Coronavirus Add to myFT
• Yuval Noah Harari Add to myFT

International Edition

COVID-19: Where we’ve been, where we are, and where we’re going

One of the hardest things to deal with in this type of crisis is being able to go the distance. Moderna CEO Stéphane Bancel

Where we're going

Living with covid-19, people & organizations, sustainable, inclusive growth, related collection.

The Next Normal: Emerging stronger from the coronavirus pandemic

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Methodist Debakey Cardiovasc J
• v.17(5); 2021

The Way Ahead: Life After COVID-19

Mouaz h. al-mallah.

1 Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, US

Much has changed in the 2 years since the start of the coronavirus disease 19 (COVID-19) pandemic. The need for social distancing catalyzed the digitization of healthcare delivery and medical education—from telemedicine and virtual conferences to online residency/fellowship interviews. Vaccine development, particularly in the field of mRNA technology, led to widespread availability of safe and effective vaccines. With improved survival from acute infection, the healthcare system is dealing with the ever-growing cohort of patients with lingering symptoms. In addition, social media platforms have fueled a plethora of misinformation campaigns that have adversely affected prevention and control measures. In this review, we examine how COVID-19 has reshaped the healthcare system, and gauge its potential effects on life after the pandemic.

Introduction

In December 2021, after many months of living with the COVID-19 pandemic, the world is still looking for a way out of this healthcare crisis. As of this writing, more than 250 million people globally have been infected with SARS-CoV-2, the virus that causes coronavirus disease 19 (COVID-19), and nearly 5 million individuals lost their lives battling the complications of severe acute respiratory syndromes. 1 Many communities experienced multiple surges of the virus, with changes in normal life and restrictions to daily activities. The intensification of vaccination efforts brought about hope for a possible end to the pandemic. However, the continued emergence of variant strains and vaccine hesitancy have been persistent challenges in the US and globally. In this article, we review the long-term effect of COVID-19 on healthcare systems and envision the future of life after the pandemic ( Figure 1 ).

The long-term effects of the coronavirus disease 19 (COVID-19) pandemic on the healthcare system.

Since the beginning of the pandemic, there have been accelerated efforts to sequence the genetic material of the virus and build effective vaccines that decrease the risk of infection, hospitalization, and mortality. 2 At the time of this writing, more than 10 vaccines have been approved by local healthcare authorities in different parts of the world. 3 The pandemic has also driven innovation in the novel field of messenger ribonucleic acid (mRNA) vaccines. The US Food and Drug Administration (FDA) has approved the use of the Pfizer-BioNTech mRNA vaccine and given emergency use authorization to Moderna. 4 The mRNA vaccines have shown excellent efficacy against many of the strains, including the beta and delta strains.

More recently, booster doses have been approved by the FDA for individuals aged 65 years and older as well as individuals with comorbidities, in long-term care facilities, or at increased risk for COVID-19 exposure and transmission due to occupational or institutional settings. 5 Furthermore, the FDA has also given emergency use authorization for the Pfizer-BioNTech vaccine in individuals aged 12 to 17 years and, as of October 29, in children aged 5 to 11 years.

Although the fast-tracked vaccine production time led some skeptics to hypothesize safety concerns, the rate of adverse events has been very low. One complication that gained significant attention is myocarditis. 6 , 7 , 8 Emerging data have shown that young men are the most commonly affected demographic. Furthermore, the risk was elevated in the setting of a recent COVID-19 illness and after the second dose of the vaccine. 6 , 7 Although the rate of myocarditis is low and the majority of patients recover, the risk of recurrence in patients who developed myocarditis with the first dose or in patients with recent myocarditis is unclear. Similarly, the rate of recurrence after the second or booster doses also is unclear.

Vaccine Mandates

Multiple state and federal governments have issued vaccine mandates, and they have become a highly contested political issue in the United States. The Biden administration issued an executive order on September 9, 2021, requiring all federal employees to vaccinate. 9 Some state and local governments have also followed. 10

Multiple US healthcare systems have also issued COVID-19 vaccine mandates for employees. On March 31, 2021, Houston Methodist became the first healthcare system to mandate the vaccine for employees, and a wave of other healthcare systems followed suit. 11 As of this writing, more than 2,500 hospitals or health systems have followed Houston Methodist and mandated vaccines for their clinical and nonclinical staff. 12

Combating Misinformation

Since the beginning of the pandemic, misinformation has spread throughout the Internet and on social media platforms. 13 People have questioned the existence of the virus, the strain on healthcare systems, and the benefit of masks as well as emphasized the benefits of unproven therapies, many of which were useless and even harmful. 14 Political agendas have also played into the misinformation campaigns. Studies have shown that these misinformation campaigns have had measurable effects on the intent to vaccinate and created widespread fear and panic, ultimately contributing to the reduced number of people willing to vaccinate. 13 , 15 , 16 Tackling this will require concerted efforts by the government and private sector, particularly social media companies, to implement evidence-based communication strategies. 17 Individuals should also assume responsibility in seeking out accurate, evidence-based information for their own consumption.

