The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.

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According to the National Center for Health Statistics, 3544 death certificates for deaths occurring in the United States between January 1, 2020, and June 30, 2022, representing 0.3 percent of the 1,021,487 deaths with COVID-19 coded to U07.1 cited post-COVID condition (PCC or long COVID) as an underlying or contributing cause of death. The authors note that the data are provisional and subject to limitations, yet the numbers represent the first attempt to quantify who might be dying from PCC. PCC age-adjusted death rates were 7.3 per 1 million for males and 5.5 for females and appear to be highest for adults older than 85 years (117 per 1 million), and non-Hispanic American Indian or Alaska Native people (14.8 per 1 million).

The diverse symptoms that people with suspected PCC experience have created a diagnostic challenge. Machine learning analysis of over 137 symptoms and conditions found in electronic health record data from the National Patient-Centered Clinical Research Network (PCORnet, a PCORI-funded initiative) suggests PCC generally fall into 4 distinct types of disease manifestations: cardiac and renal; respiratory, sleep, and anxiety; musculoskeletal and nervous system; and digestive and respiratory system, following acute disease.

Preventing SARS-CoV-2 infection might be the only way to avoid PCC entirely. However, a recent literature review and meta-analysis of studies evaluating 1,600,830 individuals who had received at least 1 dose of Pfizer/BioNTech, Moderna, AstraZeneca, or Janssen vaccine found that vaccines were 35.3 percent effective against PCC if given before the person contracted COVID-19 and 27.4 percent if given afterward, relative to unvaccinated controls. So far this season we are facing a "tripledemic" of unprecedented rates of combined hospitalization due to respiratory syncytial virus (RSV), influenza, and COVID-19 that is overwhelming the healthcare system. Researchers continue to develop vaccines to mitigate the risks of respiratory illness. See Topics to watch for 2 investigational RSV vaccines.

Combination Prednisolone and Losartan to Treat Post-COVID Conditions with Inflammatory Cardiac Involvement

At a Glance

  • Research has shown that even mild cases of SARS-CoV-2 infection increase a patient’s risk for a wide range of long-term, post-COVID-19 conditions (PCCs). Cardiovascular symptoms, including shortness of breath, exercise intolerance, and chest pain are common.
  • While inflammation has been identified as a likely contributing factor in the development and persistence of cardiovascular PCC, treatment options are limited, and no standard of care has been established.
  • An ongoing phase 3 trial is testing whether prednisolone (a corticosteroid) combined with losartan (an angiotensin II receptor blocker) can reduce inflammation and enlargement of the heart following COVID-19 infection. Data are expected in December 2024.
  • Both losartan and prednisolone have long been available in generic form. If effective, the combination treatment might offer an inexpensive, widely accessible oral therapy for patients suffering from cardiovascular PCC.

Respiratory Syncytial Virus (RSV) Vaccines for Older Adults

At a Glance

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Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.

We welcome your comments on this Scan. Send them by email to [email protected].

Posted: December 30, 2022

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