First state-level look at long COVID reveals the seven hardest-hit states

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Enlarge / A woman with Long COVID who is completely bedridden, requiring the use of a wheelchair to move between rooms of her home.

Over four years after SARS-CoV-2’s debut, researchers still struggle to understand long COVID, including the ostensibly simple question of how many people have it. Estimates for its prevalence vary widely, based on different study methods and definitions of the condition. Now, for the first time, the Centers for Disease Control and Prevention has attempted to estimate its prevalence among adults in each US state and territory. The results again show a wide range of prevalence estimates while revealing the states that were hardest hit as well as those that seem relatively spared.

Overall, the CDC found that seven states in the South, West, and Midwest had the highest prevalence of long COVID in the country, between 8.9 percent and 10.6 percent: Alabama, Montana, North Dakota, Oklahoma, Tennessee, Wyoming, and, the state with the highest prevalence of 10.6 percent, West Virginia. The results are published today in the CDC’s Morbidity and Mortality Weekly Report.

On the other end of the spectrum, New England states, Washington, and Oregon had lower prevalence rates, between 3.7 percent and 5.3 percent. The lowest rate was seen in the US Virgin Islands with 1.9 percent. Washington, DC, and Guam had ranges between 1.9 percent and 3.6 percent.

Prevalence of reported experience of Long COVID among adults aged ≥18 years, by jurisdiction.

Prevalence of reported experience of Long COVID among adults aged ≥18 years, by jurisdiction.

For these estimates, CDC researchers defined long COVID cases by having any self-reported symptoms lasting 3 or more months that were not present before getting COVID-19. Those symptoms can include a wide spectrum of ailments, from gastrointestinal problems to heart palpitations, joint pain, respiratory symptoms, neurological conditions, and fatigue.

The estimates are based on survey responses from a national surveillance system in 2022. The survey didn’t capture some notable data, including whether people had treatment during the acute phase of their COVID-19 infection, how long it had been since their infection, the ultimate length of their long COVID (if not ongoing), and vaccination status. Vaccination data was only available from a subset of people who took the survey and isn’t included in the report.

The authors hope that the findings can “help identify geographic disparities in long COVID across the United States that could guide interventions to promote health equity.”

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