Telemedicine

As many states and cities implemented measures to reduce transmission, telehealth emerged as the ideal tool to continue patient care while protecting the health of both patients and providers. Many patients preferred this option, especially when hospitals were dealing with record numbers of COVID-19 infections. In 2020, telemedicine was the main means by which ambulatory care was provided, accounting for 10% to 20% of visits when virus transmissibility was low and as high as 80% of visits during the surges. 18

Accordingly, the US Department of Health and Human Services relaxed enforcement of software-based Health Insurance Portability and Accountability Act violations, the Centers for Medicaid and Medicare Services provided waivers for telehealth reimbursements, and, in many instances, commercial insurances provided the same either directly or through mandates provided by local state governments. 19 , 20 The removal of regulatory and reimbursement barriers led to a dramatic increase in the use of telehealth, with some institutions reporting multifold increase in telehealth visits. 21

The pandemic also served as a catalyst for innovation in the software and hardware necessary for telemedicine. 22 For example, important tools were developed to enable secure connections with physicians and allow remote vital sign and weight monitoring. 23 , 24 Unfortunately, not all have equally benefitted from the expanded use of telehealth. Data indicate that minorities and disadvantaged groups often lack access to telehealth-based care. 25 Although the positive response and uptake by physicians and patients indicates the likelihood of telemedicine continuing past the pandemic, it remains to be seen whether the regulatory and reimbursement aspects will continue.

Post Covid-19 Condition

There is a growing body of evidence that some patients have prolonged recovery and/or residual symptoms after acute infection with COVID-19. The World Health Organization has defined this as “post COVID-19 condition.” Common presentation includes shortness of breath, palpitation, anxiety, and depression lingering for several months after acute infection. 26 , 27 Recent data also suggests that post COVID-19 condition might not be limited to somatic symptoms, with studies showing a 7-fold increased risk of developing depression and mental health issues. 28

Although the cause of these symptoms is not clear, one possible link that partly explains the prolonged shortness of breath experienced by some patients is COVID-19–associated myocarditis and the associated microvascular dysfunction. 26 As the pandemic continues and therapeutics improve survival from acute infection, the number of patients reporting post COVID-19 condition is predicted to grow. Several medical centers have already established clinics to better coordinate care and conduct research on the long-term impact and treatment of COVID-19. 29

Collateral Damage

Many patients delayed regular and preventive care during the pandemic due to fear of contracting COVID-19. 30 , 31 Such change in health-seeking behavior also extended to emergency conditions, with studies showing how some patients did not seek care for new onset chest pain. 32 Indirect indicators of this are the reduced rates of cardiovascular testing globally and within the United States 33 , 34 and the increased rate of myocardial infarctions and other emergencies seen on the trailing end of COVID-19–infection surges. 32 There has also been an increase in late complications of myocardial infarction such as ventricular septal rupture, a rare occurrence in the prepandemic reperfusion era and one partly explained by delayed care and ignored early warning signs. 35

Disparities in Healthcare

The pandemic exposed significant disparities in healthcare delivery, particularly among minorities. They were more likely to be affected by misinformation campaigns and less likely to accept research supporting clinical therapies and vaccines. Understanding the disparities and identifying measures to bridge the gap will be an important area of research for policy.

Globally, the pandemic also exposed significant inequities regarding vaccine access. While many developed countries were able to reach vaccination rates as high as 70%, rates in low-to-middle-income countries have remained low. 35 As the delta variant has clearly shown, no one is safe until everyone is safe. To this end, the World Health Organization and the COVAX (COVID-19 Vaccines Global Access) alliance have been a vital source of affordable vaccines. 36

Changes to Medical Education

The pandemic resulted in significant changes to both graduate and continued medical education. Much like patient-physician encounters, postgraduate training programs limited large face-to-face gatherings and transitioned all teaching to online platforms. 37 Residency and fellowship recruitment interviews also shifted to online settings. Lastly, there has been an exponential increase in the number of continued medical education offerings, with many societal meetings and conferences transitioning to online or hybrid formats. 38

The medical community has, for the most part, been very receptive to these changes, and it has afforded unforeseen advantages to trainees. Residency and fellowship applicants no longer need to bear the logistic and financial burden of in-person interviews. More importantly, virtual meetings and conferences have significantly increased audiences and, by extension, enabled the wider dissemination of medical knowledge.

The COVID-19 pandemic has dramatically changed clinical practice, medical education, and research. Beyond the immediate increase in morbidity and mortality, the healthcare system is having to deal with a growing cohort of patients with lingering symptoms. Misinformation, vaccine hesitancy, and vaccine inequity will be continuing challenges to attaining herd immunity. Clinicians, educators, and healthcare administrators will also have to determine how best to leverage the transition to virtual platforms. Lastly, healthcare leaders and policy makers will have to help the country and world chart a course through the end of the pandemic.

• The coronavirus disease 19 (COVID-19) pandemic has dramatically changed clinical practice, medical education, and research.
• It has brought about new challenges for the healthcare system, such as how best to combat misinformation, address the disproportionate impact on minorities and marginalized groups, and treat the ever-growing population of patients with lingering “long COVID” symptoms.
• The pandemic has also catalyzed much needed change in vaccine development, telemedicine, and medical education.
• Addressing these challenges and charting a way forward will require the concerted effort of clinicians, healthcare leaders, and policy makers.

Competing Interests

Dr. Al-Mallah has completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Review Article
• Published: 25 July 2023

Epidemiology, clinical presentation, pathophysiology, and management of long COVID: an update

• Sizhen Su 1 ,
• Yimiao Zhao 2 , 3 ,
• Na Zeng 2 , 3 ,
• Xiaoxing Liu 1 ,
• Yongbo Zheng 4 ,
• Jie Sun 5 ,
• Yi Zhong 1 ,
• Shuilin Wu 2 , 3 ,
• Shuyu Ni 2 , 3 ,
• Yimiao Gong 1 , 4 ,
• Zhibo Zhang 1 ,
• Nan Gao 6 ,
• Kai Yuan   ORCID: orcid.org/0000-0002-3498-8163 1 ,
• Wei Yan   ORCID: orcid.org/0000-0002-5866-6230 1 ,
• Le Shi   ORCID: orcid.org/0000-0003-4750-3492 1 ,
• Arun V. Ravindran 7 ,
• Thomas Kosten   ORCID: orcid.org/0000-0003-1505-555X 8 ,
• Jie Shi   ORCID: orcid.org/0000-0001-6567-8160 2 ,
• Yanping Bao   ORCID: orcid.org/0000-0002-1881-0939 2 , 3 &
• Lin Lu   ORCID: orcid.org/0000-0003-0742-9072 1 , 2 , 4  

