Long COVID appears to carry a US adult disability burden comparable to Alzheimer’s disease and asthma while receiving less NIH funding than its burden would suggest.
Evidence
This population-based burden and funding analysis estimated Long COVID from Census Bureau survey prevalence and Global Burden of Disease disability weights, then compared FY2022-2024 NIH funding across 68 conditions.
Caveat
The analysis depends on survey-derived prevalence, assigned disability weights, and funding-to-YLD comparisons, which can show mismatch but not determine the optimal funding level for any condition.
Simplified
BACKGROUND: Five years since the scientific and patient communities first identified the syndrome now known as Long COVID, affected individuals lack treatments, and the US lacks population-based data on its disability burden and correlation with National Institutes of Health (NIH) funding. Moreover, akin to other debilitating conditions it often co-occurs with, e.g., Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia, Long COVID disproportionately impacts females whose concerns are often marginalized.
METHODS: We quantify Long COVID (YLDs= prevalence x disability weight) in US adults and its actual/YLD-commensurate average annual NIH FY2022-2024 funding versus 68 comparator conditions, by sex predominance. We derive Long COVID prevalence from Census Bureau surveys (9/2022-8/2023) and apply disability weights from the Global Burden of Disease Study.
RESULTS: Long COVID YLDs approximate those of Alzheimer's and Asthma. Long COVID received 14% of its disability commensurate funding: $106 million vs. $739.8 million. ME/CFS is the most under-funded condition, receiving <1% of its YLD proportionate funding. Among conditions analyzed, 24 are female-predominant (we estimate Long COVID funding two ways), 12 male-predominant, and 33 show no sex predominance. Among the 12 below-median funded/above-median YLD conditions, 7/12 are female-predominant, none are male-predominant. Median funding/per YLD is 5.2 times higher for male- vs. female-predominant conditions (7.0 vs 1.3 million per YLD, p = 0.007). Overall, YLDs explain 6.5% of funding variance in a linear regression model using YLD as the sole predictor (Adjusted R-squared: 0.065).
CONCLUSIONS: With chronic conditions like Long COVID rising, disability burden merits greater consideration in funding decisions, as does biological sex.
Key numbers
3,801,986
Long COVID Prevalence
Estimated number of US adults experiencing disabling Long COVID.
$106 million vs. $739.8 million
Funding Shortfall
Actual funding vs. estimated funding needed based on disability burden.
5.2×
Funding Disparity
Median funding per for male-predominant conditions compared to female-predominant conditions.
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Long Covid