International journal of infectious diseases : IJID : official publication of the International Society for Infectious DiseasesJan 25, 2026

How Self-Reported Symptoms Change Over Time After COVID-19 Infection in a Community Group

Long Covid Weekly Brief ↗PubMed ↗DOI ↗

Updated Jan 26, 2026

Abstract

The adjusted risk of any long-COVID symptom was 22.6% among infected individuals at 4-8 months compared to 11.3% among uninfected controls.

Infected individuals demonstrated a significantly higher risk of new-onset long-COVID symptoms compared to uninfected controls at multiple time points.
At 4-8 months post-infection, the adjusted risk difference for long-COVID symptoms was 11.3%, with an adjusted risk ratio of 2.01.
At 9-12 months, the adjusted risk of long-COVID symptoms among infected individuals was 19.2%, compared to 12.4% for those uninfected, reflecting a 6.7% adjusted risk difference.
Increased risks for long-COVID symptoms were consistently observed across three symptom clusters: neurological, autonomic, and exercise intolerance.
Results indicate that SARS-CoV-2 infection is associated with long-lasting symptoms that may persist up to 12 months post-infection.

Simplified

BACKGROUND: Using a prospective, community-recruited cohort with data on background symptom prevalence and repeated longitudinal symptom assessments, we estimated post-infection risks of long COVID symptoms compared with contemporaneous uninfected controls.

METHODS: We analyzed the CHASING COVID Cohort, a U.S. longitudinal study with surveys and serology (March 2020-December 2023). Infection status (January 2021-December 2022) was determined from self-reported PCR/antigen results, serology, or CSTE probable criteria. We emulated 24 monthly target trials comparing individuals newly infected at time zero with those remaining uninfected. Outcomes were new-onset long-COVID symptoms not reported pre-infection, assessed overall and within three clusters (neurological, autonomic, exercise intolerance) at 4-8 and 9-12 months post-infection. Inverse probability of treatment and censoring weights adjusted for confounding and informative loss to follow-up.

RESULTS: The analysis included 1,055 infected and 52,310 uninfected person-trials. At 4-8 months, the adjusted risk of any long-COVID symptom was 22.6% (95% CI, 20.5-24.8) among infected versus 11.3% (11.1-11.5) among uninfected (adjusted risk difference [aRD], 11.3% [9.2-13.5]; adjusted risk ratio [aRR], 2.01 [1.81-2.20]). At 9-12 months, risks were 19.2% (17.0-21.3) vs 12.4% (12.2-12.7) (aRD, 6.7% [4.6-8.9]; aRR, 1.54 [1.37-1.72]). Across all three clusters, infected participants had consistently higher risks at both intervals.

CONCLUSIONS: SARS-CoV-2 infection was associated with elevated risk of new-onset long-COVID symptoms persisting up to 12 months. Using a national community-recruited cohort, contemporaneous uninfected controls, and target-trial emulation clarifies the burden attributable to infection and supports ongoing surveillance and targeted prevention and care.

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Declaration of competing interest The authors have no competing interests to declare.

PubMed

How Self-Reported Symptoms Change Over Time After COVID-19 Infection in a Community Group

Abstract

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Funding

Competing interests

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