Molecular Psychiatry volume  28 ,  pages 4056–4069 ( 2023 ) Cite this article

4100 Accesses

16 Citations

30 Altmetric

Metrics details

• Prognostic markers

The increasing number of coronavirus disease 2019 (COVID-19) infections have highlighted the long-term consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection called long COVID. Although the concept and definition of long COVID are described differently across countries and institutions, there is general agreement that it affects multiple systems, including the immune, respiratory, cardiovascular, gastrointestinal, neuropsychological, musculoskeletal, and other systems. This review aims to provide a synthesis of published epidemiology, symptoms, and risk factors of long COVID. We also summarize potential pathophysiological mechanisms and biomarkers for precise prevention, early diagnosis, and accurate treatment of long COVID. Furthermore, we suggest evidence-based guidelines for the comprehensive evaluation and management of long COVID, involving treatment, health systems, health finance, public attitudes, and international cooperation, which is proposed to improve the treatment strategies, preventive measures, and public health policy making of long COVID.

This is a preview of subscription content, access via your institution

Access options

Subscribe to this journal

Receive 12 print issues and online access

251,40 € per year

only 20,95 € per issue

Buy this article

• Purchase on Springer Link
• Instant access to full article PDF

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID

Post-acute COVID-19 syndrome

A COVID-19 pandemic guideline in evidence-based medicine

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl J Med. 2020;382:727–33.

Article   CAS   PubMed   PubMed Central   Google Scholar  

WHO. WHO coronavirus (COVID-19) dashboard. 2023. https://covid19.who.int/ (Accessed 1 May 2023).

Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324:782–93.

Article   CAS   PubMed   Google Scholar  

Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ. 2020;371:m3862.

Article   PubMed   Google Scholar  

Kondratiuk AL, Pillay TD, Kon OM, Lalvani A. A conceptual framework to accelerate the clinical impact of evolving research into long COVID. Lancet Infect Dis. 2021;21:756–7.

Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, Ballouz T, et al. Estimated global proportions of individuals with persistent fatigue, cognitive, and respiratory symptom clusters following symptomatic COVID-19 in 2020 and 2021. JAMA. 2022;328:1604–15.

Article   PubMed   PubMed Central   Google Scholar  

Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601–15.

Crook H, Raza S, Nowell J, Young M, Edison P. Long covid-mechanisms, risk factors, and management. BMJ. 2021;374:n1648.

Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022;22:e102–e107.

Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020;370:m3026.

Datta SD, Talwar A, Lee JT. A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: illness beyond acute infection and public health implications. JAMA. 2020;324:2251–2.

Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021;372:n136.

WHO. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 .

Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med. 2022;10:863–76.

Pazukhina E, Andreeva M, Spiridonova E, Bobkova P, Shikhaleva A, El-Taravi Y, et al. Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective, cohort study in Moscow (StopCOVID). BMC Med. 2022;20:244.

Evans RA, McAuley H, Harrison EM, Shikotra A, Singapuri A, Sereno M, et al. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med. 2021;9:1275–87.

Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: a 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med. 2021;18:e1003773.

Antonelli M, Pujol JC, Spector TD, Ourselin S, Steves CJ. Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2. Lancet. 2022;399:2263–4.

Perlis RH, Santillana M, Ognyanova K, Safarpour A, Lunz Trujillo K, Simonson MD, et al. Prevalence and correlates of long COVID symptoms among US adults. JAMA Netw Open. 2022;5:e2238804.

Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global prevalence of post-coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. J Infect Dis. 2022;226:1593–607.

Zeng N, Zhao YM, Yan W, Li C, Lu QD, Liu L et al. A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: call for research priority and action. Mol Psychiatry 2023;28:423–33.

Thompson EJ, Williams DM, Walker AJ, Mitchell RE, Niedzwiedz CL, Yang TC, et al. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records. Nat Commun. 2022;13:3528.

Alkodaymi MS, Omrani OA, Fawzy NA, Shaar BA, Almamlouk R, Riaz M, et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect. 2022;28:657–66.

Montefusco L, Ben Nasr M, D'Addio F, Loretelli C, Rossi A, Pastore I, et al. Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection. Nat Metab. 2021;3:774–85.

Fernández-Ortega M, Ponce-Rosas ER, Muñiz-Salinas DA, Rodríguez-Mendoza O, Nájera Chávez P, Sánchez-Pozos V, et al. Cognitive dysfunction, diabetes mellitus 2 and arterial hypertension: Sequelae up to one year of COVID-19. Travel Med Infect Dis. 2023;52:102553.

Lee JH, Yim JJ, Park J. Pulmonary function and chest computed tomography abnormalities 6-12 months after recovery from COVID-19: a systematic review and meta-analysis. Respir Res. 2022;23:233.

Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered From coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5:1265–73.

Lam MH, Wing YK, Yu MW, Leung CM, Ma RC, Kong AP, et al. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Arch Intern Med. 2009;169:2142–7.

Epstein L, Wong KK, Kallen AJ, Uyeki TM. Post-Ebola signs and symptoms in U.S. survivors. N. Engl J Med. 2015;373:2484–6.

Choudhury A, Tariq R, Jena A, Vesely EK, Singh S, Khanna S, et al. Gastrointestinal manifestations of long COVID: a systematic review and meta-analysis. Ther Adv Gastroenterol. 2022;15:17562848221118403.

