langley research center

Langley Research Center: 100 Years of Exploring Flight

Decades before NASA existed, Langley Research Center studied the challenges of flight, a mission that prepared the United States for the space race and modern astronaut exploration. Researchers at the center helped design a plane to break the sound barrier, plotted how to put humans in orbit and then stay in contact, hunted where the first lunar astronauts should take their first steps on the moon, and then trained those astronauts in simulated gravity. The center went on to help develop the space shuttle, built and maintained satellites to study Earth, and is currently working on the Space Launch System, an advanced vehicle that will one day allow humans to travel into deep space.

The Langley research lab is located in Hampton, Virginia, only a few miles from Virginia Beach. Its Air & Space Center serves as the official visitors center, and contains a wealth of aircraft and spacecraft exhibits.

Solving the fundamentals of flight

Langley Memorial Aeronautical Laboratory started in 1917, months after the United States entered World War I. The center's original focus was on airplane technology, with a goal "to solve the fundamentals of flight," according to Langley staffer Jim Schulz in an article about the center's history. The agency made groundbreaking aeronautical advances, including better propellers and new kinds of rotorcraft and helicopters.

During World War II, planes like the P-51 Mustang were tested in the United States' first wind tunnel built for full-sized aircraft. The research helped engineers to reduce fuel use and increase wind speeds, a combination that "helped win the war," Schulz wrote.

But wartime wasn't the only time Langley worked on planes. The center helped to design the Bell X-1, an experimental aircraft that then-Air Force Captain Chuck Yeager would use to break the speed of sound. Langley would continue researching hypersonic aircraft, helping to design the X-15 that flew five times faster than the speed of sound by 1959. 

"Data gathered during the X-15 flights would directly contribute to the creation of the U.S. space program," Schulz wrote.

From Earth to space

Only days after NASA was founded, the Space Task Group (STG) was established to help get humans into space. Many members of STG were drawn from Langley's ranks, where the unit would work as a field unit. 

"Though Langley lacked management control over the new group, the center's support of the task group's ambitious program proved remarkably strong," James R. Hansen said in his book, " Spaceflight Revolution ," part of a NASA history series.

STG helped to sift through a number of proposed capsules not only to determine which design would be the most effective but also which would be the fastest to launch into space. Leader Robert Gilruth also had to deal with politicians, not all of whom were excited about the program. Hansen wrote:

Some of these gentlemen were not at all enthusiastic about our plan to put a man into space," Gilruth later acknowledged. In fact, Presidential Science Adviser Dr. George Kistiakowsky had remarked with great displeasure that the plan "would be only the most expensive funeral man has ever had.

Nonetheless, the STG engineers launched test rockets with dummy payloads that fell back into the nearby Atlantic Ocean, checked and rechecked Mercury escape rocket and recovery systems, sent two Rhesus monkeys into space to better understand the risk to astronauts, and helped to develop the heat shield that would protect the space travelers when they re-entered Earth's atmosphere.

Gilruth later said that Project Mercury "wasn't pretty like a flower or a tree. But it had no bad traits. It was designed as a vehicle for a man to ride in, and circle the earth. With its blunt body, its retrorockets and parachutes, it was an elegant solution to the problem."

Because NASA flight operations officers and engineers wanted to maintain nearly constant radio contact with the astronauts, NASA engineers at Langley had to create a worldwide tracking network. NASA's history reveals that the original goal of mission control was to maintain a passive mode of flight control, letting the astronauts and the automatic in-flight systems do the rest. Eventually the team decided that crucial decisions should be made by a group of people on the ground. By 1959, STG was pressing to have one built at Cape Canaveral, where the rockets would launch. Hansen wrote:

The physicians were "horrified at the casualness" of one suggestion that in-flight communications with the astronauts could be handled like commercial air traffic control, with the pilot only reporting to the ground every 15 to 30 minutes. The doctors, intent on continuous and complete monitoring of the astronaut's vital physiological and mental responses to the unknown demands of spaceflight, did not like the idea of gaps in communication lasting for any appreciable length of time .

Ultimately, STG opted to set up a tracking network with no gaps larger than 10 minutes.

In a time when instantaneous phone calls were not yet possible, NASA needed to build up a global system. With STG already swamped with their duties, Gilruth asked if Langley could take on the additional responsibility. The agency stepped up to the challenge, overseeing the creation of an ambitious network made up of 18 relay stations across three continents, seven islands, and two ocean-bound ships.

On May 5, 1961, Alan Shepard became the first American to fly a Mercury capsule, Freedom 7, into space. On the third Mercury mission, aboard Friendship 7, John Glenn became the first American to orbit the Earth.

While the astronauts took center stage, Langley's human "computers" performed backup calculations to keep them safe. Originally hired during World War II to make calculations about airplane safety and rocket-launch experiments, the computers were mostly women, and included minorities.

One of those, Katherine Johnson, took center stage in the book and subsequent movie " Hidden Figures ," which tells the story of these human computers. But although they remained unknown to most people, the astronauts were well aware of their contribution. [ Related: NASA Examines Key Role of ‘Hidden Figures’ Amid Langley Center Celebration ]

As a part of the preflight checklist, Glenn asked engineers to "get the girl" — Johnson — to run the same numbers through the same equations that had been programmed into the computer, but by hand, on her desktop mechanical calculating machine. 

"If she says they're good," Johnson remembers Glenn saying , "then I'm ready to go."

To the moon …

In 1962, STG moved to the newly built Johnson Space Center in Houston, Texas. But this didn't mark the end of Langley's role in space exploration. The center continued to play a role in the trip to the moon, from the lunar capsule to touching down to astronaut training.

Familiar with aircraft, Langley helped to design and manage the Lunar Orbiter project, which photographed almost the entire surface of the moon. These photographs helped determine where Neil Armstrong and his crew would eventually take their first lunar steps for humanity. Langley was also home to aerospace engineer John Houbolt, who contributed to the design of smaller, simpler lunar modules for the landing crew. Langley also housed the Rendezvous Docking Simulator, where astronauts practiced the procedures necessary for a lunar landing.

While astronauts today spend most of their training time at Johnson, the first potential lunar astronauts spent their time at Langley. The Reduced Gravity Simulator was a vehicle suspended by a network of cables to an overhead track. Here, astronauts would test their ability to walk, run, and perform various tasks under reduced gravity. 

According to NASA, "Armstrong offered what was perhaps the greatest tribute to the importance of his Langley training in Apollo 11's success. When asked what it was like to land on the moon, he replied, 'Like Langley.'"

… and beyond!

Langley continued its groundbreaking work long after Armstrong and his crew completed their first journey. Langley evaluated designs for the space shuttle that served as NASA's main human transportation system for more than three decades. The center also improved materials and tested landing systems crucial to all 135 shuttle missions.

Langley engineers created, built, and managed a series of aircraft on board planes and spacecraft to study the planet's changing climate. The lab led the first successful mission to Mars with the 1976 touchdown of Viking 1. Advanced sensors in the heat shield of the 2012 Mars Curiosity Rover came from Langley's labs.

Today, Langley is hard at work on the next generation of rockets, the Space Launch System . The SLS is a powerful rocket designed to reduce the amount of time it takes to travel through space, reducing trip times to the outer part of the solar system. Carried into space by the SLS, the Orion spacecraft will be capable of carrying four astronauts out of Earth's atmosphere, to the moon, Mars or elsewhere. The first test is planned for 2019.

Additional resources

• Spaceflight Revolution: NASA Langley Research Center from Sputnik to Apollo
• #NASALangley 100: A 10-part series commemorating NASA's past, present, and future
• William Shatner Narrates History of NASA's 100-Year-Old Langley Research Center (Video)

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Nola Taylor Tillman is a contributing writer for Space.com. She loves all things space and astronomy-related, and enjoys the opportunity to learn more. She has a Bachelor’s degree in English and Astrophysics from Agnes Scott college and served as an intern at Sky & Telescope magazine. In her free time, she homeschools her four children. Follow her on Twitter at @NolaTRedd

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LANGLEY RESEARCH CENTER

2023 annual report.

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What if anything you imagine can come true.

Here at Langley, we are persistently curious and our wonder changes the world.

LANGLEY LEADERSHIP

From the Director

NASA's astounding success in 2022 shows what's possible when we work together. When we link our talents, energy, and goodwill, there's no obstacle we can't overcome, no frontier we can't explore. This year at Langley, people connected and discovered solutions with potential to improve lives around the globe. We're finding new ways to partner and use our expertise for even greater impact. Together, we will create a bright future.

Clayton P. Turner, Center Director

"At NASA, we aspire to know more, dig deeper, climb higher and along the way we are asking, “What if?” A simple start to endless possibilities and opportunities. Our inquisitive nature propels us on our mission to reach for new heights and reveal the unknown for the benefit of humankind. We invite you to explore all that NASA’s Langley Research Center has to offer—our amazing people, unique capabilities, and legacy of success. Come and see how Our Wonder Changes the World." --Clayton P. Turner Center Director

Clayton P. Turner

Center Director

"At NASA Langley, we continually seek answers to questions for some of the toughest challenges facing NASA and the nation. What if we can improve life on Earth by studying the air we breathe? What if we can make air travel faster and more accessible to connect with family, friends, and colleagues? What if space travel could be safer by using the sun's energy? These are just a few of the questions we are answering to reveal the unknown for the benefit of humankind." --Lisa Ziehmann Acting Deputy Director

Lisa Ziehmann

Acting Deputy Director

"It has been exciting to step into the role of Acting Associate Director and explore the breadth of skills and experience that fuel the incredible work done at NASA Langley. It takes expertise and collaboration across every function to address NASA's bold missions. A highlight from the year was welcoming 40,000 neighbors to our Open House, where we were able to share the wonder and magic of NASA while inspiring the next generation." --Kanama Bivins Acting Associate Director

Kanama Bivins

Acting Associate Director

"We’ve seen great progress in 2023 in so many areas. We’ve adapted to new and different ways of working, connecting, and communicating that have broadened our view and our reach. The aerospace industry has expanded and we’re benefiting from partnerships and collaboration like never before. Students at every grade level are looking to the stars and engaging in ways to help our planet and those we will travel to in the future. Innovation abounds and there is so much more to come." --Kevin Rivers Associate Director, Technical

Kevin Rivers

Associate Director, Technical

"At NASA Langley we have a long legacy of exploring new frontiers for NASA and the nation. Now, we are exploring how we continue to successfully execute on today’s commitments, while ensuring we are positioned for tomorrow’s opportunities. I am proud of NASA Langley’s standard of excellence, spirit of community, and commitment to paving the way for those who will continue this great work into the future." --Dave Young Senior Advisor to the Director

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As NASA prepares to send astronauts to the Moon and beyond, Langley’s expert engineers create tools to energize human and robotic exploration.

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Langley scientists study the air we breathe and atmospheres on other planets. They monitor weather and our changing climate. Our research explores the secrets of the universe for the benefit of all!

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Fiscal 2023

Budget (million), patents & inventions, internships.

Partnering to Prevent Wildfires What if drones could help prevent wildfires? NASA Langley and the U.S. Forest Service are integrating drones into wildfire prevention and land management. Learn More

Glimpse an Eclipse What can we learn from a solar eclipse? This phenomenon helps us predict space weather events that may impact space exploration and affect technology on Earth. Learn More

Looking to the Sky NASA Langley is asking, “How can new, greener aviation fuels benefit the environment?” Learn More

Self-Flying Drones What if taxis could fly?  Langley is using drones to find out! Learn More

Human Pilots Advance Autonomous Air Taxis How do you create an air taxi or delivery drone? You start by studying pilots! Learn More

Hybrid Electric Aircraft, the Future of Flight How can we improve fuel efficiency and reduce emissions in airplanes? NASA is partnering with industry to explore hybrid propulsion systems for future aircraft. Learn More

Be Curious Today Is there a place for me? Yes! The home of the hidden figures is showing girls of the Artemis generation that there is a place for them in STEM. Learn More

High School Students Helping Astronauts What do astronauts need? Students compete to create healthy meals for astronauts and address real world engineering challenges to make it easier to live on the ISS. Learn More

Pondering, “What’s Next?” Winning student artwork may have provided a controversial answer to the question, “What’s next?” AI. Learn More

Getting a Close-Up View What tools can help us learn more about vehicles during launches and landings? NASA Langley’s SCIFLI team had a unique perspective for the arrival of the OSIRIS-REx asteroid sample return capsule, collecting critical data on reentry to benefit future missions. Learn More

Keeping Spacecraft Safe How do you think it would feel to travel through the atmosphere? NASA Langley has developed a technique to protect space vehicles and astronauts during landings. Learn More

$5 Million to Women’s Colleges What if we could make a difference in the STEM gender gap? Learn how NASA is addressing the significant national gender gap in STEM. Learn More

Making Robots with an Expert What if we could make a difference for every child? At Langley we try every day. Learn More

Asteroid Sample Delivered What can we learn from an asteroid? OSIRIS-REx retrieved asteroid samples helping scientists investigate how planets formed and how life began, improving our understanding of asteroids. Learn More

Breathe Easier What if we knew what’s in the air we breathe? Data from TEMPO is helping scientists, the public, and policy makers evaluate health impacts of pollutants and aid in creating air pollution maps for neighborhoods. Learn More

Student Airborne Research Can students fly with NASA? We’re inspiring the next generation with hands-on research as they take flight on the East coast to conduct scientific research. Learn More

The Air in Your Neighborhood Can aircraft flights help track pollution data? Yes they can! Learn More

Revolutionary Aerospace What does the future hold? The collegiate community is exploring innovative ways NASA can operate on the Moon, Mars and beyond. Learn More

The Heat is On! How do you celebrate a successful test? You go bigger. Learn More

Small Packages, Huge Effect Is there a safer way to land? We are creating technology that will safely land people and payloads on the Moon and other celestial bodies, helping unlock the mysteries of the universe. Learn More

Exploring New Frontiers How can we explore other celestial bodies? At NASA Langley we’re helping to make sure that Dragonfly, a car sized drone, is ready for the unique environment it will explore on Titan. Learn More

Celebrating Artemis Success How will we go beyond the Moon? Along with the world, we watched as NASA’s SLS rocket launched the Orion spacecraft to the stars. Learn about NASA Langley’s contributions. Learn More

Groundbreaking Advances What can we learn by observing Earth from space? CALIPSO spent 17 years doing just that and it led to groundbreaking advances in our understanding of climate, weather and air quality. Learn More

Building the Future How do we study flight? Before any aircraft or rocket takes off, we use test facilities, like wind tunnels, to study every angle. Langley is home to NASA’s newest wind tunnel in more than 40 years. Learn More

Witnessing the unified efforts of the entire Center converging to organize the Open House was not only inspiring but also a genuine testament to the collective passion for our work and the eagerness to share it with the world.” Learn More Lena Little Open House Project Manager and Regional Partnerships Lead in the Strategic Partnerships Office

If you’re exercising good engineering judgment, you are leveraging a past knowledge base effectively and relying on the expertise of folks who know more than you." Learn More Jannuel Cabrera Aerospace engineer for the Vehicle Analysis Branch (VAB), part of the Systems Analysis and Concepts Directorate

I’ve been sharing stories and impact since I did the school announcements in third grade, so it’s incredibly exciting to share NASA Langley’s story with our neighbors and the world! It is essential that people understand how our work is improving their lives, and I love finding new ways to communicate how we’re inspiring a better world." Brittny McGraw NASA Langley News Chief

Through Langley’s “23 in 2023” community college outreach initiative, we engaged with more than 2,200 students and visited over 25 campuses across Virginia. We even had students take part in the STEM Takes Flight summer program because they learned about it during those visits!" Jennifer Kibler Deputy Director for Intelligent Flight Systems

We must turn to new technologies like the inflatable heat shield, like supersonic retro propulsion…That’s going to require a step change in the way that we design vehicles." Learn More Zach Ernst Aerospace engineer for the Vehicle Analysis Branch (VAB), part of the Systems Analysis and Concepts Directorate

Langley’s Human Resources training office is committed to ensuring we meet NASA’s mission requirements both today and tomorrow by investing in learning and development opportunities to continually sustain and elevate our workforce." Travis Millner Human Resources Specialist

I participate in ERGs (Employee Resource Groups) because everyone deserves to be treated with love, dignity, respect and kindness. The ability to provide employees with safe, supportive spaces at work and receive organizational and community support makes it all worth it. As a result, employees give their best contributions to the organizations’ shared vision and goals." Danielle May Contracting Officer and LaRC ERG Council Co-Chair

Beyond Earth's orbiting instruments, crucial data informs scientists and policymakers. Diligently archived and accessible on NASA's Earth data search site, this information unveils insights into Earth's atmosphere, transforming Langley's air quality measurements into an openly available and understandable format by everyone." Learn More Hazem Mahmoud ASDC DAAC Scientist

For the SAGE III/ISS mission, 2023 was a year of challenges and successes while delivering uniquely vital observations of the health of Earth’s ozone layer and additional data critical for other ISS science participants to operate safely. The team is ecstatic over news of NASA accepting our proposal extending another 3 years with the possibility through the decade." Learn More Dave Flittner SAGE III/ISS Project Scientist

In the NASA legal office, we ensure that the Agency accomplishes its mission in a legally compliant manner. Counseling NASA on the broad variety of legal issues gives us the opportunity to see the breadth and depth of amazing work that happens at NASA Langley and the impact our work can have across NASA and through businesses and communities across the Nation." Andrea Zydron Warmbier NASA Langley Chief Counsel

Inspiring minds, seeing students' eyes light up with curiosity, and witnessing the transformative power of STEM engagement after engaging in activities designed for them to learn about NASA’s endeavors in exploration and discovery makes my job in the Office of STEM Engagement incredibly rewarding!" Garnise Dennis Integration Manager, STEM Engagement

LOOKING TO THE FUTURE

Exploration.

IN MEMORIAM

Stephen G. Jurczyk

February 20, 1962 - November 23, 2023

“At NASA, we turn dreams into reality, and make the seemingly impossible possible. I am so fortunate to have been a member of the NASA family.”

Jurczyk served as NASA's Acting Administrator from January to May 2021; Associate Administrator, the agency's highest ranking civil servant, from 2018 - 2021; and Langley's Center Director from 2014 - 2015.

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The Office of Safety and Mission Assurance (OSMA) assures the safety and enhances the success of all NASA activities through the development, implementation and oversight of agencywide safety, reliability, assurance and space environment sustainability policies and procedures. OSMA includes the Mission Assurance Standards and Capabilities Division, Missions and Programs Assessment Division, Institutional Safety Management Division, and NASA Safety Center, as well as the Independent Verification and Validation Program.

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Responsible for

• Establishing and assuring compliance with NASA Safety and Mission Assurance (SMA) strategies, policies and standards
• Fostering early integration and life cycle implementation of Safety, Reliability, Maintainability and Quality Assurance (SRM&QA) into NASA's programs and operations
• Improving methodologies for risk identification and assessment and providing recommendations for risk mitigation and acceptance
• Performing independent SMA assessments and process verification reviews
• Providing analysis and recommendations for critical agency safety decisions
• Sponsoring the innovation and rapid transfer of SRM&QA technologies, processes and techniques to improve safety and reliability and reduce the cost of mission success

W. Russ DeLoach

William Russ DeLoach is NASA's chief of Safety and Mission Assurance (SMA). Appointed to this role in January 2021, DeLoach is responsible for the development, implementation and oversight of SMA policies and procedures for all NASA programs.

Prior to this assignment, DeLoach served as the SMA director at NASA’s Johnson Space Center, where he led a dedicated team of experts in assuring workforce safety and collaborating on smart solutions to human spaceflight risks since February 2019. His team worked to identify, characterize, mitigate and communicate risk to accomplish safe and successful human space exploration.

Frank Groen

Deputy chief.

Dr. Frank J. Groen is the deputy chief of NASA’s Office of Safety and Mission Assurance (OSMA). In this position, he is responsible for executive leadership, policy direction, functional management and coordination for agency-wide program and institutional Safety and Mission Assurance (SMA) activities.

