A new analysis suggests that people who suffer from long COVID-19 may be at an increased risk for death. As part of a research program to determine how long-term effects of COVID-19 affect mortality rates, the Centers for Disease Control and Prevention (CDC) is examining death certificates of more than 100 Americans who apparently died from ongoing symptoms of the disease over the past two years

People with post-COVID symptoms, also called long-haulers, may experience severe illness months after infection, according to the CDC, including multi-organ effects or autoimmune conditions. Multi-organ effects can involve damage to many body systems, including the heart, lung, kidney, skin, and brain. As a result, people who have had COVID-19, especially those who experienced intense cases, may be more likely to develop new health conditions such as diabetes, heart conditions, or neurological conditions compared with people who have not have COVID-19.

According to Politico, the National Center for Health Statistics (NCHS), a division within the CDC, collects death certificates from states after they have been completed by a coroner, medical examiner or doctor. NCHS is currently reviewing files from 2020 and 2021 to determine if there is an association between long COVID and its complications and increased risk for death. Studies have shown that up to 30% of the population who contract the virus may experience post COVID-19 symptoms.

“The overall risk factors for mortality with long COVID are going to be important and evolving,” said Dr. Mady Hornig, associate professor of epidemiology at Columbia University Mailman School of Public Health and a long-hauler herself. So far, the NCHS has identified 60 death certificates that list long COVID-19 or similar wording in 2021 and another 60 during the first five months of 2022.

The difficulty in gathering data is that there is no universal test or definition for long COVID-19, so it is difficult to determine how many people in the country died from the condition. There are a wide range of symptoms that often include fatigue, shortness of breath and brain fog, says Politico. What could be a symptom in one person may not affect another.

As of October 2021, hospitals and medical facilities in the U.S. began tracking individuals with long COVID-19 symptoms with a specific identification code known as an ICD-10 code. This has helped researchers narrow the study population. Currently, the National Institutes of Health is spearheading the RECOVER initiative to learn more about the long-term effects of COVID-19.

Since there is no set wording or terminology that hospital use on death certificates, no official estimates exist for deaths caused by long COVID-19. However, a 2021 study of European cancer patients did find that 15% of those who survived COVID-19 had long-term symptoms and their survival outcomes were worse.

“It certainly is possible and probable that someone who was sick from COVID develops complications after COVID and dies of long COVID,” said Dr. Jerry Krishnan, a professor of medicine and expert in pulmonary care at the University of Illinois Chicago. “I have not seen the data. But I have heard that people have developed heart or lung or brain complications after having had COVID. And eventually they have died.”