Article   Google Scholar  

Stefanou MI, Palaiodimou L, Bakola E, Smyrnis N, Papadopoulou M, Paraskevas GP, et al. Neurological manifestations of long-COVID syndrome: a narrative review. Ther Adv Chronic Dis. 2022;13:20406223221076890.

Daroische R, Hemminghyth MS, Eilertsen TH, Breitve MH, Chwiszczuk LJ. Cognitive impairment after COVID-19-a review on objective test data. Front Neurol. 2021;12:699582.

Douaud G, Lee S, Alfaro-Almagro F, Arthofer C, Wang C, McCarthy P, et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature. 2022;604:697–707.

Bellan M, Soddu D, Balbo PE, Baricich A, Zeppegno P, Avanzi GC, et al. Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Netw Open. 2021;4:e2036142.

McMahon DE, Gallman AE, Hruza GJ, Rosenbach M, Lipoff JB, Desai SR, et al. Long COVID in the skin: a registry analysis of COVID-19 dermatological duration. Lancet Infect Dis. 2021;21:313–4.

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397:220–32.

Wise J. Long covid: hair loss and sexual dysfunction are among wider symptoms, study finds. BMJ. 2022;378:o1887.

WHO. Tracking SARS-CoV-2 variants. 2022. https://www.who.int/activities/tracking-SARS-CoV-2-variants .

Olaiz-Fernandez G, Vicuna de Anda FJ, Diaz-Ramirez JB, Fajardo Dolci GE, Bautista-Carbajal P, Angel-Ambrocio AH, et al. Effect of Omicron on the prevalence of COVID-19 in international travelers at the Mexico city international airport. December 16th, 2021 to January 31st, 2022. Travel Med Infect Dis. 2022;49:102361.

Ra SH, Lim JS, Kim GU, Kim MJ, Jung J, Kim SH. Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. Thorax. 2021;76:61–3.

Ralli M, Morrone A, Arcangeli A, Ercoli L. Asymptomatic patients as a source of transmission of COVID-19 in homeless shelters. Int J Infect Dis. 2021;103:243–5.

Fiercehealthcare. New data offer glimpse at potential impact of emerging COVID variants. 2022. https://www.fiercehealthcare.com/payers/preliminary-data-point-challenges-new-covid-variants-present .

Cao Y, Jian F, Wang J, Yu Y, Song W, Yisimayi A et al. Imprinted SARS-CoV-2 humoral immunity induces convergent Omicron RBD evolution. Nature 2023;614:521–29.

Qu P, Evans JP, Faraone JN, Zheng YM, Carlin C, Anghelina M et al. Enhanced neutralization resistance of SARS-CoV-2 Omicron subvariants BQ.1, BQ.1.1, BA.4.6, BF.7, and BA.2.75.2. Cell Host Microbe 2023;31:9–17.e13.

Sheward DJ, Kim C, Fischbach J, Sato K, Muschiol S, Ehling RA, et al. Omicron sublineage BA.2.75.2 exhibits extensive escape from neutralising antibodies. Lancet Infect Dis. 2022;22:1538–40.

Taquet M, Sillett R, Zhu L, Mendel J, Camplisson I, Dercon Q, et al. Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: an analysis of 2-year retrospective cohort studies including 1 284 437 patients. Lancet Psychiatry. 2022;9:815–27.

Ledford H. How severe are omicron infections? Nature. 2021;600:577–8.

Hui KPY, Ho JCW, Cheung MC, Ng KC, Ching RHH, Lai KL, et al. SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo. Nature. 2022;603:715–20.

Office for National Statistics (ONS). Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK. 2022. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/3november2022 .

Wang S, Quan L, Chavarro JE, Slopen N, Kubzansky LD, Koenen KC, et al. Associations of depression, anxiety, worry, perceived stress, and loneliness prior to infection with risk of post-COVID-19 conditions. JAMA psychiatry. 2022;79:1081–91.

Kayaaslan B, Eser F, Kalem AK, Kaya G, Kaplan B, Kacar D, et al. Post-COVID syndrome: a single-center questionnaire study on 1007 participants recovered from COVID-19. J Med Virol. 2021;93:6566–74.

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med. 2021;27:626–31.

Subramanian A, Nirantharakumar K, Hughes S, Myles P, Williams T, Gokhale KM, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022;28:1706–14.

Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med. 2022;28:2398–405.

Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Bourbao-Tournois C, Laribi S, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2021;27:258–63.

Peghin M, Palese A, Venturini M, De Martino M, Gerussi V, Graziano E, et al. Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients. Clin Microbiol Infect. 2021;27:1507–13.

de Oliveira JF, de Ávila RE, de Oliveira NR, da Cunha Severino Sampaio N, Botelho M, Gonçalves FA, et al. Persistent symptoms, quality of life, and risk factors in long COVID: a cross-sectional study of hospitalized patients in Brazil. Int J Infect Dis. 2022;122:1044–51.

Boglione L, Meli G, Poletti F, Rostagno R, Moglia R, Cantone M, et al. Risk factors and incidence of long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect? QJM. 2022;114:865–71.

Bai F, Tomasoni D, Falcinella C, Barbanotti D, Castoldi R, Mulè G, et al. Female gender is associated with long COVID syndrome: a prospective cohort study. Clin Microbiol Infect. 2022;28:611.e619–611.e616.

Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pr. 2021;75:e13746.

CAS   Google Scholar  

Galal I, Hussein AARM, Amin MT, Saad MM, Zayan HEE, Abdelsayed MZ, et al. Determinants of persistent post-COVID-19 symptoms: value of a novel COVID-19 symptom score. Egypt J Bronchol. 2021;15:10.

