No, it’s not accurate to say the entire world has long COVID. But .. maybe .. why? ..
And whilst long COVID is a serious concern and can affect anyone who gets COVID-19, not everyone experiences it.
Under the current definition, you are considered to have long COVID if your symptoms have lasted for at least three months.
Long COVID occurs more frequently in people with severe COVID-19, but it can happen to anyone who has been infected.
The three strongest risk factors for long COVID were being unvaccinated for COVID-19, pre-existing comorbidity, and female sex (Hou, 2025).
So how common is long COVID?
In one very large study (1.2m people, Hanson et al), 6% of people who had had COVID-19, had long COVID symptoms at 3 months; and 15% of them had symptoms at one year. Other studies put the prevalence higher at 10-15%.
We know that some people never recover or never go into remission.
How do you know you have long COVID?
You don’t for certain – partly as there is no reliable test for it. Measuring antibodies doesn’t help, as over 90% have IgG antibodies at 3 months, and over 70% at 18 months (Besevic et al). Many will have them forever.
It is also very difficult to define. Long COVID is generally a constellation of symptoms that occur after someone has been infected with COVID-19.
It can manifest as up to 200 or more different symptoms that can affect almost any organ in the body. Here are some of the commoner ones.
What other evidence is there for a prolonged autoimmune process?
Alot actually.
A fascinating recent retrospective study (Disli et al, 2025) involved 400 participants (200 with COVID-19 and 200 healthy controls), aged 18 to 60 years, without any chronic diseases, including autoimmune conditions.
As shown in the table below, amongst the 200 healthy individuals, 38 (19%) tested positive for dsDNA (the antibody associated with SLE, a well known chronic autoimmune disease), 37 (18.5%) for ENA (Extractable Nuclear Antigen; found is a wide range of autoimmune disease), and 30 (15%) for Hep-2 nucleus antibodies.
But the rates of ANA positivity were significantly higher in individuals with COVID-19, with 97 (48.5%) positive for dsDNA, 81 (40.5%) for ENA, and 84 (42%) for Hep-2 nucleus antibodies (p < 0.05). These are very high percentages of auto-antibodies.
| Healthy | COVID-19 ( +) | |||||
|---|---|---|---|---|---|---|
| Man | Woman | p | Man | Woman | p | |
| dsDNA | 13 (34%) | 25 (66%) | 0.006 | 32 (33%) | 65 (67%) | 0.000 |
| ENA | 9 (24%) | 28 (76%) | 0.000 | 30 (37%) | 51 (63%) | 0.001 |
| Hep-2 nucleus | 6 (20%) | 24 (80%) | 0.000 | 26 (31%) | 58 (69%) | 0.000 |
Distribution of ANA positivity in healthy individuals and those with COVID-19 by gender
So. Does the whole world have long COVID?
Well. It depends how you define long COVID.
The answer is .. probably not. But a large proportion of the world have either chronic symptoms, or a disturbed immune system, or both.
And its also possible that most of us have a mild form of long COVID that leads to mild non-specific symptoms (e.g. cough, joint pain etc) that we attribute to something else or ageing – that is actually caused by long COVID.
Could vaccination be a treatment for long COVID?
‘Are vaccines a potential treatment for long COVID?’ is an article written by Sivan et al and others – suggesting vaccination can increase the right type of antibody titres and potentially eliminate viral reservoirs.
In other words, it is possible that the minority (5-15%) with ‘bad long COVID’ have ‘bad long COVID antibodies’. Whereas most of us with (mild) ‘good long COVID’ have ‘good long COVID antibodies’.
And perhaps, therefore, vaccination could be used as a treatment to replace the ‘bad’ with ‘good’ antibodies (perhaps coming from a less virulent form of the virus).
