Prevalence and Trends of Post–COVID-19 Sequelae Among U.S. Adults With Prior COVID-19 Infection, 2022–2024

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) affect a substantial proportion of U.S. adults, involving multiple organ systems and resulting in significant disability and diminished quality of life.Population-level PASC estimates include individuals without prior COVID-19 infection and therefore do not accurately reflect postinfection risk required for effective risk stratification.We estimated the prevalence and trends of PASC among U.S. adults with prior COVID-19.Methods: We analyzed data from the National Health Interview Survey (2022-2024), a nationally representative survey of the U.S. civilian noninstitutionalized population.Adults reporting prior COVID-19 infection were asked whether they ever experienced symptoms lasting ≥3 months that were not present before infection; those answering yes were classified as having PASC.Weighted analyses accounted for the complex survey design.Results: Among 42,872 adults with prior COVID-19, 6,822 reported symptoms lasting three months or longer, indicating PASC.Prevalence declined from 19.7% in 2022 to 15.1% in 2023 and 13.7% in 2024 (P<0.001 for 2022 vs subsequent years).Despite this decline, more than 21 million U.S. adults reported having experienced PASC in 2023 and 2024.Prevalence was higher among women and adults aged 35-64 years than among men and younger or elderly individuals.A lower prevalence was observed among Asian adults, whereas a higher prevalence was noted among American Indian, Alaska Native, and multiracial adults.Conclusions: Despite declining prevalence, PASC remains common among U.S. adults with prior COVID-19.These nationally representative postinfection estimates provide clinically relevant risk information to guide patient counseling, health system planning, and ongoing surveillance.