Huang Y, Pinto MD, Borelli JL, Asgari Mehrabadi M, Abrahim HL, Dutt N, et al. COVID symptoms, symptom clusters, and predictors for becoming a long-hauler looking for clarity in the haze of the pandemic. Clin Nurs Res. 2022;31:1390–8.

FAIR Health. A detailed study of patients with long-haul COVID. 2021. https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID--An%20Analysis%20of%20Private%20Healthcare%20Claims--A%20FAIR%20Health%20White%20Paper.pdf .

Strahm C, Seneghini M, Güsewell S, Egger T, Leal-Neto O, Brucher A, et al. Symptoms compatible with long coronavirus disease (COVID) in healthcare workers with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-results of a prospective multicenter cohort. Clin Infect Dis. 2022;75:e1011–19.

Hastie CE, Lowe DJ, McAuley A, Winter AJ, Mills NL, Black C, et al. Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study. Nat Commun. 2022;13:5663.

Yomogida K, Zhu S, Rubino F, Figueroa W, Balanji N, Holman E. Post-acute sequelae of SARS-CoV-2 infection among adults aged ≥18 years - Long Beach, California, April 1-December 10, 2020. MMWR Morb Mortal Wkly Rep. 2021;70:1274–7.

Poyraz BÇ, Poyraz CA, Olgun Y, Gürel Ö, Alkan S, Özdemir YE, et al. Psychiatric morbidity and protracted symptoms after COVID-19. Psychiatry Res. 2021;295:113604.

Pillay J, Rahman S, Guitard S, Wingert A, Hartling L. Risk factors and preventive interventions for post Covid-19 condition: systematic review. Emerg Microbes Infect. 2022;11:2762–80.

Singh B, Gornet M, Sims H, Kisanga E, Knight Z, Segars J. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its effect on gametogenesis and early pregnancy. Am J Reprod Immunol. 2020;84:e13351.

Scully EP, Haverfield J, Ursin RL, Tannenbaum C, Klein SL. Considering how biological sex impacts immune responses and COVID-19 outcomes. Nat Rev Immunol. 2020;20:442–7.

Zhao Y, Shi L, Jiang Z, Zeng N, Mei H, Lu Y et al. The phenotype and prediction of long-term physical, mental and cognitive COVID-19 sequelae 20 months after recovery, a community-based cohort study in China. Mol Psychiatry. 2023;28:1793–1801.

Osmanov IM, Spiridonova E, Bobkova P, Gamirova A, Shikhaleva A, Andreeva M et al. Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study. Eur Respir J. 2022;59:2101341.

Yuan K, Gong YM, Liu L, Sun YK, Tian SS, Wang YJ, et al. Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review. Mol Psychiatry. 2021;26:4982–98.

Scott HR, Stevelink SAM, Gafoor R, Lamb D, Carr E, Bakolis I, et al. Prevalence of post-traumatic stress disorder and common mental disorders in health-care workers in England during the COVID-19 pandemic: a two-phase cross-sectional study. Lancet Psychiatry. 2023;10:40–9.

Ourworldindata. Coronavirus (COVID-19) vaccinations. 2023. https://ourworldindata.org/covid-vaccinations .

Moore S, Hill EM, Dyson L, Tildesley MJ, Keeling MJ. Retrospectively modeling the effects of increased global vaccine sharing on the COVID-19 pandemic. Nat Med. 2022;28:2416–23.

Koc HC, Xiao J, Liu W, Li Y, Chen G. Long COVID and its management. Int J Biol Sci. 2022;18:4768–80.

Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID symptom study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022;22:43–55.

Ayoubkhani D, Bosworth ML, King S, Pouwels KB, Glickman M, Nafilyan V, et al. Risk of long COVID in people infected with severe acute respiratory syndrome coronavirus 2 after 2 doses of a coronavirus disease 2019 vaccine: community-based, matched cohort study. Open Forum Infect Dis. 2022;9:ofac464.

Azzolini E, Levi R, Sarti R, Pozzi C, Mollura M, Mantovani A, et al. Association between BNT162b2 vaccination and long COVID after infections not requiring hospitalization in health care workers. JAMA. 2022;328:676–8.

Gao P, Liu J, Liu M Effect of COVID-19 vaccines on reducing the risk of long COVID in the real world: a systematic review and meta-analysis. Int J Environ Res Public Health 2022;19:12422.

Taghioff SM, Slavin BR, Holton T, Singh D. Examining the potential benefits of the influenza vaccine against SARS-CoV-2: a retrospective cohort analysis of 74,754 patients. PloS One. 2021;16:e0255541.

Ahamed J, Laurence J Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches. J Clin Invest. 2022;132:e161167.

Castanares-Zapatero D, Chalon P, Kohn L, Dauvrin M, Detollenaere J, Maertens de Noordhout C, et al. Pathophysiology and mechanism of long COVID: a comprehensive review. Ann Med. 2022;54:1473–87.

Mantovani A, Morrone MC, Patrono C, Santoro MG, Schiaffino S, Remuzzi G, et al. Long Covid: where we stand and challenges ahead. Cell Death Differ. 2022;29:1891–1900.

PubMed   PubMed Central   Google Scholar  

Monje M, Iwasaki A .The neurobiology of long COVID. Neuron. 2022;110:3484–96.

Bakar Siddiq M, Rasker J. COVID-19, long COVID, and psychosomatic manifestations: a possible burden on existing rheumatology facilities. Heart Mind. 2022;6:195–202.

Stein SR, Ramelli SC, Grazioli A, Chung JY, Singh M, Yinda CK et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature. 2022;612:758–63.

