COVID-19 survivors at increased risk of pulmonary embolism, respiratory problems

Adults in the US who survived COVID-19 infection are more likely to develop incidents attributable to the virus than those who were not infected with COVID-19.

According to the latest findings, patients who have been exposed to and infected with SARS-CoV-2 are twice as likely to develop a pulmonary embolism or respiratory diseases Morbidity and Mortality Weekly Reportpublished on May 27, 2022.

Researchers used electronic health record (EHR) data for US adults from March 2020 to November 2021 to assess the incidence of 26 conditions attributed to long-standing COVID-19. They used the national de-identified dataset from Cerner Real-World Data.

“As more people are exposed to and infected with SARS-CoV-2, reports of patients who have persistent symptoms or organ dysfunction after acute COVID-19 and develop post-COVID illness have increased,” the authors explained.

Patients were followed up for 30 to 365 days after the index encounter, and patients diagnosed with COVID-19 (case patients) were matched with control patients who had no evidence of COVID-19. The controls had a visit in the same month as the matched case patients. There were 353,164 case patients (254,345 patients 18-64 years and 98,819 patients ≥ 65 years) and 1,640,776 control patients (1,051,588 patients 18-64 years and 589,188 patients ≥ 65 years).

Patients were followed up until the occurrence of 1 or more adverse events or October 31, 2021. During the study, 38% of case patients experienced an incidence compared to 16% of control patients.

The researchers found:

  • The highest risk was for pulmonary embolism and respiratory symptoms
  • Difficulty breathing and musculoskeletal pain were the most common incidents in both age groups
  • 45.4% of the case patients aged 65 years or older experienced an incident compared to 18.5% of the control group in the same age group
  • 1 in 5 COVID-19 survivors in the 18-64 age group and 1 in 4 in the ≥ 65 age group experienced a condition that could be traced back to COVID-19

There were a total of 26 incidents that the researchers evaluated, and they found that case patients aged 65 years or older were at greater risk than controls for all 26 conditions. Case patients aged 18-64 years had a higher risk of 22 events compared to controls. In patients aged 18 to 64 years, there was no significant difference between case patients and controls for cerebrovascular disease or mental illness.

The researchers identified at least 5 limitations of the study, including that the results may not be representative of patients infected with recent variants of COVID-19, given the time frame, and that the results of post-COVID-19 incidents infection may be skewed toward patients seeking treatment, and the analysis did not take into account vaccination status or other confounding factors.

“Implementation of COVID-19 prevention strategies, as well as routine assessment of post-COVID illness in individuals surviving COVID-19, is critical to reducing the incidence and impact of post-COVID illness, particularly in adults aged ≥ 65 years.” They wrote.


Bull-Otterson L, Baca S, Saydah S, et al. Post-COVID states in adult COVID-19 survivors aged 18-64 and ≥65 years – US, March 2020 – November 2021. MMWR Morb Mortal Wkly Rep. 2022;71(21);713-717. doi:

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