Prior to be appointed to this position, Groen was the director of the Safety and Assurance Requirements Division within OSMA, responsible for the development and maintenance of NASA directives and standards pertaining to SMA, as well as related methods, tools and guidance.

Organizational Chart

This organizational chart shows the various areas of the Office of Safety and Mission Assurance (OSMA), the relationships between these areas, and staff information.

The Office of Safety and Mission Assurance (OSMA) includes the Mission Assurance Standards and Capabilities Division (MASCD), Missions and Programs Assessment Division (MPAD), Institutional Safety Management Division (ISMD), and NASA Safety Center (NSC), as well as the Independent Verification and Validation (IV&V) Facility.

Mission Assurance Standards and Capabilities Division

The Mission Assurance Standards and Capabilities Division (MASCD) fosters and continually advances the state of NASA’s Safety and Mission Assurance (SMA) through the development and promulgation of policy, standards, guidance, technical knowledge and capabilities.

Missions and Programs Assessment Division 

The Missions and Programs Assessment Division (MPAD) is the primary interface between OSMA and the NASA Mission Directorates. MPAD supports the formulation and implementation of Safety and Mission Assurance objectives and requirements by the directorates and human spaceflight enterprises. 

Institutional Safety Management Division

The Institutional Safety Management Division (ISMD) monitors, promotes and actively maintains and improves the Institutional Safety discipline areas and helps identify and mitigate Institutional Safety risks.

NASA Safety Center

The NASA Safety Center (NSC) provides SMA expertise, information, verification and analysis to enable collaboration and learning while promoting a safe workplace and successful programs and projects.

Independent Verification and Validation

NASA's Katherine Johnson Independent Verification and Validation (IV&V) Program was established in 1993 as part of an agencywide strategy to provide the highest achievable levels of safety and cost-effectiveness for mission critical software.

Erin Lalime

Acting Deputy Planetary Protection Officer

Erin Lalime is the acting deputy Planetary Protection Officer for the Office of Safety and Mission Assurance (OSMA). In this role, she supports the Office of Planetary Protection (PP) in its work to promote the responsible exploration of the solar system by implementing and developing efforts that protect the science, explored environments and Earth. In addition to this role, Lalime is also an aerospace and PP engineer at Goddard Space Flight Center. Before becoming a civil servant, Lalime worked at Goddard as a microbiologist and PP engineer for Stinger Ghaffarian Technologies. 

Dr. Elaine Seasly

Acting Mission Assurance Standards and Capabilities Division Director

Dr. Elaine Seasly is the acting Mission Assurance Standards and Capabilities Division director, responsible for the development and maintenance of NASA directives and standards pertaining to SMA, as well as related methods, tools and guidance.

Seasly is also the deputy Planetary Protection Officer for the Office of Safety and Mission Assurance (OSMA). In this role, she supports the Office of Planetary Protection in its work to promote the responsible exploration of the solar system by implementing and developing efforts that protect the science, explored environments and Earth. 

Seasly joined OSMA after serving as the NASA Langley Research Center contamination control and Planetary Protection lead since 2015. As contamination control and Planetary Protection lead, Seasly was responsible for developing contamination control and Planetary Protection requirements and implementation plans and evaluating compliance of flight projects to meet NASA mission needs. In addition, she developed and led the growth strategy for Langley contamination control and Planetary Protection to increase facility capabilities, research opportunities, flight project support, knowledge management and lessons learned sharing, and collaboration through partnerships.

Prior to joining NASA, she worked for Raytheon Missile Systems, where she led contamination control efforts for missile defense and tactical missile programs and later transitioned to program management and management of small business innovation research.

Seasly has a Bachelor of Science in chemical engineering from the University of Arizona, a Master of Science in patent law from the University of Notre Dame and a Doctor of Engineering from George Washington University. She is also a registered patent agent with the U.S. Patent and Trademark Office.

Johnny Nguyen

Missions and programs assessment division director.

Johnny T. Nguyen is currently the director of the Missions and Programs Assessment Division. In this position, he leads Safety and Mission Assurance (SMA) activities in support of NASA's diverse portfolio of missions and programs, including spacecraft, science payloads, launch vehicles, technology development and aeronautics. In addition, he provides the Office of Safety and Mission Assurance's primary interface with the NASA mission directorates and the center SMA organizations.

Prior to this role, Nguyen was the associate manager for Integration and Analysis in Gateway Deep Space Logistics located at Kennedy Space Center. In this role, Nguyen provided project management leadership for the logistics missions for Gateway in the areas of budget, resources, workforce, governance, contract management, configuration management, Risk Management and life cycle schedule.

Previously, Nguyen was an office chief in Kennedy SMA Directorate. Here, he provided leadership and direction for planning, organizing and leading special projects and assuring that safe, efficient requirements, policies, practices and processes were established. Nguyen also served as the Kennedy senior strategic advisor, providing strategic guidance to all levels of leadership. He helped to identify overall Kennedy goals and objectives and then communicated and aligned center priorities to meet the objectives of the NASA Strategic Plan. In April 2014, Nguyen graduated from the White House Initiative on Asian American and Pacific Islanders’ sponsored Senior Executive Service Development Program.  Nguyen served as the chief of the Fluids Test and Technology Development Branch at Kennedy in October 2009. He was also the Kennedy Space Shuttle Transition and Retirement manager, which oversaw the strategy and execution on how to properly and most effectively transition the 300+ facilities and over one million line items of personal property located at Kennedy.

Nguyen attended the University of Central Florida where he received a Bachelor in Science degree in mechanical engineering and a master’s in business administration. He has worked for Kennedy since 1998. Nguyen is a first generation Vietnamese who enjoys traveling and drawing.

CHIEF, SAFETY AND MISSION ASSURANCE

He previously held the same role at NASA’s Kennedy Space Center, where he was responsible for the planning and execution of center and program activities. In this capacity, he developed transformative SMA approaches to enable the success of Kennedy as the world’s premier multi-use spaceport.

DeLoach began his NASA career in 1987, on assignment as an intern in the Army Material Command’s Quality and Reliability Engineering training program. Returning to Kennedy, he conducted Reliability and System Safety analyses, as well as technical reviews and assessments of integrated ground systems, equipment, and operations for the Space Shuttle and International Space Station programs. In 2000, he was selected as the SMA branch chief within the Shuttle Processing Directorate, providing surveillance of space shuttle ground operations. 

As his career progressed, he served as the shuttle processing mission assurance manager supporting ground processing, launch and landing.  In 2006, DeLoach stood up the SMA Support Office for the emerging Constellation Program and later oversaw the transition of Constellation efforts to support Orion and the Space Launch System. After the retirement of the space shuttle in 2011, he was instrumental in the transformation of Kennedy to a thriving multiuser spaceport, developing an approach to enable public-private partnerships in a manner that maintains an acceptable risk posture for NASA, while allowing flexibility and innovation for commercial interests. He became Kennedy’s deputy director of SMA in 2012 and then SMA director in 2014. 

DeLoach holds a bachelor’s degree in mechanical engineering from the University of Florida in Gainesville. He is married to Janice, a retired educator, and they have three grown children.

Agency Safety Working Group Leads

Name
Delegated Programs Safety Management
Michelle Lear-Combs
Electrical Safety
Chris Quinn
Explosives and Pyrotechnics Safety
Mike Hallock
Occupational Safety and Health
Joe Patterson
Fire Protection
Chris Scheer
Lifting Devices and Equipment
Andrew Norris
Mishap Investigation and Reporting
Carolyn Turner
Payload Safety
Tom Frattin
Pressure Vessels and Pressurized Systems
Calogero Dirienzo
Propellants and Pressurants
Miguel Maes
Range Flight Safety
Chuck Loftin
Risk Management
Sharon Thomas

Grant Watson

Institutional safety management division director.

Grant Watson is the director of the Institutional Safety Management Division in the Office of Safety and Mission Assurance. In this role, Watson is responsible for facilitating a team dynamic across the centers, advocating for centers at the Headquarters level, establishing delegated safety program leads, driving policy direction and change, and implementing Institutional Safety Authority.

Prior to this role, Watson was the Safety and Mission Assurance (SMA) director at NASA Langley Research Center in Hampton, Virginia. In this role, he was the senior management official responsible for the health and safety of over 3,600 engineers, technicians and scientists. He also was responsible for facility assurance of research facilities valued at more than $3.3 billion.

Langley, founded in 1917, is the nation’s first civilian aeronautical research facility and NASA’s oldest field center. Langley was the first federal facility to achieve the Occupational Safety and Health Administration’s (OSHA) Voluntary Protection Programs Star status in 1998, and was re-certified in 2002, 2007 and 2012. This recognition by OSHA is indicative that Langley’s health and safety program is world-class. Watson has played a role in implementing, developing and leading this world-class health and safety program since 1995.

Watson has more than 20 years of SMA experience, performing or leading work in the following areas: Occupational Safety, industrial hygiene, health and medical, facility assurance, Fire Protection, emergency services, System Safety, Reliability, and Quality Assurance. He has held key SMA positions at NASA’s Kennedy Space Center and Langley, worked in private industry, and supported the Federal Aviation Administration’s Office of Commercial Space Transportation. He also contributed to the mission success of numerous space shuttle launches, the Ares 1-X vehicle, and the Clouds and the Earth’s Radiant Energy System instruments.

Watson is a graduate of the Florida Institute of Technology where he received bachelor’s and master’s degrees in mechanical engineering. He received a master’s degree in engineering management from Old Dominion University and is a recipient of the NASA Outstanding Leadership Medal.

He currently resides in Yorktown, Virginia, with his wife and enjoys running and spending time with his daughters.

Name	Title
Grant Watson	Division Director Institutional Safety Management
Sue Roney*	Administrative Specialist
Jamal Abbed	Program Executive for Aviation Oversight
Clifton Arnold	Program Executive for Pressure Systems, Lifting Devices and Equipment, and Propellants and Pressurants
Jose Caraballo	Program Executive for Safety Management and Occupational Safety
Alfredo Colon	Policy and Requirements Manager
Tom Frattin	Delegated Program Manager for Payload Safety
Sandra Hudson	Program Executive for Range Flight Safety, Payload Safety, and Explosives and Pyrotechnics Safety
Chuck Loftin	Delegated Program Manager for Range Flight Safety
Alan Micklewright	Agency Aviation Safety Manager
Jerry Piasecki	Program Executive for Fire Protection and Electrical Safety
Richard “Cub” Schlatter	Program Executive for Aviation Operational Policy
Jeannie Wood*	Risk Manager

Nuclear Flight Safety Officer

Donald "Don" Helton is the Nuclear Flight Safety Officer in the NASA Office of Safety and Mission Assurance, responsible for reviewing the Nuclear Launch Safety Approval Requests submitted by programs and projects that plan to launch radioactive material in to space, in accordance with NASA directives and requirements. In this role, he also coordinates the Interagency Nuclear Safety Review Board, which evaluates the quality of the safety analysis associated with nuclear missions that meet criteria specified in NSPM-20, “Presidential Memorandum on Launch of Spacecraft Containing Space Nuclear Systems,” issued Aug. 20, 2019.

Prior to his current role, Helton was a senior reliability and risk analyst at the U.S. Nuclear Regulatory Commission (NRC). In this role, he performed risk assessment activities related to the significance determination of inspection findings and emergent conditions for operating commercial nuclear power plants, contributed to broad agency activities in Risk-Informed Decision Making, and supported the development of regulatory guidance relating to the use of risk-informed regulation. During his 18 years at the NRC, Helton developed and reviewed probabilistic safety assessments for spent fuel wet storage, including its use in both safety basis activities and National Environmental Policy Act activities; served as the NRC-appointed technical adviser for the nuclear launch safety review of the Mars 2020 Interagency Nuclear Safety Review; contributed to risk assessment consensus standard development; and served as a Subject Matter Expert in Level 2 Probabilistic Risk Assessment for an International Atomic Energy Agency review mission. Separately, Helton served in varying roles as a responder for the NRC’s Emergency Operations Center. He was a recipient of the NRC's Meritorious Service Award.

Helton has a master’s degree in nuclear engineering from Texas A&M university, focused on the use of computational fluid dynamics in nuclear applications, including a traineeship at France’s Le Commissariat a L’Energie Atomique’s Centre Saclay. He also holds a bachelor’s degree in nuclear engineering from North Carolina State University, which included research in the area of reactor physics. He was born and raised in Union County, North Carolina. Helton currently resides in Rockville, Maryland, with his wife and two daughters. He spends his free time fishing, biking, volunteering and playing guitar.

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Name	Title	Phone	Email
Dr. Elaine Seasly		202.358.0091
Dr. J. Nick Benardini		818.354.4453
Pamela Branch		281.483.2808
Tim Crumbley		256.544.5978
Homayoon Dezfuli, Ph.D.		202.358.2174
Tony Diventi		202.358.0936
John Evans, Ph.D.		202.358.0937
Don Helton	Technical Discipline Manager for Nuclear Safety	202.358.0311
Valle Kauniste	Supply Chain Risk Management Program Manager	281.792.5341
Peter Majewicz (Acting)		301.286.8252
Jeannette Plante		301.614.5944
Jonathan Root		301.286.0077

Delegated Programs

The Mission Assurance Standards and Capabilities Division delegates responsibility for the following programs to a center program manager:

Name
Electrical, Electronic and Electromechanical Parts
John Evans Jonny Pellish Peter Majewicz
Meteoroid Environment
William Cooke
Nondestructive Evaluation
Eric Burke
Orbital Debris
Jer Chyi Liou
Supply Chain Risk Management
Valle Kauniste
Workmanship
Alvin Boutte

Name	Title
Johnny Nguyen
Tierra Green*
Susan Anderson
Nicholas Bell
Michele Cretser
Tracy DeBerry
George Deckert
Tracy Dillinger, Psy.D.
Richard Grant
Isabel Hernandez
Vicky Hwa
Marguerite Jones
Hovanes Keseyan
Glen Lockwood
Shandy McMillian
Ariel Pavlick
Peter Tschen
Denise Zona*

Deirdre Healey

Deirdre Healey is the director of the Office of Safety and Mission Assurance (OSMA) Missions and Programs Assessment Division at NASA Headquarters. In this position, she leads Safety and Mission Assurance (SMA) activities in support of NASA's spacecraft (including the International Space Station and space hardware developed for exploration programs and commercial space activities), science payloads, expendable launch vehicles and aeronautics programs. In addition, she provides OSMA’s primary interface with the NASA mission directorates, the Office of the Chief Technologist and the center SMA organizations.

Previously, Healey supported SMA activities for the Human Exploration and Operations Exploration Systems Directorate where she led efforts to incorporate SMA policies and tenets into the agency’s various human space flight programs including Orion, the Space Launch System and the new Commercial Crew Program.

Healey has more than 26 years of experience in space systems SMA, program management, engineering, operations and policy. Prior to joining NASA, she led development and operations of national and international space systems in the U.S. Air Force. She held various roles including program manager for the Inertial Upper Stage Rocket Booster Program, director of Titan Program Operations and Integration, deputy program manager for Launch Projects at Cape Canaveral Air Station, chief of the International Policy Branch for United States Strategic Command, and technical director for requirements at the Air Force Satellite Control Network. In addition, she served on various Mishap Investigation Boards including the president-commissioned Launch Broad Area Review and the Titan IVA-20 Accident Investigation Board.

Healey has a master's degree in government from Harvard University and a bachelor's degree in aerospace engineering from the University of Illinois.

Frank J. Groen

Deputy chief, office of safety and mission assurance .

Groen worked in OSMA as the manager for Reliability and Maintainability (R&M), and also served as the document manager for NASA’s Human Rating Directive and program executive for NASA’s Expendable Launch Vehicle Payload Safety Program. During this period, he introduced the safety goal policy for human spaceflight missions to the Human-Rating Directive, oversaw the development of an accident precursor analysis methodology for NASA and initiated an objectives-driven approach for the standardization of R&M activities.

Before joining NASA, Groen was active in academia and industry, where he focused on method and tool development in the field of reliability and risk assessment, with a focus on Bayesian data analysis, accident scenario modeling and analysis, and Monte Carlo simulation. He received his Doctor of Philosophy degree in reliability engineering from the University of Maryland in 2000 and a Master of Science degree in mechanical engineering from the Delft University of Technology, Netherlands.

Terrence W. Wilcutt

Terrence W. Wilcutt is NASA's chief of Safety and Mission Assurance. Appointed to this role in September 2011, Wilcutt is responsible for the development, implementation and oversight of all Safety and Mission Assurance policies and procedures for all NASA programs.

Wilcutt is a retired Marine colonel and veteran astronaut who previously served as director of Safety and Mission Assurance at NASA's Johnson Space Center from 2008 to 2011. In that position, Wilcutt was tasked with the Safety Technical Authority of the programs and projects at Johnson, as well as the center's Institutional Safety program.

Wilcutt joined NASA in 1990 as an astronaut candidate and was accepted into the corps in 1991. He logged more than 1,007 hours in space as the pilot on two shuttle missions, STS-68 in 1994 and STS-79 in 1996, and commander of two others, STS-89 in 1998 and STS-106 in 2000. His technical assignments as an astronaut included work on space shuttle main engine and external tank issues; supporting shuttle launches and landings as a member of the astronaut support personnel team at Kennedy Space Center; and technical issues for the Astronaut Office Operations Development Branch at Johnson.

Wilcutt also served as NASA director of operations at the Yuri Gagarin Cosmonaut Training Center in Star City, Russia; and at Johnson as chief of the Astronaut Office Shuttle Operations Branch, manager of Safety and Mission Assurance for the Space Shuttle Program, and deputy director of Safety and Mission Assurance.

A native of Louisville, Kentucky, Wilcutt earned a Bachelor of Arts degree in math from Western Kentucky University in 1974. He taught high school math for two years before entering the Marine Corps in 1976 and earned his naval aviator wings in 1978.

From 1980 until 1983, he was stationed in Kaneohe, Hawaii, and flew F-4 Phantoms during two overseas deployments to Japan, Korea and the Philippines. For the next three years, he served as an F/A-18 fighter weapons and air combat maneuvering instructor while assigned to Squadron VFA-125 at Lemoore Naval Air Station in California. From 1986 until his selection by NASA, Wilcutt attended the United States Naval Test Pilot School and served as a test pilot and project officer for the Strike Aircraft Test Directorate of the Naval Aircraft Test Center in Patuxent River, Maryland, flying the F/A-18 Hornet, the A-7 Corsair II, the F-4 Phantom and other aircraft. He has more than 6,600 flight hours in more than 30 different aircraft.

Wilcutt has received numerous special honors, including NASA's Outstanding Leadership Medal, Distinguished Service Medal, Exceptional Service Medal and four space flight medals; the Distinguished Flying Cross; the Defense Superior Service and Meritorious Service medals; and the Navy Commendation Medal. He also has received the American Astronautical Society Flight Achievement Award; the V.M. Komarov Diploma, Federation Aeronautique Internationale space award for outstanding achievements in space exploration; and distinguished alumnus recognition and an honorary doctorate degree from Western Kentucky University.

Wilcutt maintains offices in Houston and Washington.

Come & Explore Our New & Improved Spaces!

The new Space Exploration Gallery and Adventures in Early Learners Gallery The SPACE (Smile, Play, Achieve, Create, Explore), invites you to celebrate the spirit of exploration through state-of-the-art, interactive exhibits that explore our solar system! Come and enjoy our galleries that are designed for explorers of all ages!

Also, check out unique space flight artifacts such as the Apollo 12 Command Module and tons of historic aircraft

IMAX Theatre

Superhuman body 3d.