Li Q, Zheng XS, Shen XR, Si HR, Wang X, Wang Q, et al. Prolonged shedding of severe acute respiratory syndrome coronavirus 2 in patients with COVID-19. Emerg Microbes Infect. 2020;9:2571–7.

Han Y, Yuan K, Wang Z, Liu WJ, Lu ZA, Liu L, et al. Neuropsychiatric manifestations of COVID-19, potential neurotropic mechanisms, and therapeutic interventions. Transl Psychiatry. 2021;11:499.

de Melo GD, Lazarini F, Levallois S, Hautefort C, Michel V, Larrous F et al. COVID-19-related anosmia is associated with viral persistence and inflammation in human olfactory epithelium and brain infection in hamsters. Sci Transl Med. 2021;13:eabf8396.

Merad M, Blish CA, Sallusto F, Iwasaki A. The immunology and immunopathology of COVID-19. Science. 2022;375:1122.

Cohen JI. Epstein-Barr virus infection. N. Engl J Med. 2000;343:481–92.

Gold JE, Okyay RA, Licht WE, Hurley DJ. Investigation of long COVID prevalence and its relationship to epstein-barr virus reactivation. Pathogens. 2021;10:763.

Su Y, Yuan D, Chen DG, Ng RH, Wang K, Choi J, et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell. 2022;185:881–895.e820.

Gaebler C, Wang Z, Lorenzi JCC, Muecksch F, Finkin S, Tokuyama M, et al. Evolution of antibody immunity to SARS-CoV-2. Nature. 2021;591:639–44.

Theofilopoulos AN, Kono DH, Baccala R. The multiple pathways to autoimmunity. Nat Immunol. 2017;18:716–24.

Wallukat G, Hohberger B, Wenzel K, Furst J, Schulze-Rothe S, Wallukat A, et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent long-COVID-19 symptoms. J Transl Autoimmun. 2021;4:100100.

Klein J, Wood J, Jaycox J, Lu P, Dhodapkar RM, Gehlhausen JR et al. Distinguishing features of long COVID identified through immune profiling. medRxiv 2022;2022.08.09.22278592.

Proal AD, VanElzakker MB. Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms. Front Microbiol. 2021;12:698169.

Liu X, Yan W, Lu T, Han Y, Lu L. Longitudinal abnormalities in brain structure in COVID-19 patients. Neurosci Bull. 2022;38:1608–12.

Tian T, Wu J, Chen T, Li J, Yan S, Zhou Y et al. Long-term follow-up of dynamic brain changes in patients recovered from COVID-19 without neurological manifestations. JCI Insight. 2022;7:e155827.

Cecchetti G, Agosta F, Canu E, Basaia S, Barbieri A, Cardamone R, et al. Cognitive, EEG, and MRI features of COVID-19 survivors: a 10-month study. J Neurol. 2022;269:3400–12.

Du YY, Zhao W, Zhou XL, Zeng M, Yang DH, Xie XZ, et al. Survivors of COVID-19 exhibit altered amplitudes of low frequency fluctuation in the brain: a resting-state functional magnetic resonance imaging study at 1-year follow-up. Neural Regen Res. 2022;17:1576–81.

Pretorius E, Venter C, Laubscher GJ, Kotze MJ, Oladejo SO, Watson LR, et al. Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Cardiovasc Diabetol. 2022;21:148.

Kruger A, Vlok M, Turner S, Venter C, Laubscher GJ, Kell DB, et al. Proteomics of fibrin amyloid microclots in long COVID/post-acute sequelae of COVID-19 (PASC) shows many entrapped pro-inflammatory molecules that may also contribute to a failed fibrinolytic system. Cardiovasc Diabetol. 2022;21:190.

Kell DB, Laubscher GJ, Pretorius E. A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications. Biochem J. 2022;479:537–59.

Cheng HY, Ning MX, Chen DK, Ma WT. Interactions between the gut microbiota and the host innate immune response against pathogens. Front Immunol. 2019;10:607.

Alharbi KS, Singh Y, Hassan Almalki W, Rawat S, Afzal O, Alfawaz Altamimi AS, et al. Gut microbiota disruption in COVID-19 or post-COVID illness association with severity biomarkers: a possible role of pre / pro-biotics in manipulating microflora. Chem Biol Interact. 2022;358:109898.

Zuo T, Zhang F, Lui GCY, Yeoh YK, Li AYL, Zhan H, et al. Alterations in gut microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology. 2020;159:944–55.e948.

Vestad B, Ueland T, Lerum TV, Dahl TB, Holm K, Barratt-Due A, et al. Respiratory dysfunction three months after severe COVID-19 is associated with gut microbiota alterations. J Intern Med. 2022;291:801–12.

Mandal S, Barnett J, Brill SE, Brown JS, Denneny EK, Hare SS, et al. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2021;76:396–8.

Phetsouphanh C, Darley DR, Wilson DB, Howe A, Munier CML, Patel SK, et al. Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nat Immunol. 2022;23:210–6.

Bizjak DA, Stangl M, Börner N, Bösch F, Durner J, Drunin G, et al. Kynurenine serves as useful biomarker in acute, long- and post-COVID-19 diagnostics. Front Immunol. 2022;13:1004545.

Zhao J, Schank M, Wang L, Dang X, Cao D, Khanal S, et al. Plasma biomarkers for systemic inflammation in COVID-19 survivors. Proteom Clin Appl. 2022;16:e2200031.

Li H, Xiang X, Ren H, Xu L, Zhao L, Chen X, et al. Serum amyloid A is a biomarker of severe coronavirus disease and poor prognosis. J Infect. 2020;80:646–55.

