Tiffany Ang, Class of 2026

Post-acute sequelae of COVID-19 (PASC), or “Long COVID,” refers to ongoing or new symptoms that persist at least three months after a SARS-CoV-2 infection. Common symptoms include chest pain, cognitive dysfunction, shortness of breath, brain fog, headache, and fatigue. A study by Dr. Luft from Stony Brook University investigated the association between SARS-CoV-2 re-infection and the incidence of PASC among essential workers enrolled in the Stony Brook University World Trade Center (WTC) Health and Wellness Monitoring Program. Dr. Luft’s team hypothesized that individuals with two or more SARS-CoV-2 infections are at a higher risk of developing PASC. 

Data from 2,511 essential workers, particularly first responders, who tested positive for SARS-CoV-2 between March 2020 and February 2024 were retrospectively analyzed. Statistical analyses were used to calculate the Relative Risk (RR) for the association between PASC and factors such as re-infection, severity, and vaccination status at first infection. Bivariate analyses, such as Chi-square and t-tests, were conducted to compare each factor with the incidence of PASC.  

The study identified 475 participants with PASC. A significant association was found between having a history of hypertension and PASC, with 37.9% of the PASC group reporting hypertension, compared to 31.8% in the non-PASC group. PASC was more prevalent among individuals who experienced severe symptoms or complications from SARS-CoV-2 and unvaccinated individuals. 

The study also found that multiple COVID-19 episodes, severe infections, and unvaccinated status significantly increased the risk of PASC. Among patients with multiple infections, 30.8% developed PASC, compared to 16.7% of those with a single infection, supporting Dr. Luft’s team’s hypothesis. Repeated infections may impair viral load clearance, allowing the SARS-CoV-2 genome to persist in the body, which contributes to PASC development. No significant association was found between PASC and demographic factors, such as age, gender, race/ethnicity, or comorbidities. 

Given the self-reported nature of PASC symptoms and the demographic limitations of this study, which predominantly consisted of Caucasian men, the findings have limited generalizability. While the study suggested no significant association between demographic factors and PASC symptoms, the overrepresentation of Caucasian males in the data set may have skewed the results. Future research should focus on a broader demographic, including various racial/ethnic backgrounds and varying socio-economic statuses, to ensure generalizability so that the development of targeted interventions and treatments for PASC truly addresses the needs of all affected individuals.

Figure 1: First responders who responded to the 9/11 attacks 

Works Cited:

[1] Babalola TK, Clouston SAP, Sekendiz Z, Chowdhury D, Soriolo N, Kawuki J, Meliker J, Carr M, Valenti BR, Fontana A, Melendez OA, Morozova O, Luft BJ. SARS-COV-2 re-infection and incidence of post-acute sequelae of COVID-19 (PASC) among essential workers in New York: a retrospective cohort study. Lancet Reg Health Am. 2025 Jan 8;42:100984. doi: 10.1016/j.lana.2024.100984. PMID: 39866362; PMCID: PMC11764319.

[2] Image retrieved from: https://www.rawpixel.com/image/3978610