Superhuman Body: World of Medical Marvels explores the inner workings of the human body and the incredible breakthroughs in science and bioengineering that are changing the course of human health. Told through the inspiring stories of researchers, scientists, and everyday people behind these ground-breaking medical innovations, Superhuman Body shows the extraordinary ways our bodies work …

Cities of The Future

Prepare to step into the future and discover a world where smart cities are totally sustainable. Renewable energy is our primary power source, solar energy beamed down from space powers entire cities, and we travel in electric flying cars on aerial highways! This isn’t science fiction. Engineers are making plans for a more sustainable world right now. And it’s coming to the giant screen! Learn more in the new film “Cities of The Future”.

Astronaut: Ocean to Orbit

In 2013, a critical life-support system on the International Space Station failed, requiring an immediate spacewalk to fix it. NASA astronaut Chris Cassidy made the repair and saved the Space Station. As an astronaut, he was trained extensively for space walks. But how do astronauts train here on Earth to work in the microgravity of space? Astronaut: Ocean to Orbit explores the ways in which NASA uses underwater environments to simulate life and work in space, offering a fascinating look into the high-tech world of astronauts…

Become a Member TODAY!

Membership includes unlimited exhibit and IMAX admission for one year & free Admission to 300+ reciprocal science/natural history centers around the world through the ASTC Passport Program.

Sigma Series Lectures

The   Sigma Series Lectures , presented by NASA Langley Research Center and hosted at the Virginia Air & Space Science Center in downtown Hampton, provide an opportunity to the general public to learn more about science and technology subjects. Lectures are the first Tuesday of every month and, unless otherwise indicated, the starting time for all lectures is 7:30 pm.

Sigma Series lectures are open to the general public at no charge.

For more information on Sigma Series please visit their website at:   colloqsigma.larc.nasa.gov

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Remote Sensing Branch

Welcome to the website for the Remote Sensing Branch or the NASA Langley Research Center. This website provides explanations of what we do as a branch, our history, the people that make up the branch, and much more.

Click on one of the tabs above to view the contents of the section, or use the drop down menus to select a sub-section of our website.

The Remote Sensing Branch has also put together an interactive database of a large quantity of laser and spectroscopy data, to access this resource navigate to the Launch page under Lasers Database .

Who We Are.

From the air we breathe to upper atmospheres with commercial aircraft and stationary satellites, to less familiar planetary atmospheres explored by landing spacecraft, the Science Directorate at NASA’s Langley Research Center is on it.

NASA Langley provides essential science leadership to NASA with decades of intellectual expertise in the areas of Atmospheric Composition, Air Quality, Earth’s Energy Budget and Lidar Remote Sensing that supports aeronautics, space technology, exploration and Earth science.

Our data can be used to help others to respond in responsible ways.

What We Do.

The Science Directorate at NASA’s Langley Research Center studies atmospheres using passive and lidar remote sensing, in situ and airborne instruments. Our Flight Projects execute visions to obtain ground-breaking science through spaceflight platforms.​

We are committed to delivering science that is balanced between Research & Analysis, technology development, airborne science and flight development. Through our ground and flight hardware development, we infuse technology and gather science observations that produce knowledge, information and insight that informs policy and serves society.

We provide and maintain capabilities to ensure effective and affordable delivery of that knowledge.

January 24, 2022

Four joint flights were conducted this past Tuesday and Wednesday (Jan 18-19) to capitalize on another cold air outbreak event, similar to the previous week. We observed significant temperature variations in the various vertical profiles conducted by the low-flying Falcon, with evidence of significant precipitation near the transition from overcast to open-cell cloud conditions. A significant decreasing gradient in cloud drop number concentrations was observed with distance offshore especially during the January 18 flights.

June 20, 2022

ACTIVATE’s final flight deployment ended this past week with Research Flight 179 (Saturday June 18) transiting back from Bermuda to Virginia. A number of flights in the past week continued to build on the dataset for aerosol-cloud-meteorology interactions surrounding the Bermuda area, including on Tuesday June 14 a “process study flight” where the coordinated aircraft characterized a building cumulus cloud system. The Falcon conducted its traditional “wall” pattern used during process study flights with ~20 stacked legs going from below to above the cloud. Meanwhile the UC-12 flew overhead conducting remote sensing measurements of the same system while launching numerous dropsondes. A day earlier (June 13), the joint research flight conducted was synchronized with a CALIPSO overpass in conditions that are ideal for intercomparison of data including cloud-free air with significant aerosol concentrations and a diversity of aerosol types including in particular African dust. Now the ACTIVATE team focuses on processing and data archival of the 2022 flight deployments.

June 14, 2021

This past week included two double-flight days on Monday-Tuesday (June 7-8). June 7 was notable in that the second flight (RF 80) was a “process study” flight, which accounts for approximately 10% of ACTIVATE flights. We targeted an area with a cluster of clouds and conducted a total of 10 Falcon legs in cloud at different altitudes ranging from ~2 to ~13 kft. These legs and a subsequent downward spiral resulted in 10 cloud water samples for a single cloud system. Simultaneously, the King Air conducted a ‘wheel and spoke” pattern far above to allow the remote sensors to characterize the environment and cloud that the Falcon was directly sampling. A total of 14 dropsondes were launched by the King Air in the ~3 hr flight. This flight and the other “process study” flight in this summer campaign (RF77 on June 2) will provide a remarkable dataset to investigate aerosol-cloud-meteorology interactions with very detailed measurements for single evolving cloud systems.

March 15, 2021

ACTIVATE conducted four more successful joint flights (Research Flights 51-54) this past week. We characterized a variety of cloud conditions including post-frontal clouds associated with another cold air outbreak on Monday (March 8) in contrast to the following day (Tuesday March 9) where there was a sharp inversion with uniform cloud top heights and generally thin clouds. Flights this past week were marked by influence from local and regional burning emissions. The second of two flights on Friday (March 12) was coordinated with a CALIPSO overpass.

Febraury 5, 2021

ACTIVATE’s had its first joint flight of the winter 2021 campaign on February 3. We were successful to sample a transition from overcast stratocumulus clouds to broken cumulus clouds near our farthest southeast point of the flight track. There was extensive mixed-phase precipitation in areas closer to shore but pure liquid clouds farther offshore coinciding with the open cell cloud field. Although at low optical depth, an interesting aerosol layer was observed above 6 km that most likely was dust due to its depolarizing nature.

January 30, 2020

This past week ACTIVATE took to the skies again to begin our 2021 winter campaign. In contrast to last year, we started a bit earlier in the month of January to capitalize on a higher frequency of cold air outbreak events. Friday’s flights (January 29) were particularly ideal with both aircraft sampling along cloud streets aligned with the predominant wind direction coming from the north/northwest. We observed a transition from supercooled droplets to mixed phase precipitation with distance away from shore.

June 13, 2022

The past week coincided with a string of excellent weather conditions leading to eight joint flights between June 7-11 (RF166-173). There was evidence of African dust in the region that the aircraft sampled, in addition to coordinated efforts with glider platforms operated by the Bermuda Institute of Ocean Sciences to study the upper parts of the ocean surface that may affect the ACTIVATE measurements via sea-air interactive processes. Research flight 166 on 7 June was somewhat unique in that we sampled distinct cloud streets that we more commonly flew in during the winter season associated with cold air outbreaks. The ACTIVATE team also hosted a successful outreach event at the Longtail Aviation hangar featuring 40 students from three local grade schools.

June 6, 2022

On 31 May, the ACTIVATE team conducted a joint plane transit flight from Langley Research Center to Bermuda to base operations there until June 18. A series of flights (Research Flights 161-165) up through Sunday 5 June helped obtain statistics of atmospheric conditions around Bermuda. Many of the local Bermuda flights ended with a spiral sounding just offshore the Tudor Hill facility to obtain important vertical data for trace gases, aerosol, and weather parameters that will complement extensive surface monitoring work going on in coordination with the NSF-funded BLEACH project going on focused on halogen chemistry. Flights have already gathered important statistics associated with shallow “popcorn” cumulus cloud fields.

May 23, 2022

Four graduate students from the University of Arizona visited Langley Research Center to learn about and participate in the operational side of ACTIVATE. They took part in a very active flight week, with a total of eight joint flights deployed (Flights 153 - 160). Flights 156 and 157 on Wednesday, May 18th were special because these were the first flights to and from Bermuda that included a CALIPSO underflight. The CALIPSO track was clear of clouds and various aerosol layers such as smoke and dust were present. Another set of joint flights to and from Bermuda was conducted on Saturday, marking a successful end to the May flights. The next update will be in a couple weeks as the coming week will be used to prepare to fly out to Bermuda to base operations there from 1-18 June.

May 16, 2022

The previous week was marked by a persistent low pressure system positioned off the mid-Atlantic coast that impacted flight operations. Only one joint flight was conducted as a result on Tuesday (10 May; Research Flight 152), which featured strong northeasterly winds and warm air advection over the coastal cold waters created stratiform clouds near the surface. During parts of the flight there were several layers of decoupled stratiform cloud in the lower (free) troposphere.  There was evidence of strong sea salt influence on this day with a high volume of cloud water samples collected that will be helpful for continued characterization of the cloud chemistry in the study region. This week was marked by some visitors to Langley Research Center from the science team including Hailong Wang (PNNL) and Minnie Park (BNL), along with Simon Kirschler who is visiting from DLR in Germany.

May 09, 2022

ACTIVATE’s sixth and final deployment began this past week with three successful joint flights (Flights 149-151). In contrast to the winter deployment, aerosol optical depths increased this past week with dust and smoke signatures, with the latter possibly stemming from plumes advected from the western United States. These data will be helpful to learn more about the impacts of these aerosol types on clouds even if they reside above cloud tops. On Thursday (5 May 2022) we conducted a successful refueling trip to Providence, Rhode Island marked by extensive cloud characterization and upwards of 20 cloud water samples helpful for cloud composition studies.

March 30, 2022

We wrapped up Deployment 5 on Tuesday after finishing a couple joint flights (Research Flights 146-148). Monday’s flight was intriguing owing to the diversity of aerosol types sampled ranging from the usual marine aerosol types such as sea salt to also smoke, dust, and pollen. Tuesday’s flights were excellent for cold air outbreak characterization including upwind clear air sampling and then also the transition from overcast cloud conditions to an open cloud field. We will begin Deployment 6 in the first week of May and conduct flights through the end of June.

March 28, 2022

After considerable effort and patience due to pandemic-related barriers, ACTIVATE was able to successfully execute its first flight to Bermuda this past week. Research flights 142-143 on Tuesday March 22 nd involved out-and-back flights from Hampton, Virginia to Bermuda. Flights to Bermuda are important for a number of reasons including the ability to extend the spatial range of data off the U.S. East Coast to be farther removed from continental and Gulf Stream influence and closer to more “background marine” conditions. Flights 144-145 on Saturday March 26 th were special in that a wide range of aerosol types were sampled including dust, smoke, sea salt, and biological particles especially in the form of pollen near the coast.

March 21, 2022

ACTIVATE had a golden flight day on 13 March 2022 (Sunday) with a cold air outbreak and two joint flights in morning and afternoon. In the morning flight we sampled an overcast cloud field that began to transition into a more broken field. We conducted 3 “walls” with the low flyer (Falcon) involving level legs below and in cloud stacked vertically on top of each other for better vertical characterization of the ‘aerosol-cloud system’. We launched 11 dropsondes with the high flyer (King Air). Data suggest significant new particle formation above cloud tops offshore during the cold air outbreak event. The two flights that day provide excellent data for model intercomparison to understand boundary layer cloud evolution. Later in the week (Monday March 14) was marked by smoke conditions offshore that the Falcon was able to characterize with its suite of instruments. Two graduate students and a research scientist from the University of Arizona visited NASA Langley Research Center this past week to learn about and participate in the operational side of ACTIVATE.

March 14, 2022

This week was dominated by a stalled cold front over the ACTIVATE flight domain, which prevented the team from executing flights most of the week owing to complex conditions that would affect data quality (e.g., mid and high level clouds impacting remote sensors on the King Air) and sampling of well-defined boundary layer clouds. We were successful though with flights at the beginning of the week (Research flights 135-136) on Monday March 7 th , including both clear air and cloud characterization to the southern part of our usual sampling domain. The following week appears to be very promising with cold air outbreak conditions setting up as soon as this Sunday March 13 th .

March 7, 2022

The past week of ACTIVATE flights (research flights 130-134) including more clear air characterization than past weeks, with both dust and smoke influence over the northwest Atlantic. Two of the flights consisted of a vertical spiral sounding in cloud-free and polluted conditions with the HU-25 Falcon with the King Air flying overhead, which will be helpful for a number of types of analyses, including intercomparison between aerosol remote sensing products from the HSRL-2/RSP (on the King Air) and in situ aerosol observations from the Falcon. The two flights on Friday March 4 th in particular were excellent as there was high cloud fraction across most of our sampling region which afforded a chance to sample clouds impacted by potential dust and smoke plumes.

March 1, 2022

After standing down for a week to swap the B200 with the UC-12 King Air, flights resumed this past week (research flights 120-125) with three days of double-flights (Feb. 15, 16, 19). The statistical database representative of typical wintertime conditions continued to expand with these flights that all included cloud sampling and similar characteristics as recent weeks. For instance, gradients of decreasing cloud drop concentration with distance east of the shore continued to be observed, along with both warm and mixed-phase precipitation, and situations where cumulus clouds connected to overlying stratiform clouds.

February 22, 2022

February 7, 2022

Research flights 115-119 in the past week continued the extensive characterization of the northwest Atlantic in during typical wintertime conditions. Notable features this week included gradients offshore such as how in flight 115 (Tuesday, Feb 1) clouds were initially scattered by the coast and then rapidly started to deepen and fill in forming an overcast deck on the outbound leg. Towards the northeast part of the flight path, clouds took on a distinctly decoupled appearance with cumulus clouds feeding an upper stratiform deck. Aerosol gradients were evident too with regard to number concentration and composition. These distinct differences in the study region on individual flights present a critical opportunity for data analysis to better understand the aerosol-cloud-meteorology system.

January 31, 2022

Six joint flights were conducted this past week, including three double-flight days between January 24 and 27. The two flights on January 24 th included more sampling towards the southern part of our operation domain to get more diversity in conditions with regard to weather and aerosol conditions. The two flights on Thursday (Jan 27) included a refueling stop at Providence, Rhode Island to allow us to extend our spatial range of sampling. That day included complex cloud structure with wave characteristics (i.e., variable base and top heights) and decoupling of cloud layers. There was an abundance of ice nuclei during the two flights on this day.

January 18, 2022

ACTIVATE returned with flights this past week by executing Research Flights 100-104, including consecutive double-flight days on Tuesday and Wednesday (January 11-12, 2022). The two flights on January 11 th were used to sampled upwind and into a region of clouds during a cold air outbreak event; the second flight was used to keep tracking the evolution of the cold air outbreak farther downwind to the southeast of where the first flight left off. Intriguing features were observed on the two flights on Tuesday including steam fog, funnel clouds, and waterspouts. Both warm and mixed-phase precipitation were observed, along with new particle formation above cloud tops.

December 13, 2021

Four joint flights were conducted this past week in ACTIVATE’s final week of science flights for December before resuming flights in January 2022. Notable was the back-to-back flight day on Thursday (9 Dec 2021) when the two aircraft flew north for a refueling stop at Quonset State Airport (Rhode Island). This marks the first refueling stop at a secondary base in the ACTIVATE project. Extending our typical spatial range was helpful for a more extensive characterization of the complex cloud scene  including solid and broken boundary layer cloud structure with distinctly different cloud types including both warm and mixed-phase precipitation. ACTIVATE measurements during these two flights will be very helpful to understand gradients in the aerosol-cloud system during the transitions between cloud types (e.g., stratocumulus, fair weather cumulus) and the solid versus broken cloud fields.

December 6, 2021

The 5th ACTIVATE deployment started this past week with two joint flights having similar headings going southeast from the base of operations at NASA Langley Research Center. These flights allowed for unique sampling of trace gases, aerosols, and marine boundary layer clouds in the month of December, which has yet to be done during ACTIVATE’s first 93 flights leading up to these two flights. More flights are planned in the coming week before a break and then resumption of flights in January.

July 1, 2021

We finished our summer campaign this past week with four more ACTIVATE flights (Research Flights 90-93) between June 28 and 30. These flights focused on extensive data collection in typical summertime shallow cumulus clouds. A notable feature in these flights was sampling behind ship vessels near the coast that yielded especially large enhancements in particle concentration parameters.

June 28, 2021

Four flights were conducted last week, with two single flight days on June 22 and 24, and a double flight day on June 26. Saturday’s conditions (June 26) were in particular very good for ACTIVATE with a scattered shallow cumulus cloud scene throughout the day that both planes were able to jointly characterize. The past week also was linked to high variability in aerosol conditions with the northward advancement of African dust into our study region.

June 21, 2021

This past week included three single-flight days on Tuesday-Thursday (June 15-17). The first flight of this week (June 15) was a statistical cloud survey but proved to be a challenging flight to execute as the King Air encountered pervasive cirrus along the track and the Falcon dealt with low clouds at varying altitude ranges. The June 16 flight targeted mostly clear skies with observations of moderate aerosol loading. This flight also included an overflight of Langley Research Center at the end to intercompare with the AERONET site and the High Altitude Lidar Observatory (HALO) HSRL/water vapor lidar that was conducting upward looking ground tests. The last flight of the week (June 17) included a coordinated run along the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite overpass and then two reverse headings to capture in cloud data in vicinity of the ASTER overpass for additional contextual data. The flights on June 16-17 both saw non-spherical particles near the coast and drizzle over the ocean was observed on June 17.

June 7, 2021

Four successful joint flights occurred last week. The double flight day on Wednesday June 2 was particularly noteworthy. Our morning flight conducted our typical statistical survey flight plan to an area south of the Virginia coast where there was a cumulus cloud field, with some regions evolving into deeper, more organized, convection. Based on that flight and satellite imagery, we set up the second flight to execute a “process study” pattern where the Falcon conducted a series of transects through a selected cloud cluster to characterize the vertical microphysical properties of the developing cluster immediately followed by an environmental profile in the surrounding cloud-free region. Simultaneously, the King Air conducted a “wheel and spoke” pattern centered around the cloud system, with multiple dropsondes launched above, and on the periphery of the cloud cluster alongside remote sensing transects to characterize the cloud and aerosol system underneath. Data from both planes will be used to characterize the range of cloud types observed on that day, with a focus on understanding the processes that drive shallow cumulus organization.

June 1, 2021

The last two weeks were busy with 9 joint flights, including three separate double-sortie days. The May 21 morning flight in particular was intriguing with a mixture of different conditions offshore with the two aircraft flying mostly straight to the east and then returning on the same track to NASA LaRC. Closer to shore, the aircraft observed a stratus deck with a prominent aerosol layer just above cloud as observed by the HSRL-2. These clouds then transitioned progressively into a more scattered cumulus cloud field to the east. At the far eastern end of the track there was a cold pool that we sampled within and just outside. Throughout this and the other flights this past week, there was evidence both either (or both) smoke and dust in the free troposphere. Measurement data will help unravel how these various aerosol types interact with the different types of clouds such as in the May 21 flights. On May 19, we also coordinated the flight along the CALIPSO satellite track where both aircraft and the satellite had successful made measurements.

May 17, 2021

After a short break after the Winter 2021 campaign, ACTIVATE took back to the skies this past week to start the Summer 2021 campaign. We conducted 4 successful joint flights between May 13-15 with interesting cloud conditions in each flight. The lower-flying Falcon characterized multiple layers of clouds and observed both warm and mixed-phase precipitation. Remote sensing observations on the higher-flying King Air detected aerosol layers aloft in the free troposphere potentially from dust and smoke on separate flights.

April 5, 2021

ACTIVATE wrapped up its winter 2021 flight campaign with five joint research flights this past week (RF 57-61) capped off by a double-flight day on Friday (4/2) to capitalize on another cold air outbreak event. Those two flights included an increased number of dropsondes (~10 per flight) to get extensive temporal and spatial characterization of the vertical atmospheric structure as the cold air outbreak cloud field evolved during the day. Notable in the other flights last week was successful coordination with ASTER and CALIPSO overpasses in our flight region.

