{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:48:37Z","timestamp":1787827717665,"version":"build-2784847793"},"reference-count":74,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Prim. Care Respir. Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Long COVID, defined by symptoms persisting three months post-SARS-CoV-2 infection, presents a significant global health and economic challenge, with global prevalence estimated at 36% (ranging from 1\u201392%). This brief communication consolidates current knowledge on its economic impacts, including macroeconomic, cost-of-illness, and microeconomic impacts, which are estimated at an average annual burden of $1 trillion globally and $9000 per patient in the USA, with some individuals covering substantial out-of-pocket expenses. Annual lost earnings in the USA alone are estimated at approximately $170 billion. Long COVID was associated with increased unemployment, financial distress, and work impairment for up to three years post-infection. This paper highlights discrepancies in impact estimation methodologies and calls for standardised metrics especially in emerging economies. Key research gaps include the absence of comprehensive longitudinal studies on individual and aggregated economic burden, specific long COVID phenotypes and biomarkers, and cost-effectiveness evaluations of interventions.<\/jats:p>","DOI":"10.1038\/s41533-025-00460-8","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T17:18:15Z","timestamp":1763745495000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Economic burden of long COVID: macroeconomic, cost-of-illness and microeconomic impacts"],"prefix":"10.1038","volume":"35","author":[{"given":"Amit","family":"Bansal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"460_CR1","unstructured":"Baxa, M. An incomplete picture: understanding the burden of long Covid. The Economist Group. https:\/\/impact.economist.com\/health\/incomplete-picture-understanding-burden-long-covid (2024)."},{"key":"460_CR2","unstructured":"Technical Advisory Group on Virus Evolution (TAG-VE). A clinical case definition of post COVID-19 condition by a Delphi consensus. World Health Organization. https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 (2021)."},{"key":"460_CR3","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","volume":"27","author":"A Nalbandian","year":"2021","unstructured":"Nalbandian, A. et al. Post-acute COVID-19 syndrome. Nat. Med. 27, 601\u2013615 (2021).","journal-title":"Nat. Med."},{"key":"460_CR4","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1038\/s41579-023-00896-0","volume":"21","author":"HE Davis","year":"2023","unstructured":"Davis, H. E., McCorkell, L., Vogel, J. M. & Topol, E. J. Author correction: long COVID: major findings, mechanisms and recommendations. Nat. Rev. Microbiol. 21, 408 (2023).","journal-title":"Nat. Rev. Microbiol."},{"key":"460_CR5","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1136\/gutjnl-2021-324280","volume":"71","author":"CCL Cheung","year":"2022","unstructured":"Cheung, C. C. L. et al. Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19. Gut 71, 226\u2013229 (2022).","journal-title":"Gut"},{"key":"460_CR6","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.medj.2022.04.001","volume":"3","author":"A Natarajan","year":"2022","unstructured":"Natarajan, A. et al. Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection. Med 3, 371\u2013387.e379 (2022).","journal-title":"Med"},{"key":"460_CR7","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1038\/s41586-022-05542-y","volume":"612","author":"SR Stein","year":"2022","unstructured":"Stein, S. R. et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature 612, 758\u2013763 (2022).","journal-title":"Nature"},{"key":"460_CR8","doi-asserted-by":"publisher","unstructured":"Peluso, M. J. et al. Plasma-based antigen persistence in the post-acute phase of COVID-19. Lancet Infect Dis. https:\/\/doi.org\/10.1016\/S1473-3099(24)00211-1 (2024).","DOI":"10.1016\/S1473-3099(24)00211-1"},{"key":"460_CR9","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1053\/j.gastro.2022.04.037","volume":"163","author":"A Zollner","year":"2022","unstructured":"Zollner, A. et al. Postacute COVID-19 is characterized by gut viral antigen persistence in inflammatory bowel diseases. Gastroenterology 163, 495\u2013506.e498 (2022).","journal-title":"Gastroenterology"},{"key":"460_CR10","doi-asserted-by":"publisher","first-page":"763","DOI":"10.3390\/pathogens10060763","volume":"10","author":"JE Gold","year":"2021","unstructured":"Gold, J. E., Okyay, R. A., Licht, W. E. & Hurley, D. J. Investigation of long COVID prevalence and its relationship to epstein-barr virus reactivation. Pathogens 10, 763 (2021).","journal-title":"Pathogens"},{"key":"460_CR11","doi-asserted-by":"publisher","first-page":"e163669","DOI":"10.1172\/JCI163669","volume":"133","author":"MJ Peluso","year":"2023","unstructured":"Peluso, M. J. et al. Chronic viral coinfections differentially affect the likelihood of developing long COVID. J. Clin. Invest. 133, e163669 (2023).","journal-title":"J. Clin. Invest."},{"key":"460_CR12","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1007\/s00296-022-05146-9","volume":"42","author":"S Zubchenko","year":"2022","unstructured":"Zubchenko, S., Kril, I., Nadizhko, O., Matsyura, O. & Chopyak, V. Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatol. Int. 42, 1523\u20131530 (2022).","journal-title":"Rheumatol. Int."},{"key":"460_CR13","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1038\/s41586-023-06651-y","volume":"623","author":"J Klein","year":"2023","unstructured":"Klein, J. et al. Distinguishing features of long COVID identified through immune profiling. Nature 623, 139\u2013148 (2023).","journal-title":"Nature"},{"key":"460_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtauto.2021.100100","volume":"4","author":"G Wallukat","year":"2021","unstructured":"Wallukat, G. et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent long-COVID-19 symptoms. J. Transl. Autoimmun. 4, 100100 (2021).","journal-title":"J. Transl. Autoimmun."},{"key":"460_CR15","doi-asserted-by":"publisher","DOI":"10.1093\/oxfimm\/iqad002","volume":"4","author":"FZ El-Rhermoul","year":"2023","unstructured":"El-Rhermoul, F. Z. et al. Autoimmunity in long covid and POTS. Oxf. Open. Immunol. 4, iqad002 (2023).","journal-title":"Oxf. Open. Immunol."},{"key":"460_CR16","doi-asserted-by":"publisher","first-page":"e1010118","DOI":"10.1371\/journal.ppat.1010118","volume":"17","author":"M Emmenegger","year":"2021","unstructured":"Emmenegger, M. et al. Anti-prothrombin autoantibodies enriched after infection with SARS-CoV-2 and influenced by strength of antibody response against SARS-CoV-2 proteins. PLoS Pathog. 17, e1010118 (2021).","journal-title":"PLoS Pathog."},{"key":"460_CR17","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1038\/s41586-021-03631-y","volume":"595","author":"EY Wang","year":"2021","unstructured":"Wang, E. Y. et al. Diverse functional autoantibodies in patients with COVID-19. Nature 595, 283\u2013288 (2021).","journal-title":"Nature"},{"key":"460_CR18","doi-asserted-by":"crossref","unstructured":"Bansal, A. et al. Divergent inflammatory and neurology-related plasma protein profiles in individuals with long COVID following primary and breakthrough SARS-CoV-2 infections. medRxiv. Preprint at https:\/\/www.medrxiv.org\/content\/10.1101\/2024.09.06.24312838v1 (2024).","DOI":"10.1101\/2024.09.06.24312838"},{"key":"460_CR19","unstructured":"Bansal, A. SARS-CoV-2 infection in healthcare workers, and biomarkers of long COVID. Bergen Open Research Archive. PhD thesis, University of Bergen, Norway, https:\/\/bora.uib.no\/bora-xmlui\/handle\/11250\/3164752, https:\/\/hdl.handle.net\/11250\/3164752 (Bergen Open Research Archive, 2024)."},{"key":"460_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeoa.2021.100328","volume":"20","author":"S Chen","year":"2021","unstructured":"Chen, S., Prettner, K., Kuhn, M. & Bloom, D. E. The economic burden of COVID-19 in the United States: estimates and projections under an infection-based herd immunity approach. J. Econ. Ageing 20, 100328 (2021).","journal-title":"J. Econ. Ageing"},{"key":"460_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-024-02476-6","volume":"13","author":"A Faramarzi","year":"2024","unstructured":"Faramarzi, A. et al. The global economic burden of COVID-19 disease: a comprehensive systematic review and meta-analysis. Syst. Rev. 13, 68 (2024).","journal-title":"Syst. Rev."},{"key":"460_CR22","doi-asserted-by":"publisher","first-page":"ofaf533","DOI":"10.1093\/ofid\/ofaf533","volume":"12","author":"Y Hou","year":"2025","unstructured":"Hou, Y. et al. Global Prevalence of Long COVID, its subtypes, and risk factors: an updated systematic review and meta-analysis. Open. Forum Infect. Dis. 12, ofaf533 (2025).","journal-title":"Open. Forum Infect. Dis."},{"key":"460_CR23","doi-asserted-by":"publisher","first-page":"e0001917","DOI":"10.1371\/journal.pgph.0001917","volume":"3","author":"M De Domenico","year":"2023","unstructured":"De Domenico, M. Prevalence of long COVID decreases for increasing COVID-19 vaccine uptake. PLOS Glob. Public. Health 3, e0001917 (2023).","journal-title":"PLOS Glob. Public. Health"},{"key":"460_CR24","doi-asserted-by":"publisher","first-page":"e015245","DOI":"10.1136\/bmjgh-2024-015245","volume":"9","author":"E Pazukhina","year":"2024","unstructured":"Pazukhina, E. et al. Long Covid: a global health issue - a prospective, cohort study set in four continents. BMJ Glob. Health 9, e015245 (2024).","journal-title":"BMJ Glob. Health"},{"key":"460_CR25","first-page":"924","volume":"30","author":"J Coste","year":"2024","unstructured":"Coste, J. et al. Prevalence of long COVID in the general adult population according to different definitions and sociodemographic and infection characteristics. a nationwide random sampling survey in France in autumn 2022. Clin. Microbiol. Infect. 30, 924\u2013929 (2024).","journal-title":"Clin. Microbiol. Infect."},{"key":"460_CR26","doi-asserted-by":"crossref","unstructured":"Blanchflower, D. G. & Bryson, A. Long COVID in the United States. PLOS One. 18, e0292672 (2023).","DOI":"10.1371\/journal.pone.0292672"},{"key":"460_CR27","doi-asserted-by":"publisher","first-page":"217","DOI":"10.5694\/mja2.52400","volume":"221","author":"V Costantino","year":"2024","unstructured":"Costantino, V. et al. The public health and economic burden of long COVID in Australia, 2022-24: a modelling study. Med. J. Aust. 221, 217\u2013223 (2024).","journal-title":"Med. J. Aust."},{"key":"460_CR28","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1038\/s41591-024-03173-6","volume":"30","author":"Z Al-Aly","year":"2024","unstructured":"Al-Aly, Z. et al. Long COVID science, research and policy. Nat. Med. 30, 2148\u20132164 (2024).","journal-title":"Nat. Med."},{"key":"460_CR29","unstructured":"Cutler, D. M. The Economic Cost of Long COVID: An Update. Harvard University. https:\/\/www.hks.harvard.edu\/centers\/mrcbg\/programs\/growthpolicy\/economic-cost-long-covid-update-david-cutler (2022)."},{"key":"460_CR30","doi-asserted-by":"crossref","unstructured":"Cutler, D. M. The Costs of Long COVID. JAMA Health Forum. 3, e221809\u2013e221809 (2022).","DOI":"10.1001\/jamahealthforum.2022.1809"},{"key":"460_CR31","doi-asserted-by":"crossref","unstructured":"Cutler, D. M. & Summers, L. H. The COVID-19 Pandemic and the $16 trillion virus. JAMA. 324, 1495\u20131496 (2020).","DOI":"10.1001\/jama.2020.19759"},{"key":"460_CR32","unstructured":"Bach, K. New data shows long Covid is keeping as many as 4 million people out of work. The Brookings Institution, https:\/\/www.brookings.edu\/articles\/new-data-shows-long-covid-is-keeping-as-many-as-4-million-people-out-of-work\/ (2022)."},{"key":"460_CR33","unstructured":"National Center for Health Statistics. Long COVID Household Pulse Survey. CDC. https:\/\/www.cdc.gov\/nchs\/covid19\/pulse\/long-covid.htm#technical_notes (2023)."},{"key":"460_CR34","unstructured":"Scullin, M. Long COVID and Its Impact on the Economy and Labor Market. RPC Consulting. https:\/\/rpcconsulting.com\/long-covid-and-its-impact-on-the-economy-and-labor-market\/ (2023)."},{"key":"460_CR35","doi-asserted-by":"crossref","unstructured":"Suran, M. Long COVID linked with unemployment in new analysis. JAMA. 329, 701\u2013702 (2023).","DOI":"10.1001\/jama.2023.0157"},{"key":"460_CR36","first-page":"190","volume":"10","author":"AA Mirin","year":"2022","unstructured":"Mirin, A. A. A preliminary estimate of the economic impact of long COVID in the United States. Fatigue.: Biomedicine, Health Behav. 10, 190\u2013199 (2022).","journal-title":"Fatigue.: Biomedicine, Health Behav."},{"key":"460_CR37","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1080\/13696998.2025.2525002","volume":"28","author":"J Yang","year":"2025","unstructured":"Yang, J. et al. Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in France. J. Med. Econ. 28, 1002\u20131013 (2025).","journal-title":"J. Med. Econ."},{"key":"460_CR38","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1177\/01410768241288345","volume":"117","author":"Y Mu","year":"2024","unstructured":"Mu, Y. et al. Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis. J. R. Soc. Med. 117, 369\u2013381 (2024).","journal-title":"J. R. Soc. Med."},{"key":"460_CR39","doi-asserted-by":"publisher","first-page":"e2255795","DOI":"10.1001\/jamanetworkopen.2022.55795","volume":"6","author":"AJ Admon","year":"2023","unstructured":"Admon, A. J. et al. Assessment of symptom, disability, and financial trajectories in patients hospitalized for COVID-19 at 6 months. JAMA Netw. Open. 6, e2255795 (2023).","journal-title":"JAMA Netw. Open."},{"key":"460_CR40","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03477-x","volume":"22","author":"L-Y Lin","year":"2024","unstructured":"Lin, L.-Y. et al. Healthcare utilisation in people with long COVID: an openSAFELY cohort study. BMC Med. 22, 255 (2024).","journal-title":"BMC Med."},{"key":"460_CR41","doi-asserted-by":"publisher","first-page":"E06","DOI":"10.5888\/pcd20.220292","volume":"20","author":"J Pike","year":"2023","unstructured":"Pike, J., Kompaniyets, L., Lindley, M. C., Saydah, S. & Miller, G. Direct medical costs associated with post-COVID-19 conditions among privately insured children and adults. Prev. Chronic Dis. 20, E06 (2023).","journal-title":"Prev. Chronic Dis."},{"key":"460_CR42","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11679-5","volume":"24","author":"H Nwankwo","year":"2024","unstructured":"Nwankwo, H. et al. Cost-effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-COVID-19 condition after hospitalisation for COVID-19: the REGAIN RCT. BMC Health Serv. Res. 24, 1326 (2024).","journal-title":"BMC Health Serv. Res."},{"key":"460_CR43","doi-asserted-by":"crossref","unstructured":"Zeraatkar, D. et al. Interventions for the management of long covid (post-covid condition): living systematic review. BMJ. 387, e081318 (2024).","DOI":"10.1136\/bmj-2024-081318"},{"key":"460_CR44","doi-asserted-by":"crossref","unstructured":"Braga, L. W. et al. Long COVID neuropsychological follow-up: Is cognitive rehabilitation relevant? NeuroRehabilitation. 53, 517\u2013534 (2023).","DOI":"10.3233\/NRE-230212"},{"key":"460_CR45","doi-asserted-by":"crossref","unstructured":"Dunabeitia, J. A., Mera, F., Baro, O., Jadad-Garcia, T. & Jadad, A. R. Personalized computerized training for cognitive dysfunction after COVID-19: a before-and-after feasibility pilot study. Int. J. Env. Res. Public. Health. 20, 3100 (2023).","DOI":"10.3390\/ijerph20043100"},{"key":"460_CR46","volume":"8","author":"N Sasaki","year":"2023","unstructured":"Sasaki, N., Yamatoku, M., Tsuchida, T., Sato, H. & Yamaguchi, K. Effect of repetitive transcranial magnetic stimulation on long coronavirus disease 2019 with fatigue and cognitive dysfunction. Prog. Rehabil. Med. 8, 20230004 (2023).","journal-title":"Prog. Rehabil. Med."},{"key":"460_CR47","first-page":"393","volume":"39","author":"BA Sabel","year":"2021","unstructured":"Sabel, B. A. et al. Non-invasive brain microcurrent stimulation therapy of long-COVID-19 reduces vascular dysregulation and improves visual and cognitive impairment. Restor. Neurol. Neurosci. 39, 393\u2013408 (2021).","journal-title":"Restor. Neurol. Neurosci."},{"key":"460_CR48","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2022.103438","volume":"81","author":"Y Noda","year":"2023","unstructured":"Noda, Y. et al. Real world research on transcranial magnetic stimulation treatment strategies for neuropsychiatric symptoms with long-COVID in Japan. Asian J. Psychiatr. 81, 103438 (2023).","journal-title":"Asian J. Psychiatr."},{"key":"460_CR49","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/s43856-024-00668-8","volume":"4","author":"AK Cohen","year":"2025","unstructured":"Cohen, A. K. et al. Impact of extended-course oral nirmatrelvir\/ritonavir in established long COVID: a case series. Commun. Med. 4, 261 (2025).","journal-title":"Commun. Med."},{"key":"460_CR50","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-022-03287-w","volume":"16","author":"AM Bhaiyat","year":"2022","unstructured":"Bhaiyat, A. M. et al. Hyperbaric oxygen treatment for long coronavirus disease-19: a case report. J. Med. Case Rep. 16, 80 (2022).","journal-title":"J. Med. Case Rep."},{"key":"460_CR51","doi-asserted-by":"publisher","first-page":"e629","DOI":"10.7861\/clinmed.2021-0462","volume":"21","author":"T Robbins","year":"2021","unstructured":"Robbins, T. et al. Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention. Clin. Med. 21, e629\u2013e632 (2021).","journal-title":"Clin. Med."},{"key":"460_CR52","doi-asserted-by":"publisher","first-page":"2951","DOI":"10.1007\/s10072-024-07566-w","volume":"45","author":"A Gorenshtein","year":"2024","unstructured":"Gorenshtein, A., Liba, T., Leibovitch, L., Stern, S. & Stern, Y. Intervention modalities for brain fog caused by long-COVID: systematic review of the literature. Neurol. Sci. 45, 2951\u20132968 (2024).","journal-title":"Neurol. Sci."},{"key":"460_CR53","doi-asserted-by":"publisher","first-page":"2552","DOI":"10.3390\/cells11162552","volume":"11","author":"P De Luca","year":"2022","unstructured":"De Luca, P. et al. Effect of ultra-micronized palmitoylethanolamide and luteolin on olfaction and memory in patients with long COVID: results of a longitudinal study. Cells 11, 2552 (2022).","journal-title":"Cells"},{"key":"460_CR54","doi-asserted-by":"publisher","first-page":"293","DOI":"10.3390\/brainsci14030293","volume":"14","author":"V Cenacchi","year":"2024","unstructured":"Cenacchi, V. et al. Co-ultraPEALut in subjective cognitive impairment following SARS-CoV-2 infection: an exploratory retrospective study. Brain Sci. 14, 293 (2024).","journal-title":"Brain Sci."},{"key":"460_CR55","doi-asserted-by":"publisher","first-page":"e1004195","DOI":"10.1371\/journal.pmed.1004195","volume":"20","author":"AB Hogan","year":"2023","unstructured":"Hogan, A. B. et al. Long-term vaccination strategies to mitigate the impact of SARS-CoV-2 transmission: a modelling study. PLoS Med. 20, e1004195 (2023).","journal-title":"PLoS Med."},{"key":"460_CR56","doi-asserted-by":"publisher","first-page":"e000385","DOI":"10.1136\/bmjmed-2022-000385","volume":"2","author":"O Byambasuren","year":"2023","unstructured":"Byambasuren, O., Stehlik, P., Clark, J., Alcorn, K. & Glasziou, P. Effect of covid-19 vaccination on long covid: systematic review. BMJ Med. 2, e000385 (2023).","journal-title":"BMJ Med."},{"key":"460_CR57","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.2337\/dca24-0032","volume":"47","author":"SG Johnson","year":"2024","unstructured":"Johnson, S. G. et al. Prevalent metformin use in adults with diabetes and the incidence of long COVID: An EHR-based cohort study from the RECOVER program. Diabetes Care 47, 1930\u20131940 (2024).","journal-title":"Diabetes Care"},{"key":"460_CR58","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/S1473-3099(23)00299-2","volume":"23","author":"CT Bramante","year":"2023","unstructured":"Bramante, C. T. et al. Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial. Lancet Infect. Dis. 23, 1119\u20131129 (2023).","journal-title":"Lancet Infect. Dis."},{"key":"460_CR59","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14413","volume":"60","author":"BK Datta","year":"2025","unstructured":"Datta, B. K., Fazlul, I. & Khan, M. M. Long COVID and financial hardship: a disaggregated analysis at income and education levels. Health Serv. Res. 60, e14413 (2025).","journal-title":"Health Serv. Res."},{"key":"460_CR60","doi-asserted-by":"publisher","first-page":"e2526310","DOI":"10.1001\/jamanetworkopen.2025.26310","volume":"8","author":"M Gottlieb","year":"2025","unstructured":"Gottlieb, M. et al. Work impairment and financial outcomes among adults with vs without long COVID. JAMA Netw. Open. 8, e2526310 (2025).","journal-title":"JAMA Netw. Open."},{"key":"460_CR61","doi-asserted-by":"crossref","unstructured":"Davis, H. E. et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 38, 101019 (2021).","DOI":"10.1016\/j.eclinm.2021.101019"},{"key":"460_CR62","doi-asserted-by":"publisher","first-page":"e2256152","DOI":"10.1001\/jamanetworkopen.2022.56152","volume":"6","author":"RH Perlis","year":"2023","unstructured":"Perlis, R. H. et al. Association of post\u2013COVID-19 condition symptoms and employment status. JAMA Netw. Open. 6, e2256152 (2023).","journal-title":"JAMA Netw. Open."},{"key":"460_CR63","doi-asserted-by":"crossref","unstructured":"Kim, J., Lee, S. & Weir, P. Long-COVID is associated with increased absenteeism from work. PLOS One. 20, e0325280 (2025).","DOI":"10.1371\/journal.pone.0325280"},{"key":"460_CR64","doi-asserted-by":"publisher","first-page":"e0249644","DOI":"10.1371\/journal.pone.0249644","volume":"16","author":"R Mahmud","year":"2021","unstructured":"Mahmud, R. et al. Post-COVID-19 syndrome among symptomatic COVID-19 patients: a prospective cohort study in a tertiary care center of Bangladesh. PLoS One 16, e0249644 (2021).","journal-title":"PLoS One"},{"key":"460_CR65","doi-asserted-by":"crossref","unstructured":"Su, H., Thompson, H. J., Figuracion, K. C., Patel, M. B. & Needham, D. M. Comparative analysis of financial toxicity between SARS-CoV-2 infection and common comorbidities. PLOS One. 19, e0309116 (2024).","DOI":"10.1371\/journal.pone.0309116"},{"key":"460_CR66","doi-asserted-by":"publisher","first-page":"e075756","DOI":"10.1136\/bmjopen-2023-075756","volume":"13","author":"A MacLean","year":"2023","unstructured":"MacLean, A. et al. Impact of Long Covid on the school experiences of children and young people: a qualitative study. BMJ Open. 13, e075756 (2023).","journal-title":"BMJ Open."},{"key":"460_CR67","unstructured":"Public Health - European Union. Exploring new insights and strategies for long COVID. EU-US Conference on long COVID. https:\/\/health.ec.europa.eu\/system\/files\/2023-03\/ncd_20221213_mi_en.pdf (2022)."},{"key":"460_CR68","doi-asserted-by":"publisher","unstructured":"Brand, J. et al. Comparing Disaster Costs with the Long-term Economic Impact of Chronic Illness Stemming from COVID-19 in Germany. EGU General Assembly. https:\/\/doi.org\/10.5194\/egusphere-egu25-15292 (2025).","DOI":"10.5194\/egusphere-egu25-15292"},{"key":"460_CR69","unstructured":"Bach, K. Long Covid is keeping millions of Americans out of work, new data shows. World Economic Forum. https:\/\/www.weforum.org\/agenda\/2022\/08\/long-covid-work-economy-united-states-health\/ (2023)."},{"key":"460_CR70","first-page":"1354","volume":"11","author":"I Edoka","year":"2022","unstructured":"Edoka, I., Fraser, H., Jamieson, L., Meyer-Rath, G. & Mdewa, W. Inpatient care costs of COVID-19 in South Africa\u2019s public healthcare system. Int. J. Health Policy Manag. 11, 1354\u20131361 (2022).","journal-title":"Int. J. Health Policy Manag."},{"key":"460_CR71","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1007\/s10198-023-01653-z","volume":"25","author":"J Kwon","year":"2024","unstructured":"Kwon, J. et al. Impact of Long COVID on productivity and informal caregiving. Eur. J. Health Econ. 25, 1095\u20131115 (2024).","journal-title":"Eur. J. Health Econ."},{"key":"460_CR72","doi-asserted-by":"publisher","first-page":"423","DOI":"10.14745\/ccdr.v49i10a03","volume":"49","author":"E Rafferty","year":"2023","unstructured":"Rafferty, E., Unsal, A. & Kirwin, E. Healthcare costs and effects of post-COVID-19 condition in Canada. Can. Commun. Dis. Rep. 49, 423\u2013425 (2023).","journal-title":"Can. Commun. Dis. Rep."},{"key":"460_CR73","doi-asserted-by":"crossref","unstructured":"Ham, D. Long-haulers and labor market outcomes. Opportunity & Inclusive Growth Institute. https:\/\/www.minneapolisfed.org\/research\/institute-working-papers\/long-haulers-and-labor-market-outcomes (2022).","DOI":"10.21034\/iwp.60"},{"key":"460_CR74","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.5694\/mja2.52468","volume":"221","author":"MR Angeles","year":"2024","unstructured":"Angeles, M. R., Dinh, T. T. N., Zhao, T., de Graaff, B. & Hensher, M. The economic burden of long COVID in Australia: more noise than signal?. Med. J. Aust. 221, S31\u2013S39 (2024).","journal-title":"Med. J. Aust."}],"container-title":["npj Primary Care Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41533-025-00460-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41533-025-00460-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41533-025-00460-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T19:02:33Z","timestamp":1763751753000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41533-025-00460-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":74,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["460"],"URL":"https:\/\/doi.org\/10.1038\/s41533-025-00460-8","relation":{},"ISSN":["2055-1010"],"issn-type":[{"value":"2055-1010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]},"assertion":[{"value":"16 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The author declares no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"53"}}