Brief Communication - Economic burden of long COVID: macroeconomic, cost-of-illness and microeconomic impacts, Amit Bansal, 2025

[Kalliope]

Abstract:

Long COVID, defined by symptoms persisting three months post-SARS-CoV-2 infection, presents a significant global health and economic challenge, with global prevalence estimated at 36% (ranging from 1–92%). This brief communication consolidates current knowledge on its economic impacts, including macroeconomic, cost-of-illness, and microeconomic impacts, which are estimated at an average annual burden of $1 trillion globally and $9000 per patient in the USA, with some individuals covering substantial out-of-pocket expenses. Annual lost earnings in the USA alone are estimated at approximately $170 billion. Long COVID was associated with increased unemployment, financial distress, and work impairment for up to three years post-infection.

This paper highlights discrepancies in impact estimation methodologies and calls for standardised metrics especially in emerging economies. Key research gaps include the absence of comprehensive longitudinal studies on individual and aggregated economic burden, specific long COVID phenotypes and biomarkers, and cost-effectiveness evaluations of interventions.

Economic burden of long COVID: macroeconomic, cost-of-illness and microeconomic impacts - npj Primary Care Respiratory Medicine

Long COVID, defined by symptoms persisting three months post-SARS-CoV-2 infection, presents a significant global health and economic challenge, with global prevalence estimated at 36% (ranging from 1–92%). This brief communication consolidates current knowledge on its economic impacts, including...

www.nature.com

 

[Kalliope]

The author suggests six efforts where the last one is:

Learning from other chronic conditions: It is reasonable to use the term chronic post-viral syndromes to capture the disease complexity and to help uncover the underlying cause of other life-limiting post-viral infections, such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis. The economic modelling and management strategies for other chronic post-viral syndromes or debilitating conditions (e.g., ME/CFS) can provide valuable insights for projecting and mitigating the long-term economic burden of long COVID

 

[Yann04]

Long COVID was associated with increased unemployment, financial distress, and work impairment for up to three years post-infection.

Up to? So it magically gets better after 3 years? Or was that just the cutoff date for the data?

 

[Kitty]

Or was that just the cutoff date for the data?

I suspect so, but it's very unfortunate that it's not made clearer.

 

[BrightCandle]

Up to? So it magically gets better after 3 years? Or was that just the cutoff date for the data?

We have all seen the followup on SARS to the 96 patients who were diagnosed with ME/CFS, and indeed ME/CFS. Its a lifelong condition and everyone should know that already. Its also stunning that nearly 6 years into this pandemic and they are talking about 3 years instead of the full length.

A big problem they are building for themselves is that people need to have a positive Covid test to qualify for a lot of these studies. That only happened with any regularity from mid to late 2020 through to the end of 2021. The first Long haulers could not have tested they didn't exist and the later ones wont have a test because no one is doing PCRs and the RATs are terrible and they are just selling old stock. So unless people are buying metrix or Pluslife and spending a small fortune to do a home PCR they aren't going to have proof that Covid preceded their condition. So this walking 3 years onwards is a very particular cohort of patients that doesn't exist before or after that period.

 

[Utsikt]

I struggle to make sense of this. The author cites an article that they claim shows that the global prevalence of LC is 36 %.

Global Prevalence of Long COVID, Its Subtypes, and Risk Factors: An Updated Systematic Review and Meta-analysis - PMC

This mega-systematic review evaluated the global prevalence of long COVID and its subtypes and symptoms, and assessed the effects of risk factors for long COVID. Studies published from 5 July 2021 to 29 May 2024 were searched in PubMed, Embase, and ...

pmc.ncbi.nlm.nih.gov

That is not the case. The analysis is about how many that have ever experienced long-lasting symptoms after covid.

We caution that our pooled prevalence estimates represent the percentage of individuals who ever experienced long COVID symptoms during study follow-up, rather than those who are currently experiencing symptoms at a specific point in time, among those with a history of COVID-19. Therefore, our pooled estimates may overstate the clinical burden of long COVID.

We also know that the LC classification is very prone to false positives, so you need longitudinal studies with baselines pre-infection to determine the true rate of LC. I seriously doubt that is the case for most of these studies.

The author also misses an important point: prevention of further infections.

The medical care suggestion is also a rehash of the BPS multi-disciplinary babble:

Development of integrated care pathways: The implementation of integrated, multidisciplinary care pathways for long COVID patients is crucial to optimise resource utilisation and mitigate escalating healthcare impacts. These pathways should aim to reduce diagnostic delays, streamline referrals, and ensure continuity of care, potentially drawing lessons from existing models for other chronic conditions.

We also have no idea how to treat these people, and the current approach is probably making people worse. I guess we could optimise that - why have two bad years before they get terrible, instead of just having one..

 

[rvallee]

The economic modelling and management strategies for other chronic post-viral syndromes or debilitating conditions (e.g., ME/CFS) can provide valuable insights for projecting and mitigating the long-term economic burden of long COVID

Yes, that would have been great. It would still be great. Alas, there is no such thing. Well, we have a blueprint for what not to do. Which is what has been tried and failed. But it sure looks extremely silly and incompetent to have refused to do any of this for decades. Not failed. Refused. An ongoing refusal. We still don't have good data, hence problems like estimated prevalence ranging from 1-92%, which may as well be a coin flip for all that it's useful.

Especially considering that the enormous costs of ME/CFS alone have been known for about 2 decades and everything done about it only made the price tag, and all the negative consequences, worse. On their own they justified funding of $1B/y and a large scale strategy. LC has neither and it's not even close. Mostly because of the total lack of any strategic thinking or coherent coordination of efforts.

There is not a single person in the world responsible for doing something. Responsible in the normal meaning of the word, like all other professionals are. And nothing's happened. In fact it's a total disaster. And there is no one tasked with delivering something. In every other context this would be a major embarrassment where everyone would point at the obvious problem: there is no one responsible for this, and you accomplished nothing? Well it's easy to see the problem here. It's you. You're the problem.

 

[ahimsa]

From CIDRAP at University of Minnesota:

Long COVID takes $1 trillion global economic toll each year, analysis suggests

A brief communication published last week in NPJ Primary Care Respiratory Medicine outlines the substantial economic burden of long COVID worldwide, estimating that persistent symptoms after COVID infection cost the global economy roughly $1 trillion each year, or roughly 1% of global gross domestic product.

The analysis looked at data across numerous studies and reports, analyzing long COVID’s impact on national economies, healthcare systems, labor markets, and quality of life.

Global prevalence estimates of long COVID vary widely. Conservative estimates suggest a range of 2% to 7%, while a systematic review of 144 studies published through 2024 suggests a prevalence of 36%, with higher rates reported in hospitalized patients, adults, and women.

Even using more conservative estimates, the economic footprint of long COVID is "material and persistent," write the authors. One economic model suggests $3.7 trillion in annual losses associated with long COVID, with 59% attributed to decreases in quality of life and the remaining losses attributed to reduced earnings and increased medical expenses.

In the United States alone, analyses suggest that long COVID may be responsible for $170 billion in annual lost wages, with some estimates ranging even higher.