March 29, 2021

We executed a joint flight (RF 56) on Tuesday March 23rd on a day marked by fairly ‘clean’ conditions in terms of very low aerosol and cloud drop number concentrations in the marine boundary layer. Cloud fraction on this day was markedly lower than a typical cold air outbreak type of day, which is helpful for ACTIVATE which is aiming to generate statistics in a wide range of conditions associated with aerosols, clouds, and meteorology.

March 22, 2021

The previous week posed significant weather challenges but Saturday (March 20, 2020) did finally provide low clouds evolving in a cold air outbreak. Interesting features in that joint flight (Research Flight 55) were Asian dust residing aloft above the boundary layer clouds, in addition to an interesting layer of depolarizing aerosol right above clouds near the end of flight as observed by the HSRL-2; it is unclear what the source of that layer was, but data analysis with the Falcon data will help unravel those details.

March 8, 2021

ACTIVATE executed three successful joint flights (Research Flights 48-50) this past week. On Thursday March 4th we coordinated our flight with a NASA A-Train overpass over an area with some scattered marine boundary layer clouds. The back-to-back flights on Friday March 5th served two objectives to capitalize on an excellent cold air outbreak event: (i) characterize the aerosol and meteorological characteristics upwind of the cloud field farther downwind; and (ii) characterize the evolution of the cloud field with the desire to capture the transition from overcast cloudy conditions to open cell structure. Noteworthy features in these flights were dust layers from long-range transport and significant new particle formation.

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Electra's eSTOL Goldfinch is First Piloted Electric Aircraft to Fly at NASA's Langley Research Center

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MANASSAS, Va., Aug. 7, 2024

Electra and NASA are working together on advanced aviation technologies to bring  clean, efficient, and affordable air travel to all communities

MANASSAS, Va., Aug. 7, 2024 /PRNewswire/ -- Electra.aero, Inc.  (Electra), a next-gen aerospace company committed to decarbonizing aviation and opening new air transportation markets, successfully demonstrated the flight capabilities of its EL-2 Goldfinch hybrid-electric short takeoff and landing (eSTOL) technology demonstrator aircraft at NASA's historic Langley Research Center on Monday, July 15. The achievement marks the first flight of an electric aircraft with a pilot onboard at NASA Langley.

Electra and NASA are working together on Advanced Air Mobility (AAM) research, demonstrations and information sharing under a NASA Space Act Agreement. In a separate effort, Electra is working under a NASA Small Business Innovation Research (SBIR) project on solar-electric, high-altitude, long-endurance aircraft research called a "high-altitude platform station" or HAPS. Electra has also contributed to a NASA study on connecting communities into the national transportation network through Regional Air Mobility (RAM ) using underutilized airports.

The flight demo for NASA Langley's research community showcased the eSTOL aircraft's use of distributed electric propulsion (DEP) with blown lift technology, which is capable of taking off and landing in under 150 feet. The demonstration highlighted the aircraft's hybrid-electric capabilities for longer range potential and battery-electric flight for quiet, community-friendly operations. Earlier that day, the aircraft completed the 120-mile cross-country flight from Electra's Manassas, VA facility to NASA in Hampton, VA using the hybrid propulsion system.

Electra is developing a 9-passenger eSTOL production aircraft designed to replace short- and medium-distance vehicle trips up to 500 miles with decarbonized, quiet and affordable air travel. This aircraft would be able to connect Northen Virginia to the Hampton Roads area in a quick 35-minute flight, rather than the 2.5 hours it takes to drive today.

"NASA is an incredible institution that has developed many of the foundational technologies underpinning today's aviation industry. They are now pioneering the future with advanced air mobility innovations," said JP Stewart, Electra's Vice President and General Manager. "We look forward to continuing our collaboration with them on new technologies that will extend seamless and convenient air travel to all communities."

About Electra  

Electra.aero, Inc .  (Electra) is a next-gen aerospace company leading the way in sustainable urban and regional mobility. The company is building clean, hybrid-electric, short takeoff and landing (eSTOL) airplanes that fly people and cargo quieter, further, and more affordably. Electra's technology delivers 2.5x the payload and 10X longer range with 70% lower operating costs than vertical takeoff alternatives with far less certification risk. Electra's team includes some of the most respected and successful entrepreneurs and engineers in novel aircraft design, with over 40 prior aircraft successfully developed and/or certified. Its technology development is supported by Lockheed Martin Ventures, the Virginia Innovation Partnership Corporation (VIPC), Statkraft Ventures, and other private investors in addition to contracts with NASA, the U.S. Air Force, the U.S. Army, and the U.S. Navy.

Investors Diana Siegel [email protected]

Media   Barbara Zadina  [email protected]

SOURCE Electra.aero

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• Review Article
• Published: 09 August 2024

Long COVID science, research and policy

• Ziyad Al-Aly   ORCID: orcid.org/0000-0002-2600-0434 1 , 2 ,
• Hannah Davis   ORCID: orcid.org/0000-0002-1245-2034 3 ,
• Lisa McCorkell   ORCID: orcid.org/0000-0002-3261-6737 3 ,
• Letícia Soares 3 ,
• Sarah Wulf-Hanson 4 ,
• Akiko Iwasaki   ORCID: orcid.org/0000-0002-7824-9856 5 , 6 &
• Eric J. Topol   ORCID: orcid.org/0000-0002-1478-4729 7  

Nature Medicine ( 2024 ) Cite this article

Metrics details

• Viral infection

Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling. The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis. Long COVID can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies, even threatening progress toward achieving the Sustainable Development Goals. Addressing the challenge of long COVID requires an ambitious and coordinated—but so far absent—global research and policy response strategy. In this interdisciplinary review, we provide a synthesis of the state of scientific evidence on long COVID, assess the impacts of long COVID on human health, health systems, the economy and global health metrics, and provide a forward-looking research and policy roadmap.

You have full access to this article via your institution.

Long COVID is best defined as the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection 1 , 2 , 3 . Long COVID was initially reported by patients who coined the term and, through research and advocacy, drove much of the progress in understanding this condition over the past several years (Fig. 1 ).

The history of long COVID has been defined largely by the patients themselves. In March 2020, as the COVID-19 pandemic began to unfold across the globe, patients with infection-associated chronic conditions presciently warned of the potential emergence of long-term illness after SARS-CoV-2 infection 293 .The first mainstream written personal account of non-recovery from acute COVID-19 was an op-ed by the American journalist Fiona Lowenstein in the New York Times in April 2020 (ref. 294 ). Around the same time, patients began self-organizing, coined the term long COVID 295 and conducted the first known survey—which was subsequently formally published—documenting the breadth of symptomatology experienced by people with long COVID 42 . Considerable activity then ensued, including mainstream media coverage (first by Ed Yong in The Atlantic ) 296 , recognition by national governments (of the United States 281 , Canada 297 , United Kingdom 298 , European Union 299 , Australia 300 and others) and the WHO. Patients continue to lead the way in advocacy and research, which led the US Senate to hold its first-ever hearing on long COVID 275 , 301 . This timeline was curated to provide a brief overview of the history of long COVID, with a focus on the role played by patients and advocates, and does not comprehensively include all events and milestones. ICD, International Classification of Diseases.

Long COVID is a complex, multisystem disorder that affects nearly every organ system, including the cardiovascular system 4 , the nervous system 5 , 6 , 7 , 8 , the endocrine system 9 , 10 , 11 , the immune system 12 , 13 , the reproductive system 14 and the gastrointestinal system 15 . It affects people across the age spectrum (from children 16 , 17 , 18 to older adults 19 , 20 ), people of different race and ethnicities, sex and gender, and baseline health status 21 . Cardinal manifestations include brain fog (or cognitive dysfunction) 7 , fatigue, dysautonomia (which commonly manifests as postural orthostatic tachycardia syndrome (POTS)) 22 and post-exertional malaise 23 . Many of the health effects seen in long COVID are shared across several infection-associated chronic conditions, also called post-acute infection syndromes 23 , 24 , 25 , 26 .

The epidemiology of long COVID is influenced by various factors. The Omicron variant of SARS-CoV-2 is associated with less risk of long COVID than the Delta and pre-Delta variants 27 . Vaccines (before infection) and antivirals (during the acute phase of infection) may reduce the risk of long COVID. Reinfection, on the other hand, is a risk factor for long COVID 28 , 29 ; even if individuals did not experience long COVID after a first SARS-CoV-2 infection, they remain at risk of developing it with subsequent infections 28 , 29 , 30 . Reinfection can trigger de novo long COVID or exacerbate the severity of existing long COVID 28 , 29 . Cumulatively, two infections yield a higher risk of long COVID than one infection and three infections yield a higher risk than two infections 28 , 29 .

A unifying thread of evidence across most studies evaluating the risk of long COVID is the finding that the risk increases as the severity of acute infection increases 3 . People who had severe COVID-19 that necessitated hospitalization exhibit a higher risk of long COVID than those with mild COVID-19. However, because most people around the globe had mild COVID-19, they constitute more than 90% of people with long COVID, despite their lower relative risk compared with that of people with severe COVID-19 (ref. 31 ).

Studies evaluating recovery from long COVID are sparse and inconsistent 32 ; this is largely due to use of various definitions, incomplete accounting for all the manifestations of long COVID and misclassification of remission as ‘recovery’ 33 . However, studies carefully evaluating individual manifestations show that recovery rates are generally low at 1 year 34 , and several studies show only 7–10% fully recovered at 2 years 30 , 33 , 35 , 36 . Furthermore, some manifestations of long COVID, including heart disease, diabetes, myalgic encephalomyelitis and dysautonomia are chronic conditions that last a lifetime 31 , 37 , 38 , 39 . Adding to this are the concerns about the possible emergence of new latent sequelae—that have not yet been characterized—years after the acute infection 37 , 40 , 41 .

The impact of long COVID is not limited to the health and well-being of individual patients and their communities. Owing to its prevalence and the breadth of its clinical manifestations 42 , 43 , 44 , 45 , 46 , it represents a major public health crisis 47 ; it strains health systems and national economies, and threatens progress on global health, including the Sustainable Development Goals (SDGs).

In this interdisciplinary review, we provide a brief synthesis of the current state of scientific evidence on long COVID, including knowns, unknowns and the key controversies. We provide an assessment of the impacts of long COVID on human health, health systems, the economy and global health metrics and, finally, we provide a forward-looking research and policy roadmap that we hope will stimulate global discussion on how to address the challenge of long COVID.

State of the science on long COVID

The global burden.

Estimating the global burden of long COVID presents substantial challenges due to the variability in study designs and populations, follow-up times, choice of control groups (for example, whether studies evaluated people with negative SARS-CoV-2 tests or no known SARS-CoV-2 infection as controls), assessment of baseline health before the infection (to ascertain emergence of a true new health condition) and definitions of what constitutes ‘long COVID' 48 , 49 . Variation in risk estimates also reflects the dynamic nature of the pandemic itself, which gave rise to many variants and subvariants, each yielding potentially different rates of long COVID; the effect of COVID-19 vaccines and use of antivirals in the acute phase, which may reduce the risk of long COVID; and the effect of SARS-CoV-2 reinfections, which contribute additional risk 28 , 29 .

Few countries established surveillance systems to estimate the burden of long COVID at the population level. Data from the US Centers for Disease Control and Prevention (CDC)’s National Health Interview Survey show that in 2022, 6.9% of US adults 50 and 1.3% of children 51 ever had long COVID. Data from the Medical Expenditure Panel Survey—a nationally representative survey of US adults—found that 6.9% of adults had ever had long COVID as of early 2023 (ref. 52 ). Estimates from the CDC’s Household Pulse Survey show that prevalence of current long COVID in US adults was around 6.7% in March 2024 (ref. 53 ). In the United Kingdom, point prevalence estimates from the Office of National Statistics show that 2.9% of the UK population (including children) were experiencing self-reported long COVID in March 2023 (ref. 54 ). Overall, estimates of the burden of long COVID in the general population converge around a point prevalence of 6% to 7% in adults and ~1% in children 50 , 51 , 52 , 53 , 54 .

Also important are estimates of the incidence of long COVID, which can be informed by high-quality meta-analyses of large-scale cohort studies among people infected with SARS-CoV-2. For instance, one analysis pooled results from 54 studies in 22 countries and estimated that approximately 6.2% of symptomatic COVID-19 survivors experience at least one of three common symptom clusters at 3 months after acute infection, across all ages and accounting for different severity levels of the initial infection and pre-COVID health status 31 . This analysis only considers three major symptom clusters in long COVID (fatigue with bodily pain/mood swings, and cognitive and respiratory symptom clusters); however, it sets a conservative benchmark to estimate the global risk of long COVID 31 .

We estimated the global incidence of long COVID on the basis of meta-regression studies that pool together all the available evidence 31 (Fig. 2 ). Incorporating a number of assumptions, including the Institute for Health Metrics and Evaluation’s annual estimates of SARS-CoV-2 infections 31 , 55 , 56 , 57 , 58 , 59 , a proportion symptomatic cases among infections of 65% (ref. 31 ), and a reduction in the risk of long COVID for 2022 and 2023 to account for the putative lower severity of the Omicron variant and the effect of vaccination 60 , we estimated a cumulative global incidence of long COVID by the end of 2023 of approximately 400 million. It is crucial to emphasize that these estimates only represent cases arising from symptomatic infections and are likely to be conservative. The actual incidence of long COVID, including cases from asymptomatic infections 61 or those with a broader range of symptoms, is expected to be higher. Furthermore, the estimates do not account for the added burden of long COVID due to reinfection 29 and the possibility of latent risks (that is, risks that are not yet manifest and may emerge years or decades after infection) 3 , 37 , 41 . The emergence of new variants, changes in public health measures and changes in the effectiveness and uptake of vaccination may also substantially influence these estimates in the future.

We estimated the global incidence of long COVID on the basis of meta-regression estimates that pool together all the available evidence. Considering the Institute for Health Metrics and Evaluation’s annual estimates of SARS-CoV-2 infections 31 , 55 , 56 , 57 , 58 , 59 and assuming the lower risk estimate of 6.2% for long COVID at 3 months after infection 31 , a proportion symptomatic cases among infections of 65% (ref. 31 ), and a reduction in the risk of long COVID for 2022 and 2023 (to account for the combination of the putative lower severity of the Omicron variant and the mildly protective effect of vaccination) 60 , the estimated cumulative global incidence of long COVID was 65 million, 211 million, 337 million and 409 million in 2020, 2021, 2022 and 2023, respectively.

While it is challenging to provide estimates of new cases with high precision, the current evidence makes it compellingly clear that long COVID represents a substantial and ongoing challenge to global health.

Mechanisms of long COVID

The pathophysiological mechanisms of long COVID are still being elucidated 2 , 62 , and it is unlikely that a single mechanism can explain the broad and heterogeneous set of symptoms and diseases spanning various organ systems. Long COVID likely represents a disease with many subtypes; each may have their own risk factors, biological mechanisms and disease trajectory, and may respond differently to treatments 3 . Multiple pathological pathways may be engaged depending on various factors, including prior environmental exposures, genetic makeup, age, sex, prior health, microbiome health, viral characteristics (SARS-CoV-2 variant, viral load), the immune response (which may be influenced by prior infections, vaccines and use of immunosuppressive agents) and medical treatments (antivirals, steroids). All of these drivers likely shape the human host response during the acute phase of SARS-CoV-2 infection and may trigger pathophysiological mechanisms that ultimately produce phenotypes of long COVID.

Several mechanistic pathways have been proposed for long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, prothrombotic inflammation and microbiome dysbiosis 3 , 7 , 12 , 63 , 64 , 65 , 66 , 67 , 68 , 69 (Fig. 3 ). Viral persistence (either replicating virus or viral RNA or protein fragments)—which may be common 70 —in immune-privileged sites may trigger chronic low-grade inflammation and tissue injury 63 , 71 , 72 , 73 , and may correlate with long COVID symptomatology 72 .

Initial triggers (gray boxes) include viral persistence in tissue reservoirs (or immune-privileged sites) and possible replication of SARS-CoV-2 leading to the generation of viral antigens and RNA, which stimulates adaptive and innate immune cells, respectively. This can lead to immune cell activation, cytokine secretion, T cell exhaustion, antibody secretion against SARS-CoV-2 antigens and complement activation (top yellow box). Innate recognition of viral RNA by myeloid cells can lead to enhanced phagocytosis and cytokine secretion and inflammasome activation (bottom yellow box). These events can trigger autoimmunity (bystander activation or molecular mimicry) and reactivation of dormant herpesviruses (EBV, VZV) and uncoordinated cross-talk between cellular and adaptive immunity. Immune activation can cause downstream pathologies (pink boxes), including mitochondrial dysfunction and impaired energy metabolism; microbiome dysbiosis and translocation and gut nervous system dysregulation; neuronal inflammation, activation of microglia and immune cells with reduced neurogenesis and loss of oligodendrocytes and myelinated axons, possible fusion between neurons and neurons and glial cells and formation of multicellular syncytia, which compromises neuronal activity; dysfunctional hypothalamic–pituitary–adrenal response leading to inappropriately low levels of cortisol; complement activation, endothelial inflammation, platelet activation and red blood cell lysis leading to thromboinflammation and tissue injury. These mechanisms are non-exclusive and may cause inflammation, tissue dysfunction and tissue damage (blue box) leading to clinical manifestations of long COVID.

Studies have demonstrated persistence of the virus in extrapulmonary sites, including the brain and coronary arteries, of individuals with severe COVID-19 (refs. 68 , 74 ). Studies in human and mouse brain organoids showed that SARS-CoV-2 infection induces fusion between neurons and between neurons and glial cells, which may progressively lead to formation of multicellular syncytia compromising neuronal activity 75 . Neuroimaging studies performed in humans 10 months after they ‘recovered’ from mild-to-moderate SARS-CoV-2 infection showed significant alterations (commensurate with 7 ‘years of healthy aging’) of cerebral white matter, including widespread increases of extracellular free water and mean diffusivity (indicative of inflammation) encompassing all brain lobes 76 . Pre- and post-SARS-CoV-2 infection imaging studies showed structural abnormalities and accelerated aging in the brains of people with mild-to-moderate SARS-CoV-2 infection 74 , 77 , 78 . Even in the absence of direct infection in the brain, a transient respiratory infection with SARS-CoV-2 induces prolonged neuroinflammatory responses, activation of microglial cells and impaired neurogenesis 64 , 77 . In addition to neuroinflammation, people with brain fog due to long COVID were shown to have disrupted blood–brain barriers 79 .

Abnormalities in the immune system have been documented in people with long COVID, including increased humoral responses directed against SARS-CoV-2; higher antibody responses against Epstein–Barr virus (EBV) 66 , varicella zoster virus (VZV) 66 and cytomegalovirus 67 (suggesting possible reactivation of herpesviruses 80 ); exhausted T cell responses 12 , 66 ; and uncoordinated cross-talk between the cellular and humoral adaptive immunity 12 , 13 . Autoimmune responses triggered by SARS-CoV-2 infection may underlie long COVID symptoms 81 , 82 . Passive transfer of IgG antibodies from patients with long COVID to healthy mice recapitulated heightened pain sensation and locomotion deficits 82 , 83 .

In the heart, SARS-CoV-2 infects coronary vessels, preferentially targeting coronary artery plaque macrophages and inducing plaque inflammation 68 . Vascular disease in long COVID is likely triggered by complement activation, red blood cell lysis, platelet activation and thromboinflammation—leading to altered coagulation and tissue injury 67 , 84 . Dysfunctional hypothalamic–pituitary–adrenal response with inappropriately low levels of cortisol may mediate some of the symptomatology observed in long COVID (including fatigue, sleep abnormalities and metabolic derangements) 66 , and has been seen in those with persistent respiratory symptoms of long COVID 80 . SARS-CoV-2 infection may lead to reduced intestinal absorption of tryptophan (a serotonin precursor) and subsequently reduced levels of circulating serotonin, which may impair cognition via reduced vagal signaling 85 . SARS-CoV-2 infection may also lead to mitochondrial dysfunction, systemic metabolic abnormalities and abnormal skeletal muscle response to exercise—including exercise-induced myopathy and tissue infiltration of amyloid-containing deposits and leukocytes 65 .

The proposed mechanisms of long COVID share similarities with those of other post-acute infection syndromes, which are beyond the scope of this article and are discussed in detail elsewhere 24 .

Prevention, treatment and care models

Non-pharmaceutical interventions (for example, masking, improved indoor air quality) can reduce the risk of SARS-CoV-2 infection and consequently reduce the risk of long COVID. COVID-19 vaccines may partially reduce the risk of long COVID in adults by 15–70% (mean, ~40%) 86 , 87 , 88 , 89 ; they may also partially reduce the risk of long COVID in children 90 , 91 . In nonhospitalized individuals (mild-to-moderate COVID-19) who have at least one risk factor for the development of severe COVID-19, use of the SARS-CoV-2 antivirals (ritonavir-boosted nirmatrelvir and molnupiravir) in the acute phase may reduce the risk of long COVID 92 , 93 , 94 , 95 , 96 , 97 . However, the effectiveness of these antivirals in reducing risk of long COVID in low-risk groups, including younger individuals with no comorbidities 98 , has not been evaluated. Simnotrelvir—a new SARS-CoV-2 antiviral available in China 99 —resulted in earlier reduction in viral load and faster resolution of acute symptoms (than placebo) 100 , but its effectiveness against long COVID has not yet been evaluated. Exploratory analyses showed that another new SARS-CoV-2 antiviral, ensitrelvir (currently available in Japan), reduced the risk of long COVID when initiated in the acute phase of COVID-19 (refs. 101 , 102 ). Furthermore, metformin (initiated within 7 days of SARS-CoV-2 infection) has been shown to reduce the risk of long COVID in a randomized controlled trial 103 .

Evidence for long COVID treatments is beginning to emerge, but it is still limited. A randomized, double-blind, placebo-controlled trial showed that treatment with a synbiotic preparation (a gut microbiome modulator) alleviated multiple symptoms of long COVID—highlighting the need to further explore microbiome modulators as potential therapeutics in this setting 104 . Another randomized, controlled trial showed that a 15-day course of ritonavir-boosted nirmatrelvir did not reduce the burden of long COVID symptoms in comparison to ritonavir with placebo 105 .

Due to near-total absence of evidence from randomized clinical trials to guide treatment decisions, approaches for the assessment and treatment of respiratory sequelae 106 , cardiovascular complications 107 , fatigue 108 , cognitive symptoms 109 , autonomic dysfunction (including POTS) 110 , 111 , 112 , 113 , 114 and neuropsychiatric impairment 115 , 116 in adults and children 117 are based on evidence of treating similar symptomatology from other conditions—including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Gulf War illness 26 , 118 , 119 , 120 .

Care for people with long COVID varies widely across settings and practitioners 118 , 119 , 121 , 122 , 123 . It is often challenged by lack of widespread recognition and understanding of long COVID among medical professionals, constrained resources and competing demands on healthcare systems still recovering from the shock of the pandemic, lack of standardized care pathways, lack of definitive diagnostic and treatment tools, and a general pervasive pandemic fatigue with an urge to ‘move on’ 124 , 125 . Much of the global burden of long COVID remains undiagnosed, particularly in low-resource settings, and in many instances are erroneously attributed to psychosomatic causes 126 .

Overall, care models for long COVID are evolving, with substantial variability across health systems 127 . While there is still no empirical evidence evaluating comparative effectiveness of long COVID care models 121 , optimal models should be context dependent—based on available resources, expertise and the population being served 121 , 128 .

Impacts of long COVID

In addition to its impact on patients’ daily lives and health outcomes, long COVID has a devastating impact on communities and can have wide-reaching ramifications for health systems, national economies and global health metrics.

Impact on individuals and communities

Long COVID drastically affects patients’ well-being and sense of self, as well as their ability to work, socialize, care for others, manage chores and engage in community activities—which also affects patients’ families, caregivers and their communities 129 . Over three quarters of people with long COVID report a moderate or severe impact on general well-being 130 . The high rates of cognitive and physical symptoms also affect individuals’ identity and sense of self. One in four people with long COVID limit activities outside work in order to continue working 131 . Many patients with long COVID experience social exclusion, isolation and stigma, often from medical providers 43 , 132 , 133 , 134 . These challenges are exacerbated by societal barriers to the inclusion of people with disabilities and chronic illnesses.

Impact on health systems

Because of the large burden of long COVID and its multisystemic effects 135 , it has profound impacts on health systems 136 , 137 . Patients with long COVID frequently require ongoing medical care and multiple specialist consultations to manage their complex symptoms. This increased demand exacerbates existing pressures on health systems, leading to longer wait times, potential delays in essential care and increased costs. In the United States, people with long COVID are more likely to report unmet healthcare needs in the past year because of costs and difficulties finding a clinician and getting an appointment when needed 138 . These issues are exacerbated in low- and middle-income countries 126 , 139 . Furthermore, the lack of standardized diagnostic criteria, treatment protocols and models of care for long COVID adds to the complexity and places additional burdens on healthcare providers 137 , 140 , 141 .

Perhaps the most enduring challenge to health systems lies in the rise in the burden of non-communicable diseases (NCDs; for example, cardiovascular disease and diabetes) as a consequence of SARS-CoV-2 infection 4 , 5 , 9 , 10 , 15 , 136 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 . NCDs are chronic conditions that require lifelong care, impact health system utilization (competing for access and quality of care) and raise healthcare costs 137 .

Impact on economies

Long COVID strains individual financial health 153 and has wide and deep ramifications on national economies 154 , 155 , 156 , 157 , 158 , 159 . In addition to the substantial direct healthcare costs 160 , there is also financial strain on support services and disability benefits. In addition, long COVID affects labor participation, employment and productivity of impacted individuals and their caregivers 129 , 156 , 161 , 162 , 163 —resulting in depleted savings, food and housing insecurity 131 , 164 and negative impact on labor supply, thereby fueling labor shortages 156 . Studies indicate a significant percentage of individuals with long COVID experience a reduced ability to work or may be unable to work at all 165 . A report by the US Brookings Institute estimated that between 2 and 4 million US adults were out of work because of long COVID in 2022 (ref. 165 ). A US Federal Reserve Bank report found that people with long COVID had 10% less likelihood of being employed and worked 25% to 50% fewer hours when employed than uninfected individuals 166 . Survey data from the UK’s Trades Union Congress show that 20% of people with long COVID were not working and that an additional 16% were working reduced hours 167 . An analysis by the European Commission suggested that long COVID had a negative impact on the European labor supply of 0.2–0.3% in 2021 and 0.3–0.5% in 2022 (ref. 168 ).

Quantitative estimates of the total economic impact of long COVID remain preliminary. A study in 2022 estimated the economic cost of three key parameters in the United States, including lost quality of life ($2,195 billion), cost of lost earning ($997 billion) and spending on healthcare ($528 billion), for up to a total cost of $3.7 trillion 154 , 155 —this amounts to $11,000 per capita or 17% of the 2019 gross domestic product (GDP). These economic losses are on par with the global 2008 Great Recession. Assumptions included in these estimates are that burden of disability from long COVID is on par with that of ME/CFS and that long COVID lasts on average for 5 years 155 .

Among OECD (Organization for Economic Co-operation and Development) countries, a preliminary conservative estimate suggested that excluding the direct costs of healthcare, long COVID is likely costing OECD countries as much as $864 billion to $1.04 trillion per year due to reductions in quality of life and labor force participation 169 . A recent analysis by the Economist Impact (a think tank of The Economist) suggested that the economic cost of long COVID in 2024 is expected to be around 0.5% to 2.3% of the GDP of several large economies 170 (Table 1 ). On the basis of all the available data, a conservative estimate of the annual global economic toll of long COVID could be around $1 trillion amounting to 1% of the 2024 global GDP 154 , 155 , 169 , 170 .

Impact on the SDGs

The profound immediate health, social and economic shocks triggered by the COVID-19 pandemic have undermined the ability of many countries to achieve the SDGs by 2030 (ref. 171 ). In addition to the immediate effect of the pandemic, its long tail—in the form of long COVID—presents a more profound and enduring challenge to SDGs than the direct initial disruptions 171 .

Long COVID’s multifaceted impact jeopardizes progress across many SDGs, particularly those aimed at promoting health and economic well-being, and reducing inequalities 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 . Long COVID can limit access to and quality of healthcare 136 , 137 , reduce labor participation, worsen poverty and hinder economic productivity 169 , and exacerbate existing inequalities 180 , 181 , 182 , 183 . Table 2 lists the impacts of long COVID on several of the SDGs and identifies which collaborative, multi-sectoral partnerships and actions are needed to address these impacts.

The full extent to which long COVID will undermine the SDGs is still evolving and is difficult to fully quantify 174 , 175 ; a deeper understanding of the full scope and scale of this impact is needed.

Research and policy roadmaps

Substantial work lies ahead to address the broad and multifaceted challenges posed by long COVID—including preventing further increase in the number of people with long COVID and addressing the care needs of people already impacted 184 . Responding to these challenges will require coordinated, long-term policy response and visionary research strategies, guided by the principles of health equity and patient centeredness 185 , 186 , 187 . We developed the following research and policy roadmaps on the basis of our assessment of the evidence and policy gaps, as well as our own clinical, research and policy experience and in partnership with patients.

Research roadmap

Biological mechanisms.

Leading mechanistic hypotheses (discussed above) should be examined carefully, particularly for their interactions and potential to guide disease management, trials to test existing drugs and the development of new drugs 3 . Continued investigation (via animal models 188 , 189 or other approaches) of neuroinflammation, immune dysregulation, sex differences 190 , tissue damage and susceptibility features, including genomic 191 , epigenomic 192 , 193 , 194 and other '-omics', is warranted. In evaluating the mechanisms of long COVID, detailed assessment of specific manifestations, for example, understanding the pathophysiology of post-exertional malaise, may yield mechanistic insights that guide clinical management 65 , 195 , 196 .

That SARS-CoV-2 leads to long COVID is unlikely to be a unique property; many other viral agents (including influenza, SARS, Middle East respiratory syndrome, EBV, Dengue, Ebola, Polio, Chikungunya, West Nile virus, Ross River virus, Coxsackie B and VZV) and nonviral agents ( Coxiella burnetii , Borrelia , Giardia lamblia ) also lead to post-acute and long-term health effects 24 , 197 . A deeper understanding of the similarities and distinctions in the biological mechanisms of long COVID and other infection-associated chronic conditions is needed 2 , 3 , 24 , 25 , 26 , 198 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 .

Diagnostics

A research agenda is needed to foster the development, testing and validation of more advanced imaging, new blood tests, molecular probes, '-omics' and novel approaches to tissue investigation and analyses—toward better diagnosis of long COVID. Traditional imaging techniques may not reveal abnormalities in long COVID that may be evident in more advanced imaging. For example, new imaging technologies, including magnetic resonance imaging (MRI) with xenon-129 ( 129 XE-MRI) 215 for lungs, diffusion MRI to map glial activity 216 , imaging for glymphatic functioning 217 and arterial spin labeling MRI 218 for cerebral blood flow, have identified abnormalities in long COVID where conventional imaging has not. In a preliminary study, imaging flow cytometry was shown to detect fibrin microclots, which may be more abundant in people with long COVID than controls 219 . Whole-body positron emission tomography imaging using a highly selective radiotracer ([ 18 F]F-AraG) that allows anatomical quantification of activated T lymphocytes, showed increased radiotracer uptake indicative of T cell activation in various anatomic sites (for example, spinal cord, lungs) that were associated with long COVID 220 . These imaging modalities—along with other approaches—should be further investigated for their potential to establish diagnosis of long COVID, to guide trial designs, and for targeted disease management.

Biomarkers are helpful, not only as diagnostics, but also to aid in risk stratification (to guide trials and choice of treatment), determine potential subtypes of disease, and assess severity, prognosis and response to treatment. Candidate biomarkers include immune cell phenotypes, cytokines/chemokines, immunoglobulins, complement and coagulation proteins, acute phase proteins, endocrine markers and markers of neurologic or vascular injury 66 , 67 , 73 , 221 , 222 . Integrated '-omics' analyses 223 , 224 , including genomic, epigenomic, transcriptomic 225 , proteomic 226 , 227 , 228 , metabolomic 229 , lipidomic 230 , and microbiome 231 profiling, may help identify fingerprints for various types of long COVID. However, because of the complexity of long COVID and its diverse manifestations, which likely represent distinct mechanistic pathways, a single or even a panel of laboratory tests may not achieve high-enough performance. Sequela-specific approaches for biomarker discovery may also be productive 221 .

In addition to imaging modalities and biomarkers, harnessing health data from wearable biosensors and other sources may also be useful for diagnosis and to identify triggers and track disease activity.

Epidemiology and clinical course

Studies to understand the incidence, prevalence, severity and trajectory of long COVID over time are critical 35 , 36 , 232 , 233 . Comprehensive understanding of risk factors, including social determinants of health, genetic, environmental, dietary, health behavior (for example, smoking) and other risks of long COVID, is also important.

Research to identify the putative subtypes (or clusters of sequelae) of long COVID has yielded variable results thus far 234 , 235 , 236 , 237 ; greater clarity is needed on putative subtypes and how might they differ in terms of epidemiological features (for example, risk factors), clinical course and potential response to treatment.

Real-world evidence using high-quality data and advanced causal inference approaches (for example, target trial emulation) to evaluate effectiveness of therapeutic interventions will complement evidence generated by randomized trials 238 , 239 . This is particularly relevant in the evaluation of the long-term effects of therapeutic interventions and risks of rare adverse events; trials may have a relatively short follow-up, limiting assessment of long-term outcomes. Moreover, trials may not be adequately powered to detect rare adverse events.

Because long COVID is a new entity (it has been in existence for less than 5 years), longitudinal studies to characterize the long-term health trajectories of people with long COVID—up to 10 years, 20 years and 30 years—are needed, to understand rates and predictors of recovery and relapse of the various manifestations. These long-term studies will also help identify any latent consequences of the disease (that is, impacts that have not yet been realized) and secondary consequences (for example, the downstream health effects that emanate from long COVID). For example, understanding whether people with cognitive dysfunction (or brain fog) are at a higher risk of developing neurodegenerative diseases later in life is critical.

Comparative analyses to understand the post-acute and long-term health consequences of SARS-CoV-2 infection (and reinfection) versus other infections (for example, seasonal and pandemic influenza, respiratory syncytial virus infections and others) is important to enhance our understanding of similarities and differences in their epidemiology and clinical course 197 , 240 , 241 , 242 .

Quantifying the burden of NCDs attributable to long COVID would bring greater clarity to the extent to which billions of SARS-CoV-2 infections around the world may have impacted the global epidemiology of NCDs. The effects of long COVID on global health metrics, including SDGs, should also be periodically evaluated.

Trials to test therapeutics for long COVID

When it comes to clinical trials for long COVID therapeutics, innovation, urgency and scale are all needed 243 , 244 . Long COVID is a complex disease with many manifestations that are likely driven by several different biological mechanisms, and may need different therapeutic approaches. Approaches that reimagine trial design to incorporate the complexities of the disorder and meaningfully incorporate patient input—from trial inception to completion—are needed 244 , 245 . This may include large-scale platform trials with adaptive designs that would test a large battery of potential drug candidates to quickly identify treatments for the various forms of long COVID.

There is a large array of existing drugs that could be readily repurposed and clinically evaluated to address existing hypotheses from viral persistence to immune system dysfunction to vascular damage. Some of these drugs include SARS-CoV-2 antivirals, neutralizing monoclonal antibodies against SARS-CoV-2, non-SARS-CoV-2 antivirals (targeting reactivated EBV and VZV), immunomodulators (for example, JAK–STAT inhibitors, checkpoint inhibitors), anticoagulants, histamine 1 and 2 antagonists, metformin, GLP-1 receptor agonists, SGLT2 inhibitors, microbiome modulators, anti-inflammatory agents, and drugs that improve glymphatic functioning 2 , 62 , 246 . Research agendas must also include development of new antivirals and other new targeted drugs to prepare for the possibility that repurposed drugs may not be sufficiently effective 247 , 248 , 249 . Testing and evaluation of combinations of treatments should also be undertaken when evidence suggests complementary or synergistic mechanisms of action.

Innovation in developing and validating entry criteria and clinical endpoints for long COVID trials is also needed, along with cultivating support for these parameters from stakeholders, including regulators such as the US Food and Drug Administration and European Medicines Agency 250 . Endpoints must include newly developed or improved patient-reported outcomes specific to long COVID and should reflect the often cyclical or relapsing–remitting dynamic of many manifestations of long COVID—with particular focus on tracking post-exertional malaise, a pathophysiological state that impacts all collected data.

Care delivery and health systems research

Research—including comparative analyses—to evaluate the cost and effectiveness of various care pathways in improving quality of care and outcomes in people with long COVID is needed 121 , 127 , 251 . Research to identify and address health inequities and barriers to effective care, especially in low- and middle-income countries, in low-resource settings and in underserved communities, is essential 252 .

Economic impacts

The effect of long COVID on human capital 253 , labor participation, productivity losses (workforce absenteeism, presenteeism and disability) and other economic indicators (including job retention, career advancement and income instability) should be thoroughly evaluated. Research should explore potential disparities in the economic impact of long COVID across various demographic groups, including racial and ethnic minorities, urban and rural communities, socioeconomically marginalized populations, and individuals with preexisting health conditions.

In addition, studies are needed to quantify the direct healthcare costs associated with long COVID. The costs of disability and support systems required to address the needs of people with long COVID should be quantified. The strain that these costs pose on payors (insurance providers and governments) should also be evaluated.

Understanding the economic barriers to healthcare access and affordability for people with long COVID is also important. This includes evaluating out-of-pocket expenses, insurance coverage gaps, and disparities in access to care, rehabilitation services and support services.

Societal impacts

Long COVID affects individual lives and impacts societal well-being. Understanding the effects of long COVID on societies is important, along with understanding the social responses, the perceptions and the genesis and propagation of stigma. Improved knowledge of the social consequences of being affected by long COVID—for example, lost friendships, strained marriages and reduced ability to network—along with the interplay between them and health outcomes, will help to inform supportive interventions. It will also be important to evaluate the burden on caregivers, families and social groups.

Research to develop a deeper understanding of the causes and consequences of misinformation, disinformation and anti-science rhetoric (for example, long COVID denialism) and how to effectively combat them is also needed 254 . Identifying ways to improve science communication, scientific literacy and public trust in science and to bridge the science–policy gap would all help to improve public understanding, as well as the scientific and policy responses to long COVID 254 .

Medical anthropology should also contextualize the response of the science and medicine profession to long COVID within the broader history of medicine. This should include comparative analyses to evaluate and juxtapose the response to long COVID against the responses to the aftereffects of the 1889–1892 flu pandemic and the 1918 flu pandemic and other health crises, including the AIDS crisis in the 1980s 198 , 199 , 201 , 255 , 256 , 257 . Careful anthropologic analysis of how the medical profession approached long COVID as a new disease that emerged in the context of the COVID-19 pandemic is important. It will not only provide historic insights and greater context for our collective response, but also offer insights into how we can optimize responsiveness to emergence of new infection-associated diseases in the future.

Policy roadmap

Given the wide-ranging impact of long COVID on society and the inadequate response thus far, priorities for policy changes are vast. Policies are necessarily dependent on context, resources and various other considerations. The recommendations outlined below are general guidelines that may be adapted to fit the needs of various locales.

Prevention of long COVID

The best way to prevent long COVID is, plainly, to prevent SARS-CoV-2 infection or reinfection in the first place. Masking, especially in high-risk places 258 (for example, healthcare settings), is important—along with isolation guidelines and sick leave policies that permit people with infection to recuperate at home, thereby diminishing the probability of transmission and reducing the risk of long COVID 45 .

Although vaccines may reduce the risk of long COVID, vaccine policies in much of the world restrict vaccine availability to high-risk groups. These policies consider risks of death and hospitalization in the acute phase (which are manifest primarily in older adults and those with comorbidities) and ignore the risk of long COVID. Adding to these policy challenges are the low rates of vaccine uptake in 2023–2024 among eligible populations 259 . Vaccine policies must consider the risk of long COVID, as well as the risk of hospitalization and death during the acute phase of SARS-CoV-2 infection; and strategies to improve vaccine uptake (for example, pairing the COVID-19 vaccine with the annual influenza vaccine and other approaches) should be utilized to achieve wider vaccine coverage and greater protection to populations.

Because SARS-CoV-2 is likely to remain for decades to come, it is important to develop long-term, sustainable prevention solutions. Airborne transmission risk assessment tools, such as the one developed by the World Health Organization (WHO), help inform risk reduction strategies 260 . Ventilation and air filtration systems can play a major role in reducing the risk of infection with airborne pathogens 261 . Calls have been made for mandatory improved air quality standards for public spaces and policies that would support design and equipment of homes to meet these standards 261 . Investment in infrastructure supporting improved indoor air quality will help reduce the risk of SARS-CoV-2 transmission and other airborne pathogens and will ensure greater resilience against future threats from airborne pathogens 262 . Amelioration of indoor air quality also has the added benefit of reducing risk of health effects due to indoor air pollutants 263 , 264 , 265 , thereby improving human health, well-being, productivity and learning 261 , 262 , 266 . Investment in vaccine technologies to develop more durable, variant-proof vaccines that are not rendered ineffective by ongoing mutations of the SARS-CoV-2 virus are important. Vaccine technologies that induce strong mucosal immunity to block SARS-CoV-2 infection and transmission are also needed 267 .

Supporting people with long COVID

Because of the considerable impacts of long COVID on people’s ability to work and care for themselves, it is imperative that an adequate response to the long COVID crisis involves ensuring people have the financial, physical and emotional support 132 . Streamlining of disability benefit processes, as well as increased access to home and community-based services and food and cash assistance is critical. Workplace policies that support individuals with long COVID could include flexible working hours, increased breaks to allow for pacing, the option for remote work, and sick leave policies. Funding should be provided to support patient groups and community-based organizations, which can provide and connect people to critical supports and services.

Access, quality and equity of care

Governments must work to build and expand access to long COVID care, in particular for marginalized communities (for example, rural and indigenous communities). Improving access to care may take various forms in different countries, depending on the structure of the healthcare system and the involvement of national and local governments in financially supporting healthcare services. Adequate coverage of long COVID treatments and rehabilitation services by insurance providers is requisite. Development of quality-of-care metrics for long COVID and policies to monitor and incentivize quality of care should be pursued 121 . As diagnostics and treatments are developed, governments must also ensure equitable access. Shining historical examples include the Brazilian National AIDS Program, which was established in 1996 in response to the HIV/AIDS crisis to ensure free and universal provision of antiretroviral drugs 268 , 269 , and the Ryan White HIV/AIDS Program (based in the United States), which provides outpatient HIV care, treatment and support services to those without health insurance and fills gaps in coverage and cost for those with insurance limitations 270 , 271 , 272 .

Professional education and training

Currently, very few medical schools and health professional training programs include in their curricula any meaningful training about identification and clinical management of infection-associated chronic conditions, including long COVID. A survey of physicians in the United States showed that 78% agree that long COVID is a problem but only about one-quarter feel prepared to address it 273 . Training of healthcare professionals to recognize and manage long COVID effectively must be prioritized. This includes embedding up-to-date information on long COVID and infection-associated chronic conditions into training curricula for health professions, as well as providing regular high-quality continuing education to qualified health providers.

Public health communication

Existing public health education on long COVID has been minimal. A survey in the United States showed that one-third of American adults still had not heard of long COVID as of August 2023 (ref. 274 ), and there remains very low awareness of long COVID in low- and middle-income countries. Through public education campaigns, governments must raise awareness about long COVID and the risk of chronic conditions after infection; combat social stigma across adults and children; and use a harm reduction framework to promote awareness of prevention measures (including vaccination, masking and improved indoor air quality) 258 , 260 , 261 .

Supporting coordinated interdisciplinary research

To achieve the research priorities listed above, governments must substantially increase the amount of funding toward research. In the United States, existing calls for the establishment of a center for infection-associated chronic conditions at the US National Institutes of Health—with a funding request of at least $1 billion per year toward long COVID research and with additional substantial funding for other infection-associated chronic conditions—should be vigorously supported 275 . This proposal would create a coordinating entity to lead a long-term, large-scale interdisciplinary research portfolio to address long COVID research priorities. Other governments should also explore similar proposals.

Policies supporting research should explicitly mandate meaningful patient engagement in research from inception to implementation, and should leverage existing expertise (including scientific, clinical and lived experience) in infection-associated chronic conditions. Furthermore, meaningful efforts must be made to expand the pool of researchers working on infection-associated chronic conditions, by encouraging early career scientists and clinician–researchers to focus on these conditions and providing resources to current experts to lead training and research.

Given the complexity of long COVID and its similarities to other infection-associated chronic conditions, a coordinated approach that integrates research, policy and regulatory efforts across these conditions would reduce duplication of efforts and allow a more comprehensive understanding of the common underlying mechanisms, trial designs and potential treatment strategies.

Policies from funders are needed to mandate meaningful data sharing, which will maximize the utility and pooled insights that can be generated from existing health information. Current open data protocols are insufficient, laden with bureaucratic hurdles and do not allow access to primary data, and consequently do not enable meaningful analyses. Funders must establish data banks (a pioneering exemplar of this is the UK Biobank) for the collection, storage, analysis, retrieval and dissemination of data to make long COVID research more accessible in near real time, all while upholding data privacy and data security standards 276 , 277 .

Building consensus on definitions and clinical endpoints for long COVID

Various interim definitions of long COVID exist 39 , 278 , 279 , 280 , 281 , 282 , 283 , but there is not yet a universal consensus on the most optimal definition—which must be sufficiently nuanced to capture the complexity of the condition and its various manifestations. It is unlikely that a single definition will fit all needs. Consensus definitions that are optimized and empirically tested for various applications, including clinical care, epidemiological surveillance, and research, should be developed. Definitions must necessarily evolve to incorporate new understanding as the evidence base for long COVID grows.

Similarly, developing consensus on clinical endpoints for trials of long COVID is needed. Drug regulatory agencies in consultation with stakeholders, including patients and scientists, should lead in this arena and provide regulatory guidance on clinical endpoints for trials. These endpoints will also have to necessarily evolve as our understanding of long COVID expands.

Building consensus on definitions and clinical endpoints would catalyze progress in this field, remove barriers to entry for the pharmaceutical industry into long COVID trials and facilitate comparative analyses across studies.

Global coordination

The global nature of long COVID necessitates international cooperation in both research and policy. International bodies (for example, the WHO) should facilitate partnership and collaboration among countries across the globe. This collaboration is pivotal to coordinate and synergize efforts across the globe and accelerate progress on the different challenges posed by long COVID.

Professional societies for long COVID

Professional societies (national and global) should be established for long COVID. Because of the multisystemic nature of long COVID (and the other infection-associated chronic conditions), it does not fit neatly under any of the traditional organ-based organizational structures of medical care and research 284 , hence the need for professional home(s) for long COVID and associated conditions. Dedicated professional societies could provide strategic leadership and guidance in the clinical management of long COVID and associated conditions 284 . They could serve as hubs to coordinate education, research and advocacy efforts 284 . These professional societies could play a major role in organizing and hosting national and international conferences, spearheading efforts to provide periodic synthesis of evidence that distills existing research into actionable insights guiding care of people with long COVID. The newly established Clinical Post COVID Society in the United Kingdom may be a promising example of this 284 .

Preparedness for the next pandemic

We must reflect on our collective experience with COVID-19 to enhance resilience and preparedness for future pandemics 285 , 286 , 287 . A major lesson learned from long COVID is that pandemics leave in their wake a long tail of disease and disability 198 . This is not unique to the COVID-19 pandemic 198 ; historical accounts show similar phenomena following previous pandemics 198 , 199 , 255 . Due to climate change, deforestation, human encroachment on animal habitat, increased frequency of travel, a growing livestock industry and other anthropogenic factors, the risk of zoonotic spillover and novel viral sharing among species is likely higher in the twenty-first century than it was in the twentieth century 286 , 288 , 289 , 290 , 291 , 292 . Many of the geographic areas that are most prone to these changes are also projected to have high population density—creating ripe conditions for pandemics 289 , 291 . Future pandemics are likely to also produce long-term disability and disease 198 . Investment in systems to measure the population-level incidence and prevalence of post-acute and chronic disease caused by infectious agents, including SARS-CoV-2, will aid in the characterization of the epidemiology of long COVID and will position us to be better prepared to deal with post-acute and chronic illnesses that will emerge in future pandemics. Incorporating the potential emergence of long-term health effects into initiatives for pandemic preparedness and resilience (for example, the WHO Preparedness and Resilience for Emerging Threats Initiative) is essential to optimize response to the long-term consequences of future pandemics.

Conclusions

Considerable progress has been made in the past several years in characterizing the epidemiology, clinical course and biology of long COVID. But much remains to be done. The scale of long COVID and its far-reaching impacts necessitate a robust and coordinated research and policy response strategy. Addressing the research and care needs of people impacted by long COVID will have broad benefits, potentially unlocking a better understanding of infection-associated chronic illnesses (an ignored area for decades) and optimizing our preparedness for the next pandemic.

Al-Aly, Z., Xie, Y. & Bowe, B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 594 , 259–264 (2021).

Article   CAS   PubMed   Google Scholar  

Davis, H. E., McCorkell, L., Vogel, J. M. & Topol, E. J. Long COVID: major findings, mechanisms and recommendations. Nat. Rev. Microbiol. 21 , 133–146 (2023).

Article   CAS   PubMed   PubMed Central   Google Scholar  

Al-Aly, Z. & Topol, E. Solving the puzzle of Long COVID. Science 383 , 830–832 (2024).

Xie, Y., Xu, E., Bowe, B. & Al-Aly, Z. Long-term cardiovascular outcomes of COVID-19. Nat. Med. 28 , 583–590 (2022).

Xu, E., Xie, Y. & Al-Aly, Z. Long-term neurologic outcomes of COVID-19. Nat. Med. 28 , 2406–2415 (2022).

Xie, Y., Xu, E. & Al-Aly, Z. Risks of mental health outcomes in people with COVID-19: cohort study. Br. Med. J. 376 , e068993 (2022).

Article   Google Scholar  

Al-Aly, Z. & Rosen, C. J. Long COVID and impaired cognition - more evidence and more work to do. N. Engl. J. Med. 390 , 858–860 (2024).

Article   PubMed   PubMed Central   Google Scholar  

Kim, S. et al. Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan. Nat. Hum. Behav. https://doi.org/10.1038/s41562-024-01895-8 (2024).

Xie, Y. & Al-Aly, Z. Risks and burdens of incident diabetes in long COVID: a cohort study. Lancet Diabetes Endocrinol 10 , 311–321 (2022).

Xu, E., Xie, Y. & Al-Aly, Z. Risks and burdens of incident dyslipidaemia in long COVID: a cohort study. Lancet Diabetes Endocrinol. 11 , 120–128 (2023).

Bowe, B., Xie, Y., Xu, E. & Al-Aly, Z. Kidney outcomes in long COVID. J. Am. Soc. Nephrol. 32 , 2851–2862 (2021).

Yin, K. et al. Long COVID manifests with T cell dysregulation, inflammation and an uncoordinated adaptive immune response to SARS-CoV-2. Nat. Immunol. 25 , 218–225 (2024).

Peluso, M. J., Abdel-Mohsen, M., Henrich, T. J. & Roan, N. R. Systems analysis of innate and adaptive immunity in Long COVID. Semin. Immunol. 72 , 101873 (2024).

Pollack, B. et al. Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review. Front. Rehabil. Sci. 4 , 1122673 (2023).

Xu, E., Xie, Y. & Al-Aly, Z. Long-term gastrointestinal outcomes of COVID-19. Nat. Commun. 14 , 983 (2023).

Zimmermann, P., Pittet, L. F. & Curtis, N. How common is Long COVID in children and adolescents? Pediatr. Infect. Dis. J. 40 , e482–e487 (2021).

Rao, S. et al. Postacute sequelae of SARS-CoV-2 in children. Pediatrics 153 , e2023062570 (2024).

Article   PubMed   Google Scholar  

Gurdasani, D. et al. Long COVID in children. Lancet Child Adolesc. Health 6 , e2 (2022).

Mansell, V., Hall Dykgraaf, S., Kidd, M. & Goodyear-Smith, F. Long COVID and older people. Lancet Healthy Longev. 3 , e849–e854 (2022).

Fung, K. W., Baye, F., Baik, S. H., Zheng, Z. & McDonald, C. J. Prevalence and characteristics of long COVID in elderly patients: An observational cohort study of over 2 million adults in the US. PLoS Med. 20 , e1004194 (2023).

Xie, Y., Bowe, B. & Al-Aly, Z. Burdens of post-acute sequelae of COVID-19 by severity of acute infection, demographics and health status. Nat. Commun. 12 , 6571 (2021).

Blitshteyn, S. & Whitelaw, S. Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients. Immunol. Res. 69 , 205–211 (2021).

Volberding, P. A., Chu, B. X. & Spicer, C. M. Long-Term Health Effects of COVID-19 (The National Academies Press, 2024).

Choutka, J., Jansari, V., Hornig, M. & Iwasaki, A. Unexplained post-acute infection syndromes. Nat. Med. 28 , 911–923 (2022).

Marshall-Gradisnik, S. & Eaton-Fitch, N. Understanding myalgic encephalomyelitis. Science 377 , 1150–1151 (2022).

Komaroff, A. L. & Lipkin, W. I. ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature. Front. Med. 10 , 1187163 (2023).

Xie, Y., Choi, T. & Ziyad, A.-A. Postacute sequelae of SARS-CoV-2 infection in the pre-delta, delta, and omicron eras. N. Engl. J. Med . https://doi.org/10.1056/NEJMoa2403211 (2024).

Kuang, S. et al. Experiences of Canadians with long-term symptoms following COVID-19. Statistics Canada https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm (8 December 2023).

Bowe, B., Xie, Y. & Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat. Med. 28 , 2398–2405 (2022).

Bosworth, M. L. et al. Risk of new-onset long COVID following reinfection with severe acute respiratory syndrome coronavirus 2: a community-based cohort study. Open Forum Infect. Dis. 10 , ofad493 (2023).

Global Burden of Disease Long COVID Collaborators et al. Estimated global proportions of individuals with persistent fatigue, cognitive, and respiratory symptom clusters following symptomatic COVID-19 in 2020 and 2021. J. Am. Med. Assoc. 328 , 1604–1615 (2022).

Graham, F. Daily briefing: answers emerge about long COVID recovery. Nature https://doi.org/10.1038/d41586-023-02190-8 (2023).

Mateu, L. et al. Determinants of the onset and prognosis of the post-COVID-19 condition: a 2-year prospective observational cohort study. Lancet Reg. Health Eur. 33 , 100724 (2023).

Gutiérrez-Canales, L. G. et al. Persistence of COVID-19 symptoms and quality of life at three and twelve months after hospital discharge. Medicina 60 , 944 (2024).

Huang, L. et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet 398 , 747–758 (2021).

Zhang, H. et al. 3-year outcomes of discharged survivors of COVID-19 following the SARS-CoV-2 omicron (B.1.1.529) wave in 2022 in China: a longitudinal cohort study. Lancet Respir. Med. 12 , 55–66 (2024).

Bowe, B., Xie, Y. & Al-Aly, Z. Postacute sequelae of COVID-19 at 2 years. Nat. Med. 29 , 2347–2357 (2023).

Al-Aly, Z. Diabetes after SARS-CoV-2 infection. Lancet Diabetes Endocrinol. 11 , 11–13 (2023).

Fineberg, H. V., Brown, L., Worku, T. & Goldowitz, I. A Long COVID Definition (National Academies Press, 2024).

Taquet, M. 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 9 , 815–827 (2022).

Cai, M., Xie, Y., Topol, E. J. & Al-Aly, Z. Three-year outcomes of post-acute sequelae of COVID-19. Nat. Med. 30 , 1564–1573 (2024).

Davis, H. E. et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 38 , 101019 (2021).

Re’em, Y. et al. Factors associated with psychiatric outcomes and coping in Long COVID. Nat. Ment. Health 1 , 361–372 (2023).

Re’em, Y., Symeonides, M. & McCorkell, L. Serology test results and other important characteristics of patients with persistent COVID-19 symptoms. JAMA Intern. Med. 182 , 576–577 (2022).

Ziauddeen, N. et al. Characteristics and impact of Long Covid: findings from an online survey. PLoS ONE 17 , e0264331 (2022).

O’Brien, K. K. et al. Conceptualising the episodic nature of disability among adults living with Long COVID: a qualitative study. BMJ Glob. Health 8 , e011276 (2023).

Blitshteyn, S. & Verduzco-Gutierrez, M. Long COVID: a major public health issue. Am. J. Phys. Med. Rehabil. https://doi.org/10.1097/PHM.0000000000002486 (2024).

Ledford, H. How common is long COVID? Why studies give different answers. Nature 606 , 852–853 (2022).

Woodrow, M. et al. Systematic review of the prevalence of Long COVID. Open Forum Infect. Dis. 10 , ofad233 (2023).

Adjaye-Gbewonyo, D., Vahratian, A., Perrine, C. G. & Bertolli, J. Long COVID in adults: United States, 2022. NCHS Data Brief 480 , 1–8 (2023).

Google Scholar  

Vahratian, A., Adjaye-Gbewonyo, D., Lin, J. S. & Saydah, S. Long COVID in children: United States, 2022. NCHS Data Brief 479 , 1–6 (2023).

Fang, Z., Ahrnsbrak, R. & Rekito, A. Evidence mounts that about 7% of US adults have had long COVID. J. Am. Med. Assoc 332 , 5–6 (2024).

National Center for Health Statistics. Long COVID: Household Pulse Survey. CDC https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm (accessed 1 July 2024).

UK Office of National Statistics. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 30 March 2023. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/30march2023/ (30 March 2023).

COVID-19 Cumulative Infection Collaborators. Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis. Lancet 399 , 2351–2380 (2022).

GBD 2021 Demographics Collaborators. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 403 , 1989–2056 (2024).

GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 403 , 2100–2132 (2024).

GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 403 , 2133–2161 (2024).

GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 403 , 2162–2203 (2024).

Antonelli, M., Pujol, J. C., Spector, T. D., Ourselin, S. & Steves, C. J. Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2. Lancet 399 , 2263–2264 (2022).

Ma, Y. et al. Long-term consequences of asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis. Int. J. Environ. Res. Public Health 20 , 1613 (2023).

Altmann, D. M., Whettlock, E. M., Liu, S., Arachchillage, D. J. & Boyton, R. J. The immunology of long COVID. Nat. Rev. Immunol. 23 , 618–634 (2023).

Proal, A. D. et al. SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC). Nat. Immunol. 24 , 1616–1627 (2023).

Fernández-Castañeda, A. et al. Mild respiratory COVID can cause multi-lineage neural cell and myelin dysregulation. Cell 185 , 2452–2468 (2022).

Appelman, B. et al. Muscle abnormalities worsen after post-exertional malaise in Long COVID. Nat. Commun. 15 , 17 (2024).

Klein, J. et al. Distinguishing features of long COVID identified through immune profiling. Nature 623 , 139–148 (2023).

Cervia-Hasler, C. et al. Persistent complement dysregulation with signs of thromboinflammation in active Long COVID. Science 383 , eadg7942 (2024).

Eberhardt, N. et al. SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels. Nat. Cardiovas. Res. 2 , 899–916 (2023).

