Long COVID risk: A person’s risk of long COVID may depend on the sequence in which their chronic conditions developed before catching the coronavirus, according to a new study from Spain.
Researchers examined 15 years of clinical and genetic data from more than 8,300 participants in Catalonia’s “Genomes for Life” project, reconstructing disease histories from 2010–2019 and linking them to post-COVID outcomes. They identified 162 pre-infection “disease trajectories”; 38 were tied to a significantly higher likelihood of long COVID, most commonly involving mental health, neurological, respiratory, metabolic or digestive disorders.
Also Read | COVID-19 in pregnancy tied to higher risk of developmental delays by age 3: Study
“It’s not enough to list a patient’s conditions; the order matters, particularly in women,” said first author Natalia Blay of the Germans Trias i Pujol Research Institute. One newly noted pathway, obesity followed by knee joint dysfunction, was associated with elevated long-COVID risk, especially among women.
The analysis also found that certain combinations, such as co-existing neurological and mental health disorders, increased risk independent of the initial infection’s severity, suggesting long Covid cannot be explained solely by how acute the illness was.
The team reported links between migraine and digestive symptoms, pointing to a possible gut–brain axis role, and suggested that chronic pain and reduced activity from musculoskeletal problems may worsen cardiovascular and respiratory symptoms after COVID. “Our findings indicate long COVID emerges from prior health trajectories rather than a single factor,” said project director Rafael de Cid.
The authors said long-term, population-level health data can help predict risk, refine prevention, and support more personalised public health strategies. The study appears in BMC Medicine.