Hua-Huy T, Günther S, Lorut C, Subileau M, Aubourg F, Morbieu C et al. Distal lung inflammation assessed by alveolar concentration of nitric oxide Is an individualised biomarker of severe COVID-19 pneumonia. J Pers Med 2022;12:1631.

Yang Z, Wu D, Lu S, Qiu Y, Hua Z, Tan F, et al. Plasma metabolome and cytokine profile reveal glycylproline modulating antibody fading in convalescent COVID-19 patients. Proc Natl Acad Sci USA. 2022;119:e2117089119.

Fernández-de-Las-Peñas C, Ryan-Murua P, Rodríguez-Jiménez J, Palacios-Ceña M, Arendt-Nielsen L, Torres-Macho J. Serological biomarkers at hospital admission are not related to long-term post-COVID fatigue and dyspnea in COVID-19 survivors. Respiration. 2022;101:658–65.

Sabanoglu C, Inanc IH, Polat E, Peker SA. Long-term predictive value of cardiac biomarkers in patients with COVID-19 infection. Eur Rev Med Pharm Sci. 2022;26:6396–403.

Motloch LJ, Jirak P, Gareeva D, Davtyan P, Gumerov R, Lakman I, et al. Cardiovascular biomarkers for prediction of in-hospital and 1-year post-discharge mortality in patients with COVID-19 pneumonia. Front Med (Lausanne). 2022;9:906665.

Petersen EL, Goßling A, Adam G, Aepfelbacher M, Behrendt CA, Cavus E, et al. Multi-organ assessment in mainly non-hospitalized individuals after SARS-CoV-2 infection: The Hamburg City Health Study COVID programme. Eur Heart J. 2022;43:1124–37.

Myhre PL, Heck SL, Skranes JB, Prebensen C, Jonassen CM, Berge T, et al. Cardiac pathology 6 months after hospitalization for COVID-19 and association with the acute disease severity. Am Heart J. 2021;242:61–70.

Tong M, Yan X, Jiang Y, Jin Z, Zhu S, Zou L, et al. Endothelial biomarkers in patients recovered from COVID-19 one year after hospital discharge: a cross-sectional study. Mediterr J Hematol Infect Dis. 2022;14:e2022033.

Puntmann VO, Martin S, Shchendrygina A, Hoffmann J, Ka MM, Giokoglu E, et al. Long-term cardiac pathology in individuals with mild initial COVID-19 illness. Nat Med. 2022;28:2117–23.

Wais T, Hasan M, Rai V, Agrawal DK. Gut-brain communication in COVID-19: molecular mechanisms, mediators, biomarkers, and therapeutics. Expert Rev Clin Immunol. 2022;18:947–60.

García-Grimshaw M, Chirino-Pérez A, Flores-Silva FD, Valdés-Ferrer SI, Vargas-Martínez M, Jiménez-Ávila AI, et al. Critical role of acute hypoxemia on the cognitive impairment after severe COVID-19 pneumonia: a multivariate causality model analysis. Neurol Sci. 2022;43:2217–29.

Alvarez M, Trent E, Goncalves BS, Pereira DG, Puri R, Frazier NA, et al. Cognitive dysfunction associated with COVID-19: prognostic role of circulating biomarkers and microRNAs. Front Aging Neurosci. 2022;14:1020092.

Kanberg N, Simrén J, Edén A, Andersson LM, Nilsson S, Ashton NJ, et al. Neurochemical signs of astrocytic and neuronal injury in acute COVID-19 normalizes during long-term follow-up. EBioMedicine. 2021;70:103512.

Sun B, Tang N, Peluso MJ, Iyer NS, Torres L, Donatelli JL et al. Characterization and biomarker analyses of post-COVID-19 complications and neurological manifestations. Cells. 2021;10:386.

Guasp M, Muñoz-Sánchez G, Martínez-Hernández E, Santana D, Carbayo Á, Naranjo L, et al. CSF biomarkers in COVID-19 associated encephalopathy and encephalitis predict long-term outcome. Front Immunol. 2022;13:866153.

Rhea EM, Logsdon AF, Hansen KM, Williams LM, Reed MJ, Baumann KK, et al. The S1 protein of SARS-CoV-2 crosses the blood-brain barrier in mice. Nat Neurosci. 2021;24:368–78.

Meinhardt J, Radke J, Dittmayer C, Franz J, Thomas C, Mothes R, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci. 2021;24:168–75.

Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18–22.

Al-Hadrawi DS, Al-Rubaye HT, Almulla AF, Al-Hakeim HK, Maes M Lowered oxygen saturation and increased body temperature in acute COVID-19 largely predict chronic fatigue syndrome and affective symptoms due to Long COVID: A precision nomothetic approach. Acta Neuropsychiatr. 2022;35:76-87.

Mazza MG, Palladini M, De Lorenzo R, Magnaghi C, Poletti S, Furlan R, et al. Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: effect of inflammatory biomarkers at three-month follow-up. Brain Behav Immun. 2021;94:138–47.

Carson G. Research priorities for long covid: refined through an international multi-stakeholder forum. BMC Med. 2021;19:84.

National institute for health and care excellence: clinical guidelines. COVID-19 rapid guideline: managing the long-term effects of COVID-19 . National Institute for Health and Care Excellence (NICE) Copyright © NICE 2020: London, 2020.

Sachs JD, Karim SSA, Aknin L, Allen J, Brosbøl K, Colombo F et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet. 2022;400:1224–80.

Greenhalgh T, Sivan M, Delaney B, Evans R, Milne R. Long covid-an update for primary care. BMJ. 2022;378:e072117.