Guarnieri, J. W. et al. Core mitochondrial genes are down-regulated during SARS-CoV-2 infection of rodent and human hosts. Sci. Transl. Med. 15 , eabq1533 (2023).

Ghafari, M. et al. Prevalence of persistent SARS-CoV-2 in a large community surveillance study. Nature 626 , 1094–1101 (2024).

Peluso, M. J. et al. Plasma-based antigen persistence in the post-acute phase of COVID-19. Lancet Infect. Dis. 24 , e345–e347 (2024).

Zuo, W. et al. The persistence of SARS-CoV-2 in tissues and its association with long COVID symptoms: a cross-sectional cohort study in China. Lancet Infect. Dis. https://doi.org/10.1016/S1473-3099(24)00171-3 (2024).

Menezes, S. M. et al. Blood transcriptomic analyses reveal persistent SARS-CoV-2 RNA and candidate biomarkers in post-COVID-19 condition. Lancet Microbe https://doi.org/10.1016/S2666-5247(24)00055-7 (2024).

Stein, S. R. et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature 612 , 758–763 (2022).

Martínez-Mármol, R. et al. SARS-CoV-2 infection and viral fusogens cause neuronal and glial fusion that compromises neuronal activity. Sci. Adv. 9 , eadg2248 (2023).

Petersen, M. et al. Brain imaging and neuropsychological assessment of individuals recovered from a mild to moderate SARS-CoV-2 infection. Proc. Natl Acad. Sci. USA 120 , e2217232120 (2023).

Monje, M. & Iwasaki, A. The neurobiology of long COVID. Neuron 110 , 3484–3496 (2022).

Douaud, G. et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature 604 , 697–707 (2022).

Greene, C. et al. Blood-brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment. Nat. Neurosci. 27 , 421–432 (2024).

Su, Y. et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 185 , 881–895 (2022).

Chang, R. et al. Risk of autoimmune diseases in patients with COVID-19: a retrospective cohort study. EClinicalMedicine 56 , 101783 (2023).

Santos Guedes de Sa, K. et al. A causal link between autoantibodies and neurological symptoms in long COVID. Preprint at medRxiv https://doi.org/10.1101/2024.06.18.24309100 (2024).

Chen, H. -J. et al. Transfer of IgG from Long COVID patients induces symptomology in mice. Preprint at bioRxiv https://doi.org/10.1101/2024.05.30.596590 (2024).

Turner, S. et al. Long COVID: pathophysiological factors and abnormalities of coagulation. Trends Endocrinol. Metab. 34 , 321–344 (2023).

Wong, A. C. et al. Serotonin reduction in post-acute sequelae of viral infection. Cell 186 , 4851–4867 (2023).

Català, M. et al. The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia. Lancet Respir. Med. 12 , 225–236 (2024).

Trinh, N. T. et al. Effectiveness of COVID-19 vaccines to prevent long COVID: data from Norway. Lancet Respir. Med. 12 , e33–e34 (2024).

Lundberg-Morris, L. et al. COVID-19 vaccine effectiveness against post-COVID-19 condition among 589,722 individuals in Sweden: population based cohort study. Br. Med. J. 383 , e076990 (2023).

Marra, A. R. et al. The effectiveness of COVID-19 vaccine in the prevention of post-COVID conditions: a systematic literature review and meta-analysis of the latest research. Antimicrob. Steward Healthc. Epidemiol. 3 , e168 (2023).

Atchison, C. J. et al. Long-term health impacts of COVID-19 among 242,712 adults in England. Nat. Commun. 14 , 6588 (2023).

Yousaf, A. R. et al. COVID-19 mRNA vaccination reduces the occurrence of post-COVID conditions in U.S. children aged 5-17 years following omicron SARS-CoV-2 infection, July 2021-September 2022. Open Forum Infect. Dis. 10 , ofad500.2466 (2023).

Article   PubMed Central   Google Scholar  

Xie, Y., Bowe, B. & Al-Aly, Z. Molnupiravir and risk of hospital admission or death in adults with COVID-19: emulation of a randomized target trial using electronic health records. Br. Med. J. 380 , e072705 (2023).

Xie, Y., Bowe, B. & Al-Aly, Z. Nirmatrelvir and risk of hospital admission or death in adults with covid-19: emulation of a randomized target trial using electronic health records. Br. Med. J. 381 , e073312 (2023).

Gottlieb, R. L. et al. Early remdesivir to prevent progression to severe COVID-19 in outpatients. N. Engl. J. Med. 386 , 305–315 (2022).

Xie, Y., Choi, T. & Al-Aly, Z. Molnupiravir and risk of post-acute sequelae of COVID-19: cohort study. Br. Med. J. 381 , e074572 (2023).

Xie, Y., Choi, T. & Al-Aly, Z. Association of treatment with nirmatrelvir and the risk of post-COVID-19 condition. JAMA Intern. Med. 183 , 554–564 (2023).

Fung, K. W., Baye, F., Baik, S. H. & McDonald, C. J. Nirmatrelvir and molnupiravir and post–COVID-19 condition in older patients. JAMA Intern. Med. 183 , 1404–1406 (2023).

Hammond, J. et al. Nirmatrelvir for vaccinated or unvaccinated adult outpatients with COVID-19. N. Engl. J. Med. 390 , 1186–1195 (2024).

Jiang, X. et al. Structure-based development and preclinical evaluation of the SARS-CoV-2 3C-like protease inhibitor simnotrelvir. Nat. Commun. 14 , 6463 (2023).

Cao, B. et al. Oral simnotrelvir for adult patients with mild-to-moderate COVID-19. N. Engl. J. Med. 390 , 230–241 (2024).

Antar, A. A. R. & Peluso, M. J. CROI 2023: acute and post-acute COVID-19. Top. Antivir. Med 31 , 493–509 (2023).

PubMed   PubMed Central   Google Scholar  

Yotsuyanagi, H. et al. Prevention of post COVID-19 condition by early treatment with ensitrelvir in the phase 3 SCORPIO-SR trial. Antiviral Res. 229 , 105958 (2024).

Bramante, C. T. et al. Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial. Lancet Infect. Dis. 23 , 1119–1129 (2023).

Lau, R. I. et al. A synbiotic preparation (SIM01) for post-acute COVID-19 syndrome in Hong Kong (RECOVERY): a randomised, double-blind, placebo-controlled trial. Lancet Infect. Dis. 24 , 256–265 (2024).

Geng, L. N. et al. Nirmatrelvir-ritonavir and symptoms in adults with postacute sequelae of SARS-CoV-2 infection: the STOP-PASC randomized clinical trial. JAMA Intern. Med. 7 , e242007 (2024).

Maley, J. H. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 14 , 77–95 (2022).

Whiteson, J. H. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of cardiovascular complications in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 14 , 855–878 (2022).

Herrera, J. E. et al. Response to letter to the editor regarding ‘multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of fatigue in patients with post-acute sequelae of SARS-CoV-2 infection (PASC)’. PM R. 13 , 1439–1440 (2021).

Fine, J. S. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 14 , 96–111 (2022).

Blitshteyn, S. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of autonomic dysfunction in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 14 , 1270–1291 (2022).

Raj, S. R. et al. Canadian Cardiovascular Society Position Statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Can. J. Cardiol. 36 , 357–372 (2020).

Espinosa-Gonzalez, A. B. et al. Orthostatic tachycardia after COVID-19. Br. Med. J. 380 , e073488 (2023).

Fedorowski, A. et al. Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden. Nat. Rev. Cardiol. 21 , 379–395 (2024).

Fedorowski, A. & Sutton, R. Autonomic dysfunction and postural orthostatic tachycardia syndrome in post-acute COVID-19 syndrome. Nat. Rev. Cardiol. 20 , 281–282 (2023).

Cheng, A. L. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 15 , 1588–1604 (2023).

Melamed, E. et al. Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of neurologic sequelae in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 15 , 640–662 (2023).

Malone, L. A. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of postacute sequelae of SARS-CoV-2 infection (PASC) in children and adolescents. PM R. 14 , 1241–1269 (2022).

Greenhalgh, T. & Knight, M. Long COVID: a primer for family physicians. Am. Fam. Physician 102 , 716–717 (2020).

PubMed   Google Scholar  

Greenhalgh, T., Sivan, M., Delaney, B., Evans, R. & Milne, R. Long COVID—an update for primary care. Br. Med. J. 378 , e072117 (2022).

Palacio, A., Bast, E., Klimas, N. & Tamariz, L. Lessons learned in implementing a multidisciplinary long COVID clinic. Am. J. Med. https://doi.org/10.1016/j.amjmed.2024.05.020 (2024).

Greenhalgh, T., Darbyshire, J. L., Lee, C., Ladds, E. & Ceolta-Smith, J. What is quality in long covid care? Lessons from a national quality improvement collaborative and multi-site ethnography. BMC Med. 22 , 159 (2024).

Sunkersing, D. et al. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 14 , e080967 (2024).

Heightman, M. et al. Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals. BMJ Open Respir. Res. 8 , e001041 (2021).

Clutterbuck, D. et al. Barriers to healthcare access and experiences of stigma: Findings from a coproduced Long Covid case-finding study. Health Expect. 27 , e14037 (2024).

Routen, A. et al. Understanding and tracking the impact of long COVID in the United Kingdom. Nat. Med. 28 , 11–15 (2022).

Ledford, H. Long COVID is a double curse in low-income nations - here’s why. Nature 625 , 20–22 (2024).

Chou, R. et al. Long COVID definitions and models of care: a scoping review. Ann. Intern. Med. https://doi.org/10.7326/M24-0677 (2024).

Turk, F. et al. Pathways to care for Long COVID and for long-term conditions from patients’ and clinicians’ perspective. J. Evid. Based Med. 16 , 435–437 (2023).

Kwon, J. et al. Impact of Long COVID on productivity and informal caregiving. Eur. J. Health. Econ. https://doi.org/10.1007/s10198-023-01653-z (2023).

O’Mahony, L. et al. Impact of Long COVID on health and quality of life. HRB Open Res 5 , 31 (2022).

Karpman, M. et al. Employment and material hardship among adults with long COVID in December 2022. Urban Institute https://www.urban.org/sites/default/files/2023-07/Employment%20and%20Material%20Hardship%20among%20Adults%20with%20Long%20COVID%20in%20December%202022.pdf (July 2023).

McNabb, K. C. et al. ‘It was almost like it’s set up for people to fail’ A qualitative analysis of experiences and unmet supportive needs of people with Long COVID. BMC Public Health 23 , 2131 (2023).

Hossain, M. M. et al. Living with ‘long COVID’: a systematic review and meta-synthesis of qualitative evidence. PLoS ONE 18 , e0281884 (2023).

Au, L., Capotescu, C., Eyal, G. & Finestone, G. Long COVID and medical gaslighting: dismissal, delayed diagnosis, and deferred treatment. SSM Qual. Res. Health 2 , 100167 (2022).

Nalbandian, A. et al. Post-acute COVID-19 syndrome. Nat. Med. 27 , 601–615 (2021).

Al-Aly, Z., Agarwal, A., Alwan, N. & Luyckx, V. A. Long COVID: long-term health outcomes and implications for policy and research. Nat. Rev. Nephrol. 19 , 1–2 (2023).

Katz, G. M. et al. Understanding how post–COVID-19 condition affects adults and health care systems. JAMA Health Forum 4 , e231933 (2023).

Karpman, M., Zuckerman, S. & Morriss, S. Health care access and affordability among US adults aged 18 to 64 years with self-reported post-COVID-19 condition. JAMA Netw. Open 6 , e237455 (2023).

Jassat, W. et al. Long COVID in low-income and middle-income countries: the hidden public health crisis. Lancet 402 , 1115–1117 (2023).

Menges, D. et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: a population-based cohort study. PLoS ONE 16 , e0254523 (2021).

Greenhalgh, T., Knight, M., A’Court, C., Buxton, M. & Husain, L. Management of post-acute COVID-19 in primary care. Br. Med. J. 370 , m3026 (2020).

Bull-Otterson, L. et al. Post–COVID conditions among adult COVID-19 survivors aged 18–64 and ≥65 years—United States, March 2020–November 2021. MMWR Morb. Mortal. Wkly Rep. 71 , 713–717 (2022).

Article   CAS   PubMed Central   Google Scholar  

Barrett, C. E. et al. Risk for newly diagnosed diabetes >30 days after SARS-CoV-2 infection among persons aged <18 years—United States, March 2020–June 2021. MMWR Morb. Mortal. Wkly Rep . 71 , 59–65 (2022).

Zhang, T. et al. Risk for newly diagnosed diabetes after COVID-19: a systematic review and meta-analysis. BMC Med. 20 , 444 (2022).

Koyama, A. K. et al. Risk of cardiovascular disease after COVID-19 diagnosis among adults with and without diabetes. J. Am. Heart Assoc. 12 , e029696 (2023).

Wang, W., Wang, C. -Y., Wang, S. -I. & Wei, J. C. -C. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: a retrospective cohort study from the TriNetX US collaborative networks. EClinicalMedicine 53 , 101619 (2022).

Ayoubkhani, D. et al. Post-Covid syndrome in individuals admitted to hospital with COVID-19: retrospective cohort study. Br. Med. J. 372 , n693 (2021).

Lawson, C. A. et al. Long COVID and cardiovascular disease: a prospective cohort study. Open Heart 11 , e002662 (2024).

Roca-Fernandez, A. et al. Cardiac abnormalities in Long COVID 1-year post-SARS-CoV-2 infection. Open Heart 10 , e002241 (2023).

Dennis, A. et al. Multi-organ impairment and long COVID: a 1-year prospective, longitudinal cohort study. J. R. Soc. Med 116 , 97–112 (2023).

O’Mahoney, L. L. et al. The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: a systematic review and meta-analysis. EClinicalMedicine 55 , 101762 (2023).

Al-Aly, Z. & Cao, B. The enduring effect of the COVID-19 pandemic on diabetes. Lancet Diabetes Endocrinol. 12 , 508–510 (2024).

Rhead, R. et al. Long COVID and financial outcomes: evidence from four longitudinal population surveys. J. Epidemiol. Community Health 78 , 458–465 (2024).

Cutler, D. M. The costs of long COVID. JAMA Health Forum 3 , e221809 (2022).

Cutler, D. The economic cost of long COVID: an update. Harvard Kennedy School https://scholar.harvard.edu/sites/scholar.harvard.edu/files/cutler/files/long_covid_update_7-22.pdf (2022).

Reuschke, D. & Houston, D. The impact of Long COVID on the UK workforce. Appl. Econ. Lett. 30 , 2510–2514 (2023).

Gandjour, A. Long COVID: costs for the German economy and health care and pension system. BMC Health Serv. Res. 23 , 641 (2023).

Alexandri, E. et al. The economic burden of Long Covid in the UK. Cambridge Econometric s https://www.camecon.com/wp-content/uploads/2024/03/The-Economic-Burden-of-Long-Covid-in-the-UK_Cambridge-Econometrics_March2024.pdf (March 2024).

Fischer, K., Reade, J. J. & Schmal, W. B. What cannot be cured must be endured: the long-lasting effect of a COVID-19 infection on workplace productivity. Labour Econ. 79 , 102281 (2022).

Wolff Sagy, Y., Feldhamer, I., Brammli-Greenberg, S. & Lavie, G. Estimating the economic burden of long-COVID: the additive cost of healthcare utilisation among COVID-19 recoverees in Israel. BMJ Glob. Health 8 , e012588 (2023).

Ziauddeen, N., Pantelic, M., O’Hara, M. E., Hastie, C. & Alwan, N. A. Impact of long COVID-19 on work: a co-produced survey. Lancet 402 , S98 (2023).

Perlis, R. H. et al. Association of post–COVID-19 condition symptoms and employment status. JAMA Netw. Open 6 , e2256152 (2023).

Ayoubkhani, D. et al. Employment outcomes of people with Long Covid symptoms: community-based cohort study. Eur. J. Public Health 34 , 489–496 (2024).

Packard, S. E. & Susser, E. Association of long COVID with housing insecurity in the United States, 2022–2023. SSM Popul. Health 25 , 101586 (2024).

Bach, K. New data shows Long COVID is keeping as many as 4 million people out of work. Brookings https://www.brookings.edu/articles/new-data-shows-long-covid-is-keeping-as-many-as-4-million-people-out-of-work/ (24 August 2022).

Ham, D. Long-haulers and labor market outcomes. Federal Reserve Bank of Minneapolis https://www.minneapolisfed.org/research/institute-working-papers/long-haulers-and-labor-market-outcomes (7 July 2022).

Trades Union Congress. Workers’ experiences of Long Covid. A TUC report. TUC https://www.tuc.org.uk/research-analysis/reports/workers-experience-long-covid (27 March 2023).

Ramos, S. C., Maldonado, J. E., Vandeplas, A & Ványolós, I. Long COVID: a tentative assessment of its impact on labour market participation and potential economic effects in the EU. In ECONOMIC BRIEF 077 (European Commission Directorate-General for Economic and Financial Affairs, 2024).

Gonzalez, A. E. & Suzuki, E. The impacts of long COVID across OECD countries. OECD Health Working Papers 167 (OECD Publishing, 2024).

Baxa, M. An incomplete picture: understanding the burden of long COVID. The Economist Impact https://impact.economist.com/perspectives/sites/default/files/download/ei264_-_an_incomplete_picture_understanding_the_burden_of_long_covid_v8.pdf (29 April 2024).

Yuan, H. et al. Progress towards the Sustainable Development Goals has been slowed by indirect effects of the COVID-19 pandemic. Commun. Earth Environ. 4 , 184 (2023).

Luyckx, V. A. et al. Sustainable Development Goals relevant to kidney health: an update on progress. Nat. Rev. Nephrol. 17 , 15–32 (2021).

Azar, K. M. J. et al. Disparities in outcomes among COVID-19 patients in a large health care system in California. Health Aff. 39 , 1253–1262 (2020).

Martín-Blanco, C., Zamorano, M., Lizárraga, C. & Molina-Moreno, V. The impact of COVID-19 on the Sustainable Development Goals: achievements and expectations. Int. J. Environ. Res. Public Health 19 , 16266 (2022).

Shuai, C. et al. Quantifying the impacts of COVID-19 on Sustainable Development Goals using machine learning models. Fundam. Res. https://doi.org/10.1016/j.fmre.2022.06.016 (2022).

Luyckx, V. A. & Al-Aly, Z. Impact of COVID-19 on the Sustainable Development Agenda and Global Kidney Health. J. Am. Soc. Nephrol. 34 , 941–943 (2023).

Ameli, M., Shams Esfandabadi, Z., Sadeghi, S., Ranjbari, M. & Zanetti, M. C. COVID-19 and Sustainable Development Goals (SDGs): scenario analysis through fuzzy cognitive map modeling. Gondwana Res. 114 , 138–155 (2023).

Zhang, S., Anser, M. K., Yao-Ping Peng, M. & Chen, C. Visualizing the sustainable development goals and natural resource utilization for green economic recovery after COVID-19 pandemic. Resour. Policy 80 , 103182 (2023).

Zhao, W. et al. Achieving the Sustainable Development Goals in the post-pandemic era. Humanit. Soc. Sci. Commun. 9 , 258 (2022).

Lukkahatai, N., Rodney, T., Ling, C., Daniel, B. & Han, H. R. Long COVID in the context of social determinants of health. Front. Public Health 11 , 1098443 (2023).

Berger, Z., Altiery, D. E. J. V., Assoumou, S. A. & Greenhalgh, T. Long COVID and health inequities: the role of primary care. Milbank Q 99 , 519–541 (2021).

Perry, B. L., Aronson, B. & Pescosolido, B. A. Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland. Proc. Natl Acad. Sci. USA 118 , e2020685118 (2021).

Devoto, S. A. Long COVID and chronic pain: overlapping racial inequalities. Disabil. Soc. 38 , 524–529 (2023).

Al-Aly, Z. Prevention of long COVID: progress and challenges. Lancet Infect. Dis. 23 , 776–777 (2023).

Au, L., Capotescu, C., Curi, A., Gonçalves Leonel da Silva, R. & Eyal, G. Long COVID requires a global response centred on equity and dialogue. Glob. Health Action 16 , 2244757 (2023).

McCorkell, L., Assaf, G, S., Davis, H, E., Wei, H. & Akrami, A. Patient-led research collaborative: embedding patients in the Long COVID narrative. Pain Rep. 6 , e913 (2021).

Alwan, N. A. The road to addressing Long Covid. Science 373 , 491–493 (2021).

Couzin-Frankel, J. & Vogel, G. Vaccines may cause rare, Long Covid-like symptoms. Science 375 , 364–366 (2022).

Hofer, U. Animal model of long COVID? Nat. Rev. Microbiol. 20 , 446 (2022).

Silva, J. et al. Sex differences in symptomatology and immune profiles of Long COVID. Preprint at medRxiv https://doi.org/10.1101/2024.02.29.24303568 (2024).

Lammi, V. et al. Genome-wide association study of Long COVID. Preprint at medRxiv https://doi.org/10.1101/2023.06.29.23292056 (2023).

Lee, Y. et al. EWAS of post-COVID-19 patients shows methylation differences in the immune-response associated gene, IFI44L , three months after COVID-19 infection. Sci. Rep. 12 , 11478 (2022).

Ozturkler, Z. & Kalkan, R. A new perspective of COVID-19 infection: an epigenetics point of view. Glob. Med. Genet. 9 , 4–6 (2022).

Wang, R. et al. SARS-CoV-2 restructures host chromatin architecture. Nat. Microbiol. 8 , 679–694 (2023).

Gatmaitan, B. G., Chason, J. L. & Lerner, A. M. Augmentation of the virulence of murine coxsackie-virus B-3 myocardiopathy by exercise. J. Exp. Med. 131 , 1121–1136 (1970).

van Rhijn-Brouwer, F. C. C. et al. Graded exercise therapy should not be recommended for patients with post-exertional malaise. Nat. Rev. Cardiol. 21 , 430–431 (2024).

Xie, Y., Choi, T. & Al-Aly, Z. Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study. Lancet Infect. Dis. 24 , 239–255 (2024).

Spinney, L. Pandemics disable people—the history lesson that policymakers ignore. Nature 602 , 383–385 (2022).

Spinney, L. Pale Rider: The Spanish Flu of 1918 and How it Changed the World (PublicAffairs, 2017).

Bjornevik, K. et al. Longitudinal analysis reveals high prevalence of Epstein–Barr virus associated with multiple sclerosis. Science 375 , 296–301 (2022).

Stefano, G. B. Historical insight into infections and disorders associated with neurological and psychiatric sequelae similar to Long COVID. Med. Sci. Monit. 27 , e931447 (2021).

Vahratian A., Lin, J. -M. S., Bertolli J. & Unger E. R. Myalgic encephalomyelitis/chronic fatigue syndrome in adults: United States, 2021–2022. NCHS Data Brief 488 , 1–6 (2023).

Komaroff, A. L. Advances in understanding the pathophysiology of chronic fatigue syndrome. J. Am. Med. Assoc. 322 , 499–500 (2019).

Paul, B. D., Lemle, M. D., Komaroff, A. L. & Snyder, S. H. Redox imbalance links COVID-19 and myalgic encephalomyelitis/chronic fatigue syndrome. Proc. Natl Acad. Sci. USA 118 , e2024358118 (2021).

Steiner, S. et al. Understanding, diagnosing, and treating myalgic encephalomyelitis/chronic fatigue syndrome - state of the art: Report of the 2nd International Meeting at the Charite Fatigue Center. Autoimmun. Rev. 22 , 103452 (2023).

Arron, H. E. et al. Myalgic encephalomyelitis/chronic fatigue syndrome: the biology of a neglected disease. Front. Immunol. 15 , 1386607 (2024).

Goldenberg, D. L. How to understand the overlap of long COVID, chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia and irritable bowel syndromes. Semin. Arthritis Rheum. 67 , 152455 (2024).

Arun, S., Storan, A. & Myers, B. Mast cell activation syndrome and the link with long COVID. Br. J. Hosp. Med. 83 , 1–10 (2022).

Salvucci, F. et al. Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation. Front. Cardiovasc. Med. 10 , 1202696 (2023).

Sumantri, S. & Rengganis, I. Immunological dysfunction and mast cell activation syndrome in long COVID. Asia Pac. Allergy 13 , 50–53 (2023).

Weinstock, L. B. et al. Mast cell activation symptoms are prevalent in Long-COVID. Int. J. Infect. Dis. 112 , 217–226 (2021).

Chadda, K. R., Blakey, E. E., Huang, C. L. & Jeevaratnam, K. Long COVID-19 and postural orthostatic tachycardia syndrome—is dysautonomia to be blamed? Front. Cardiovasc. Med. 9 , 860198 (2022).

Finsterer, J. Small fiber neuropathy underlying dysautonomia in COVID-19 and in post-SARS-CoV-2 vaccination and long-COVID syndromes. Muscle Nerve 65 , E31–E32 (2022).

Margalit, I. & Yahav, D. The potential role of vagus nerve dysfunction and dysautonomia in long COVID. Clin. Microbiol. Infect. 30 , 423–427 (2024).

Grist, J. T. et al. Lung abnormalities detected with hyperpolarized 129Xe MRI in patients with long COVID. Radiology 305 , 709–717 (2022).

Garcia-Hernandez, R. et al. Mapping microglia and astrocyte activation in vivo using diffusion MRI. Sci. Adv. 8 , eabq2923 (2022).

Jacob, L. et al. Conserved meningeal lymphatic drainage circuits in mice and humans. J. Exp. Med. 219 , e20220035 (2022).

Ajčević, M. et al. Cerebral hypoperfusion in post-COVID-19 cognitively impaired subjects revealed by arterial spin labeling MRI. Sci. Rep. 13 , 5808 (2023).

Turner, S., Laubscher, G. J., Khan, M. A., Kell, D. B. & Pretorius, E. Accelerating discovery: a novel flow cytometric method for detecting fibrin(ogen) amyloid microclots using long COVID as a model. Heliyon 9 , e19605 (2023).

Peluso, M. J. et al. Tissue-based T cell activation and viral RNA persist for up to 2 years after SARS-CoV-2 infection. Sci. Transl. Med. 16 , eadk3295 (2024).

Espín, E. et al. Cellular and molecular biomarkers of long COVID: a scoping review. eBioMedicine 91 , 104552 (2023).

Lai, Y. J. et al. Biomarkers in long COVID-19: a systematic review. Front. Med. 10 , 1085988 (2023).

Su, Y. et al. Multi-omics resolves a sharp disease-state shift between mild and moderate COVID-19. Cell 183 , 1479–1495 (2020).

Li, H. et al. Plasma proteomic and metabolomic characterization of COVID-19 survivors 6 months after discharge. Cell Death Dis. 13 , 235 (2022).

Rusu, E. C. et al. Towards understanding post-COVID-19 condition: a systematic meta-analysis of transcriptomic alterations with sex-specific insights. Comput. Biol. Med. 175 , 108507 (2024).

Gu, X. et al. Probing long COVID through a proteomic lens: a comprehensive two-year longitudinal cohort study of hospitalised survivors. EBioMedicine 98 , 104851 (2023).

Iosef, C. et al. Plasma proteome of Long-COVID patients indicates HIF-mediated vasculo-proliferative disease with impact on brain and heart function. J. Transl. Med. 21 , 377 (2023).

Liang, X., Wang, Y. & Guo, T. Proteomics approaches to long COVID: status and outlooks. Life Med. 2 , 3 (2023).

Saito, S. et al. Metabolomic and immune alterations in long COVID patients with chronic fatigue syndrome. Front. Immunol. 15 , 1341843 (2024).

López-Hernández, Y. et al. Untargeted analysis in post-COVID-19 patients reveals dysregulated lipid pathways two years after recovery. Front. Mol. Biosci. 10 , 1100486 (2023).

Li, Z. et al. The causal role of gut microbiota in susceptibility of Long COVID: a Mendelian randomization study. Front. Microbiol. 15 , 1404673 (2024).

Huang, C. et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 397 , 220–232 (2021).

Al-Aly, Z. Long COVID and its cardiovascular implications: a call to action. Eur. Heart J. 44 , 5001–5003 (2023).

Thaweethai, T. et al. Development of a definition of postacute sequelae of SARS-CoV-2 infection. J. Am. Med. Assoc. 329 , 1934–1946 (2023).

Article   CAS   Google Scholar  

Reese, J. T. et al. Generalisable long COVID subtypes: findings from the NIH N3C and RECOVER programmes. eBioMedicine 87 , 104413 (2023).

Zhang, H. et al. Data-driven identification of post-acute SARS-CoV-2 infection subphenotypes. Nat. Med. 29 , 226–235 (2023).

Liew, F. et al. Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease. Nat. Immunol. 25 , 607–621 (2024).

Matthews, A. A., Danaei, G., Islam, N. & Kurth, T. Target trial emulation: applying principles of randomised trials to observational studies. Br. Med. J. 378 , e071108 (2022).

Hernán, M. A., Wang, W. & Leaf, D. E. Target trial emulation: a framework for causal inference from observational data. J. Am. Med. Assoc. 328 , 2446–2447 (2022).

Xie, Y., Bowe, B., Maddukuri, G. & Al-Aly, Z. Comparative evaluation of clinical manifestations and risk of death in patients admitted to hospital with COVID-19 and seasonal influenza: cohort study. Br. Med. J. 371 , m4677 (2020).

Xie, Y., Choi, T. & Al-Aly, Z. Risk of death in patients hospitalized for COVID-19 vs seasonal influenza in Fall-Winter 2022–2023. J. Am. Med. Assoc. 329 , 1697–1699 (2023).

Xie, Y., Choi, T. & Al-Aly, Z. Mortality in patients hospitalized for COVID-19 vs influenza in Fall-Winter 2023–2024. J. Am. Med. Assoc. 331 , 1963–1965 (2024).

The Lancet Infectious Diseases. Where are the long COVID trials? Lancet Infect. Dis. 23 , 879 (2023).

Fairbank, R. Long COVID still has no cure—so these patients are turning to research. Nature 628 , 26–28 (2024).

Alwan, N. A. Lessons from Long COVID: working with patients to design better research. Nat. Rev. Immunol. 22 , 201–202 (2022).

Loretelli, C. et al. PD-1 blockade counteracts post-COVID-19 immune abnormalities and stimulates the anti-SARS-CoV-2 immune response. JCI Insight 6 , e146701 (2021).

Service, R. F. Bad news for Paxlovid? Resistance may be coming. Science 377 , 138–139 (2022).

Iketani, S. et al. Multiple pathways for SARS-CoV-2 resistance to nirmatrelvir. Nature 613 , 558–564 (2023).

Duan, Y. et al. Molecular mechanisms of SARS-CoV-2 resistance to nirmatrelvir. Nature 622 , 376–382 (2023).

Buchholz, S., Di Meco, E., Balkowiec-Iskra, E. Z., Sepodes, B. & Cavaleri, M. Generating clinical evidence for treatment and prevention options for long COVID. Nat. Med. https://doi.org/10.1038/s41591-024-03031-5 (2024).

Mohamed, M. O. & Banerjee, A. Long COVID and cardiovascular disease: a learning health system approach. Nat. Rev. Cardiol. 19 , 287–288 (2022).

Alwan, N. A. et al. Long Covid active case finding study protocol: a co-produced community-based pilot within the STIMULATE-ICP study (symptoms, trajectory, inequalities and management: understanding Long-COVID to address and transform existing integrated care pathways). PLoS ONE 18 , e0284297 (2023).

Black, R. E. et al. Health and development from preconception to 20 years of age and human capital. Lancet 399 , 1730–1740 (2022).

Jin, S. L. et al. Social histories of public health misinformation and infodemics: case studies of four pandemics. Lancet Infect. Dis. https://doi.org/10.1016/S1473-3099(24)00105-1 (2024).

Ravenholt, R. T. & Foege, W. 1918 influenza, encephalitis lethargica, parkinsonism. Lancet 320 , 860–864 (1982).

Honigsbaum, M. & Krishnan, L. Taking pandemic sequelae seriously: from the Russian influenza to COVID-19 long-haulers. Lancet 396 , 1389–1391 (2020).

Dehner, G. Howard Phillips, in a time of plague: memories of the ‘Spanish’ flu epidemic of 1918 in South Africa. Soc. Hist. Med. 33 , 343–344 (2019).

Greenhalgh, T. et al. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin. Microbiol Rev. 37 , e0012423 (2024).

Etowa, J. et al. Understanding low vaccine uptake in the context of public health in high-income countries: a scoping review. Vaccines 12 , 269 (2024).

World Health Organization. Indoor airborne risk assessment in the context of SARS-CoV-2: description of airborne transmission mechanism and method to develop a new standardized model for risk assessment. https://iris.who.int/handle/10665/376346 (World Health Organization, 2024).

Morawska, L. et al. Mandating indoor air quality for public buildings. Science 383 , 1418–1420 (2024).

Lewis, D. Indoor air is full of flu and COVID viruses. Will countries clean it up? Nature 615 , 206–208 (2023).

Lunderberg, D. M. et al. Assessing residential PM 2.5 concentrations and infiltration factors with high spatiotemporal resolution using crowdsourced sensors. Proc. Natl Acad. Sci. USA 120 , e2308832120 (2023).

Grippo, A. et al. Indoor air pollution exposure and early childhood development in the Upstate KIDS Study. Environ. Res. 234 , 116528 (2023).

Lee, K. K. et al. Adverse health effects associated with household air pollution: a systematic review, meta-analysis, and burden estimation study. Lancet Glob. Health 8 , e1427–e1434 (2020).

Pulimeno, M., Piscitelli, P., Colazzo, S., Colao, A. & Miani, A. Indoor air quality at school and students’ performance: Recommendations of the UNESCO Chair on Health Education and Sustainable Development & the Italian Society of Environmental Medicine (SIMA). Health Promot. Perspect. 10 , 169–174 (2020).

Topol, E. J. & Iwasaki, A. Operation nasal vaccine—lightning speed to counter COVID-19. Sci. Immunol. 7 , eadd9947 (2022).

Nunn, A. The Politics and History of AIDS Treatment in Brazil (Springer, 2008).

Grangeiro, A. et al. Forty years of the Brazilian response to HIV: reflections on the need for a programmatic shift and policy as a common good. Cad. Saude Publica 39 , e00199423 (2023).

PubMed Central   Google Scholar  

Cheever, L. W., Rich, J. & Adashi, E. Y. The Ryan White HIV/AIDS Program: thirty years of addressing health disparities. J. Health Care Poor Underserved 35 , 726–730 (2024).

Goyal, R. et al. The health equity implications of the Health Resources and Services Administration’s Ryan White HIV/AIDS Program. AIDS 38 , 1025–1032 (2024).

Patel-Larson, A. et al. Looking back to see forward: multidirectional learning between the US Ryan White HIV/AIDS Program and the US President’s Emergency Plan for AIDS Relief. BMJ Glob. Health 8 , e013953 (2024).

de Beaumont Foundation. Poll: Physicians agree Long COVID is a problem but are unprepared to treat it. https://debeaumont.org/wp-content/uploads/2023/03/Long-COVID-Brief.pdf (2023).

National Center for Health Statistics Rapid Surveys System. Long COVID. https://www.cdc.gov/nchs/rss/round1/long-covid.html (accessed 1 July 2024).

Al-Aly, Z. Addressing Long COVID: Advancing Research and Improving Patient Care. US Senate Committee on Health, Education, Labor and Pensions https://www.help.senate.gov/download/al-aly-testimony?download=1 (18 January 2024).

Conroy, M. et al. The advantages of UK Biobank’s open-access strategy for health research. J. Intern. Med. 286 , 389–397 (2019).

Helzlsouer, K. J. & Reedy, J. Data sharing for the public good. J. Natl Cancer Inst. 112 , 867–868 (2020).

Soriano, J. B., Murthy, S., Marshall, J. C., Relan, P. & Diaz, J. V. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect. Dis. 22 , e102–e107 (2022).

US Centers for Disease Control. Long COVID or post-COVID conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/ (accessed 1 July 2024).

National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE https://www.nice.org.uk/guidance/ng188 (accessed 1 July 2024).

US Department of Health and Human Services, Office of the Assistant Secretary for Health. National Research Action Plan on Long COVID. covid.gov https://www.covid.gov/sites/default/files/documents/National-Research-Action-Plan-on-Long-COVID-08012022.pdf (August 2022).

Appel, K. S. et al. Definition of the Post-COVID syndrome using a symptom-based Post-COVID score in a prospective, multi-center, cross-sectoral cohort of the German National Pandemic Cohort Network (NAPKON). Infection https://doi.org/10.1007/s15010-024-02226-9 (2024).

Alwan, N. A. & Johnson, L. Defining long COVID: going back to the start. Med 2 , 501–504 (2021).

Sivan, M. & Heightman, M. A new professional society for post-COVID condition and other post-viral conditions. Adv. Rehabil. Sci. Pract . 13 , https://doi.org/10.1177/27536351241231351 (2024).

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Global Health; Forum on Microbial Threats. Toward a Post-Pandemic World: Lessons from COVID-19 for Now and the Future: Proceedings of a Workshop (National Academies Press, 2022).

To respond to the threat of avian influenza, look back at lessons learned from COVID-19. Nat. Med . 30 , 1507 (2024).

Sachs, J. D. et al. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 400 , 1224–1280 (2022).

Baker, R. E. et al. Infectious disease in an era of global change. Nat. Rev. Microbiol. 20 , 193–205 (2022).

de Oliveira, T. & Tegally, H. Will climate change amplify epidemics and give rise to pandemics? Science 381 , eadk4500 (2023).

Marani, M., Katul, G. G., Pan, W. K. & Parolari, A. J. Intensity and frequency of extreme novel epidemics. Proc. Natl Acad. Sci. USA 118 , e2105482118 (2021).

Carlson, C. J. et al. Climate change increases cross-species viral transmission risk. Nature 607 , 555–562 (2022).

Neumann, G. & Kawaoka, Y. Which virus will cause the next pandemic? Viruses 15 , 199 (2023).

Vastag, B. & Mazur, B. Researchers warn covid-19 could cause debilitating long-term illness in some patients. The Washington Post https://www.washingtonpost.com/health/could-covid-19-cause-long-term-chronic-fatigue-and-illness-in-some-patients/2020/05/29/bcd5edb2-a02c-11ea-b5c9-570a91917d8d_story.html (30 May 2020).

Lowenstein, F. We need to talk about what coronavirus recoveries look like. The New York Times https://www.nytimes.com/2020/04/13/opinion/coronavirus-recovery.html (13 April 2020).

Callard, F. & Perego, E. How and why patients made Long COVID. Soc. Sci. Med 268 , 113426 (2021).

Young, E. COVID-19 can last for several months. The Atlantic https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/ (4 June 2020).

Nemer, M. Post-COVID-19 condition in Canada: what we know, what we don’t know and a framework for action. Office of the Chief Science Advisor of Canada https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf (2022).

Duddy, C. et al. Coronavirus: long COVID. House of Commons Library https://researchbriefings.files.parliament.uk/documents/CBP-9112/CBP-9112.pdf (29 February 2024).

European Commission. Network of expertise on Long COVID. https://health.ec.europa.eu/non-communicable-diseases/expert-group-public-health/network-expertise-long-covid_en (accessed 26 June 2024).

Parliament of Australia. Sick and tired: casting a long shadow. https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report (April, 2023).

US Senate Committee on Health, Education, Labor, and Pensions. Chairman Bernie Sanders releases Long COVID moonshot legislative proposal. https://www.help.senate.gov/chair/newsroom/press/news-chairman-bernie-sanders-releases-long-covid-moonshot-legislative-proposal (9 April 2024).

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