Emory University and its local partners are leading the Atlanta hub for a nationwide study to identify why some people have prolonged symptoms (long COVID) or develop new or returning symptoms after an acute bout of SARS-CoV-2 infection.

Through funding from the National Institutes of Health (NIH), Emory, Morehouse School of Medicine (MSM), the Atlanta Veterans Affairs Healthcare System, and Kaiser Permanente of Georgia (KPGA) are projected to receive close to $20 million over four years to be part of a comprehensive initiative called Researching COVID to Enhance Recovery (RECOVER). The consortium brings together scientists, clinicians, patients, and caregivers to take on a critical problem: recovery from the long-term effects of COVID.

The RECOVER research team will identify the risk factors that contribute to long COVID – medically known as post-acute sequalae of SARS-CoV-2 infection (PASC) – which can affect multiple organs. The investigators will also look at characterizing the incidence, prevalence, and long-term outcomes of long COVID and examine mechanisms and causal effects of COVID-19 that may help inform approaches for treatment and prevention.

Of the over 45 million COVID-19 cases in the U.S., it is estimated that between 10 and 30 percent are long haulers.

Igho Ofotokun, MD, professor of medicine at Emory, and one of three principal investigators (PIs) for the study in Atlanta, points out that the institution has long been a leader in tackling emerging infectious diseases and their consequences or sequalae. “We are confident that this effort will advance our understanding of the root cause of PASC and accelerate the discovery of potential interventions and preventive strategies,” Ofotokun says. “Survivors of COVID-19 who are experiencing long COVID symptoms deserve answers and relief from their symptoms.” 

Some of the key questions researchers will address include:

• What does recovery for SARS-CoV-2 infection look like among different groups?
• How many people continue to have symptoms and how many develop new symptoms after acute infection?
• What causes these health effects?
• Why do some develop these health effects while others do not?
• Does COVID-19 trigger changes in the body that increase the risk of other conditions?

“PASC is a critically important public health problem that we need to understand,” says Rachel Patzer, PhD, professor and director of the Health Services Research Center in the department of medicine and surgery at Emory, and a PI on the project. “Atlanta experienced the pandemic early in its course – Spring 2020 – and we are therefore able to examine outcomes with substantial post recovery experience in addition to acute infections from the lingering pandemic.” 

Close to one thousand people will be recruited for the study in Atlanta. In all, tens of thousands of participants will be recruited from more than 200 recruiting sites around the country. The study will include patients who have had COVID-19 since the start of the pandemic, patients with a recent diagnosis of COVID-19, as well as a control population of participants who have never had COVID-19.

A multidisciplinary team including immunologists, virologists, pharmacologists, socio-behavioral scientists, epidemiologists, data scientists, and clinical and translational researchers with expertise in large cohort studies – as well as patients and patient representatives will work collaboratively with others in the RECOVER consortium to tackle the multi-dimensional issues of PASC.

Apart from Ofotokun and Patzer, the Atlanta site is also led by PI Priscilla Igho-Pemu, MD, from the Morehouse School of Medicine.

Recruiting sites in Atlanta include the Emory Hope Clinic led by Zanthia Wiley, MD; the Atlanta VA Medical Center led by Sushma Cribbs, MD and Vincent Marconi, MD; the Emory at Grady site led by Tiffany Walker, MD, and Jenny Han, MD; the Morehouse site led by Priscilla Igho-Pemu MD; and the KPGA site led by Jennifer Gander, PhD. A community engagement team will be led by Morehouse’s Tabia Akintobi, PhD, and patient partner, Marjorie Roberts, DBA.

According to the Centers for Disease Control and Prevention, persistent symptoms that clinicians see in patients reporting long COVID include increased respiratory effort, fatigue, “brain fog” or cognitive impairment, chest pain, headaches, palpitations, insomnia, fever, impaired daily function and mobility, pain, mood changes, and menstrual cycle irregularities.

Long COVID conditions are now referred to by a wide range of names, including post-COVID, post-acute COVID-19, chronic COVID, and long-haul COVID.

For those interested in learning more about the study, please email: recover.atlanta@emory.edu