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More than four years from the onset of the pandemic, a fuller and more nuanced picture of long COVID is emerging. As the puzzle pieces fall into place, researchers are gaining a clearer understanding of how even mild cases of COVID-19 can translate into long-lasting and debilitating health effects in many organs of the body. And these are having a sizable effect on Americans’ ability to participate in the workforce.

A new study by physician and long COVID researcher Ziyad Al-Aly and colleagues puts concrete numbers on how the risks of developing long COVID shifted over the first two years of the pandemic. During the early stage of the pandemic and prior to the availability of vaccines, more than 10% of people infected developed long COVID. But two years in, that number shifted to about 3.5% for vaccinated adults, while among unvaccinated people, more than 7% developed long COVID following an infection.

While public messaging often suggests that the risks have faded into the background, the threat of long-term health effects makes clear that COVID-19 cannot be dismissed, Al-Aly writes. “Trivializing COVID-19 as an inconsequential cold or equating it with flu does not align with reality.”

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Amanda Mascarelli

Senior Health and Medicine Editor

Researchers are gaining key insights into the ways that the SARS-CoV-2 virus can lead to long COVID symptoms. Catherine McQueen/Moment via Getty Images

Long COVID puzzle pieces are falling into place – the picture is unsettling

Ziyad Al-Aly, Washington University in St. Louis

A new study finds the risks of developing long COVID declined over the first two years of the pandemic. But unvaccinated adults were more than twice as likely to get long COVID compared with those who were vaccinated.

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