German Study Warns That Long COVID Can Persist for Four Years, With Brain Symptoms Raising Risks
Nikhil Prasad Fact checked by:Thailand Medical News Team Oct 11, 2026 46 minutes ago
Long COVID may continue affecting people four years after their initial coronavirus infection, with new research revealing that concentration problems, depressive symptoms, and older age are strongly associated with prolonged illness.
New research reveals that long COVID symptoms can persist for four years, with cognitive difficulties and
depression linked to prolonged illness and reduced daily functioning
Researchers from Hannover Medical School and Georg-August University of Göttingen, Germany, found that many affected individuals continued experiencing symptoms years after infection, even when their original COVID-19 illness was mild.
Long COVID Symptoms Persist After Four Years
The study followed adults infected with SARS-CoV-2 between 2020 and 2021. Of 992 participants surveyed in 2021, 609 (61.4%) reported post-COVID symptoms.
By 2024, 568 participants completed follow-up assessments, with 333 (58.6%) still meeting the study's long COVID criteria.
Importantly, among 354 participants who initially reported long COVID and completed follow-up, 77.4% remained symptomatic, while only 22.6% had recovered.
Most participants had experienced relatively mild initial infections, with 95.1% receiving outpatient care.
Brain Symptoms Signal Greater Persistence
As highlighted in this
Thailand Medical News report, neurological and psychological symptoms emerged as important indicators of prolonged illness.
Participants reporting concentration difficulties during acute infection had 4.46 times higher adjusted odds of persistent long COVID. Depressive symptoms were associated with 9.74 times higher odds, although researchers cautioned that this estimate was statistically imprecise.
Adults aged 50 or older had approximately twice the odds of persistent symptoms compared with younger participants.
Female sex was associated with long COVID at four years, while fatigue, memory difficulties, sleep disturbances, and palpitations were additional associated factors.
Persistent Symptoms Disrupt Daily Activities
Researchers also examined how lingering symptoms affected everyday functioning.
In 2024, depressive symptoms were associated with eightfold higher odds of functional limitations. Fatigue carried nearly fivefold higher odds, while concentration difficulties and breathlessness at rest were associated with approximately fourfold higher odds.
Headaches, joint pain, skin rashes, and obesity were also linked to greater functional impairment.
Among participants with earlier long COVID, 29.7% experienced functional improvement, 54.5% remained stable, and 15.8% deteriorated.
Conclusions
The findings demonstrate that long COVID can remain a significant health burden years after infection, particularly among individuals experiencing cognitive, psyc
hological, and respiratory symptoms. However, self-reported symptoms, participant attrition, and the study's selected population limit generalizability. Further research is essential to identify biological mechanisms and develop effective treatments.
The study findings were published in the peer-reviewed journal: Scientific Reports.
https://www.nature.com/articles/s41598-026-72491-1
Read Also:
https://www.thailandmedical.news/articles/long-covid 
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