Joli J, Buck P, Zipfel S, Stengel A. Post-COVID-19 fatigue: a systematic review. Front Psychiatry. 2022;13:947973.

Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS, et al. Treatment of unexplained chronic cough: CHEST guideline and expert panel report. Chest. 2016;149:27–44.

Song WJ, Hui CKM, Hull JH, Birring SS, McGarvey L, Mazzone SB, et al. Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses. Lancet Respir Med. 2021;9:533–44.

Chamberlain Mitchell SA, Garrod R, Clark L, Douiri A, Parker SM, Ellis J, et al. Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial. Thorax. 2017;72:129–36.

National institute for health and care excellence. Atrial fibrillation: diagnosis and management NICE guideline . National Institute for Health and Care Excellence (NICE) Copyright © NICE 2020: London, 2020.

National institute for health and care excellence. Acute coronary syndromes NICE guideline . National Institute for Health and Care Excellence (NICE) Copyright © NICE 2020.: London, 2020.

Parker AM, Brigham E, Connolly B, McPeake J, Agranovich AV, Kenes MT, et al. Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care. Lancet Respir Med. 2021;9:1328–41.

Murphy J, Vallières F, Bentall RP, Shevlin M, McBride O, Hartman TK, et al. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat Commun. 2021;12:29.

WHO. COVID-19 vaccines. 2022. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines .

Zheng YB, Sun J, Liu L, Zhao YM, Yan W, Yuan K, et al. COVID-19 vaccine-related psychological stress among general public in China. Front Psychiatry. 2021;12:774504.

Liu L, Ni SY, Yan W, Lu QD, Zhao YM, Xu YY, et al. Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: a systematic review, meta-analysis and call for action. EClinicalMedicine. 2021;40:101111.

Zheng YB, Shi L, Lu ZA, Que JY, Yuan K, Huang XL, et al. Mental health status of late-middle-aged adults in China during the coronavirus disease 2019 pandemic. Front Public Health. 2021;9:643988.

Gong Y, Liu X, Zheng Y, Mei H, Que J, Yuan K, et al. COVID-19 induced economic slowdown and mental health issues. Front Psychol. 2022;13:777350.

Byrne EA. Understanding long covid: nosology, social attitudes and stigma. Brain Behav Immun. 2022;99:17–24.

Yuan K, Huang XL, Yan W, Zhang YX, Gong YM, Su SZ, et al. A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action. Mol Psychiatry. 2022;27:19–33.

Zhao YM, Liu L, Sun J, Yan W, Yuan K, Zheng YB et al. Public willingness and determinants of COVID-19 vaccination at the initial stage of mass vaccination in China. Vaccines (Basel). 2021;9:1172.

Li H, Yuan K, Sun YK, Zheng YB, Xu YY, Su SZ, et al. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry. 2022;12:49.

Lazarus JV, Ratzan SC, Palayew A, Gostin LO, Larson HJ, Rabin K, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27:225–8.

Gong Y, Liu X, Su S, Bao Y, Kosten TR, Lu L. Addressing mental health issues amid the COVID-19 pandemic: a wake-up call. Sci Bull (Beijing). 2022;67:2259–62.

Download references

Acknowledgements

This study was supported by a grant from the National Key Research and Development Program of China (2021YFC0863700, 2019YFA0706200), Natural Science Foundation of Beijing Municipality of China (M23013), National Programs for Brain Science and Brain-like Intelligence Technology of China (STI2030-Major Projects, 2021ZD0200800, 2021ZD0200700), and the National Natural Science Foundation of China (no. 82288101, 82171514). The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be constructed as a potential conflict of interests.

Author information

Authors and affiliations.

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China

Sizhen Su, Xiaoxing Liu, Yi Zhong, Yimiao Gong, Zhibo Zhang, Kai Yuan, Wei Yan, Le Shi & Lin Lu

National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China

Yimiao Zhao, Na Zeng, Shuilin Wu, Shuyu Ni, Jie Shi, Yanping Bao & Lin Lu

Scholl of Public Health, Peking University, Beijing, China

Yimiao Zhao, Na Zeng, Shuilin Wu, Shuyu Ni & Yanping Bao

Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China

Yongbo Zheng, Yimiao Gong & Lin Lu

Pain Medicine Center, Peking University Third Hospital, Beijing, China

The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China

Department of Psychiatry, University of Toronto, Toronto, Canada

Arun V. Ravindran

Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA

Thomas Kosten

You can also search for this author in PubMed   Google Scholar

Contributions

LL and YB proposed the topic and main idea, SS was responsible for literature search, drafting the manuscript, and making the figures, and revising all versions. XL, NZ, YZ, YZ, SW, YZ, JS, and SN contributed to the first draft. YG, ZZ, NG, KY, WY, LS, AVR, TK, and JS revised the manuscript for intellectual content. YB and LL proposed the topic of the review and commented on and revised the manuscript.

Corresponding authors

Correspondence to Yanping Bao or Lin Lu .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Cite this article.

Su, S., Zhao, Y., Zeng, N. et al. Epidemiology, clinical presentation, pathophysiology, and management of long COVID: an update. Mol Psychiatry 28 , 4056–4069 (2023). https://doi.org/10.1038/s41380-023-02171-3

Download citation

Received : 15 January 2023

Revised : 20 June 2023

Accepted : 27 June 2023

Published : 25 July 2023

Issue Date : October 2023

DOI : https://doi.org/10.1038/s41380-023-02171-3

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

This article is cited by

Non-coding rnas expression in sars-cov-2 infection: pathogenesis, clinical significance, and therapeutic targets.

• Xiaoxing Liu
• Wandi Xiong
• Yanping Bao

Signal Transduction and Targeted Therapy (2023)

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies