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PreprintCC0medRxiv

Worsening pre-existing health conditions in U.S. adults with Long COVID

  1. 1Centers for Disease Control and Prevention

Abstract

PurposeLong COVID literature often describes new-onset symptoms or conditions following SARS-CoV-2 infection; however, Long COVID also encompasses the exacerbation of pre-existing conditions. We describe health conditions reportedly worsened by COVID-19 illness and associated concerns in U.S. adults.

MethodsWe collected longitudinal data from adults 18 years and older participating in the Track Post COVID-19 Conditions, an active Long COVID cohort surveillance project. Respondents completed surveys 3-, 6-, and 12- months after COVID-19 illness, beginning in July 2023. In each survey, respondents were asked whether they had any health conditions or concerns that were made worse by COVID-19. Those with an affirmative response were asked to specify the worsening condition(s) via free text. Some respondents used this free text to describe challenges or experiences related to their worsening conditions. This report categorizes and quantifies reported conditions and concerns by body system categories and qualitatively describes associated challenges and experiences using direct quotes from respondents free text responses.

ResultsAmong 2,227 adults, 263 (11.8%) respondents reported at least one worsening condition or concern following COVID-19 illness. Of these, nearly 32% reported a worsening respiratory condition or concern. Adults with worsening pre-existing conditions reported challenges accessing adequate care, completing daily activities, and managing their symptoms following COVID-19.

DiscussionWhile Long COVID literature often focuses on the development of new-onset long-term symptoms, more than 1 in 10 adults reported worsening of a pre-existing condition following COVID-19. Reported challenges with accessing care and daily activities highlight potential need for accommodations or support for adults with Long COVID.

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BibTeX
@misc{edwards2026worsening,
  title = {{Worsening pre-existing health conditions in U.S. adults with Long COVID}},
  author = {D. L. Edwards and A. F. Rollins and N. D. Ford and C. Pratt and R. Bloodworth and K. Pogreba-Brown and R. Jones and V. Sharma and M. Reina Ortiz and S. Saydah and Track PCC Study Group},
  howpublished = {medRxiv},
  year = {2026},
  month = sep,
  doi = {10.64898/2026.09.22.26363331},
  url = {https://www.medrxiv.org/content/10.64898/2026.09.22.26363331v2},
  note = {CC0},
}
RIS
TY  - UNPB
TI  - Worsening pre-existing health conditions in U.S. adults with Long COVID
AU  - D. L. Edwards
AU  - A. F. Rollins
AU  - N. D. Ford
AU  - C. Pratt
AU  - R. Bloodworth
AU  - K. Pogreba-Brown
AU  - R. Jones
AU  - V. Sharma
AU  - M. Reina Ortiz
AU  - S. Saydah
AU  - Track PCC Study Group
PY  - 2026
DA  - 2026/09/22
PB  - medRxiv
DO  - 10.64898/2026.09.22.26363331
UR  - https://www.medrxiv.org/content/10.64898/2026.09.22.26363331v2
AB  - PurposeLong COVID literature often describes new-onset symptoms or conditions following SARS-CoV-2 infection; however, Long COVID also encompasses the exacerbation of pre-existing conditions. We describe health conditions reportedly worsened by COVID-19 illness and associated concerns in U.S. adults.  MethodsWe collected longitudinal data from adults 18 years and older participating in the Track Post COVID-19 Conditions, an active Long COVID cohort surveillance project. Respondents completed surveys 3-, 6-, and 12- months after COVID-19 illness, beginning in July 2023. In each survey, respondents were asked whether they had any health conditions or concerns that were made worse by COVID-19. Those with an affirmative response were asked to specify the worsening condition(s) via free text. Some respondents used this free text to describe challenges or experiences related to their worsening conditions. This report categorizes and quantifies reported conditions and concerns by body system categories and qualitatively describes associated challenges and experiences using direct quotes from respondents free text responses.  ResultsAmong 2,227 adults, 263 (11.8%) respondents reported at least one worsening condition or concern following COVID-19 illness. Of these, nearly 32% reported a worsening respiratory condition or concern. Adults with worsening pre-existing conditions reported challenges accessing adequate care, completing daily activities, and managing their symptoms following COVID-19.  DiscussionWhile Long COVID literature often focuses on the development of new-onset long-term symptoms, more than 1 in 10 adults reported worsening of a pre-existing condition following COVID-19. Reported challenges with accessing care and daily activities highlight potential need for accommodations or support for adults with Long COVID.
ER  -