The COVID-19 pandemic has affected the lives of most Americans.  The consequences on the future health of the nation are unknown but likely profound.  Well known is the condition known in the lay press as “Long Covid” which leads to persistent clusters of symptoms in a significant proportion of persons for prolonged periods after the acute infection.  These clusters are quite similar to those presented by persons suffering from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) for decades, some of whom identify an infectious-like illness as the trigger for their condition; ie., Lyme disease, infectious mononucleosis.  The underlying biology of Long Covid and ME/CFS is a mystery. The RECOVER Initiative was designed to launch a comprehensive program to identify the pathophysiologic basis of Post Acute Sequelae of COVID-19 and to test treatments that might reduce the suffering due to Long Covid as well as other future health complications of the pandemic.  RECOVER includes a large natural history study of good vs. poor recovery after COVID with a tiered series of successive investigations customized to the different symptom clusters.  In addition, RECOVER includes electronic health record studies with access to 60 million patient records, and an autopsy study to examine tissues in hundreds who have died of any cause in the months after infection.  RECOVER is also designing master protocols for treatments aimed at reducing symptoms as well as potential causative pathophysiologic processes such as persistent viral infection, autoimmunity, immune dysregulation etc.

Learning Objectives:

1. Discuss the spectrum of post-acute sequelae of COVID-19 infection.

2. Recognize the similarities between what is now termed “Long-Covid” and other post viral illnesses classified as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

3. Discuss  the NIH’s RECOVER Initiative to advance knowledge of the biologic basis of “Long Covid” and other sequelae of the pandemic.