More than 1 in 5 adult Covid survivors in the U.S. may develop long Covid, a C.D.C. study suggests.

One in five adult Covid survivors under the age of 65 in the United States has experienced at least one health condition that could be considered long Covid, according to a large new study by the Centers for Disease Control and Prevention. Among patients 65 and older, the number is even higher: one in four.

In an indication of how seriously the federal health agency views the problem of long Covid, the authors of the study — members of the C.D.C.’s Covid-19 Emergency Response Team — recommended “routine assess­ment for post-Covid conditions among persons who survive Covid-19.”

Long Covid is the term used to describe an array of symptoms that can last for months or longer after the initial coronavirus infection. The researchers identified post-Covid health problems in many different organ systems, including the heart, lungs and kidneys. Other issues involved blood circulation, the musculoskeletal system and the endocrine system; gastrointestinal conditions, neurological problems and psychiatric symptoms were also identified in the study.

In both age groups, Covid patients had twice the risk of uninfected people of developing respiratory symptoms and lung problems, including pulmonary embolism, the study found. Post-Covid patients aged 65 and older were at greater risk than the younger group of developing kidney failure, neurological conditions and most mental health conditions.

“It is sobering to see the results of this study again confirming the breadth of organ dysfunction and the scale of the problem,” said Dr. Ziyad Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, who was not involved in the research.

The study evaluated electronic medical records for nearly two million people — comparing those who had been infected with the coronavirus with those who were not. The most common post-Covid conditions, regardless of age, were respiratory problems and musculoskeletal pain.

The risk of post-Covid patients aged 65 and older developing the 26 health conditions the study evaluated was between 20 percent and 120 percent greater than people who didn’t get Covid. Those aged 18 to 64 had a 10 percent to 110 percent greater risk than uninfected people of developing 22 of the health conditions. But in that age group, Covid survivors were no more likely than uninfected people to develop most mental health conditions, substance use disorders or strokes and similar cerebrovascular conditions.

Dr. Al-Aly said the study results “can potentially translate into millions of people with new diabetes, heart disease, kidney disease, neurologic problems. These are lifelong conditions — certainly manageable, but not curable conditions.”

The study analyzed records of 353,164 people who were diagnosed with Covid-19 in the first 18 months of the pandemic, beginning in March 2020. It compared them with the records of 1.64 million people who had a medical visit in the same month in which the Covid patients were diagnosed but did not become infected with the coronavirus during the study period, which ended on Oct. 31, 2021.

People in both groups who had a history of one of the 26 health conditions in the previous year were excluded from the study — an attempt by the researchers to consider medical issues that patients developed only after they had Covid.

The study, which involved patients seen at health facilities that use a record system managed by Cerner Corp., a large medical data company, said the Covid patients included people admitted to hospitals, seen in emergency departments or diagnosed in an outpatient setting. The researchers did not indicate how many patients were in each group, one of several limitations of the study’s findings.

Between 30 days and 365 days after their coronavirus diagnosis, 38 percent of the patients experienced one or more new health problems, compared to 16 percent of the non-Covid patients, the study said. The younger age group, 18-to-64, was somewhat less likely to have those problems — 35 percent developed long Covid issues, compared with 15 percent of uninfected people. In the 65-and-older group, 45 percent had new health conditions, compared with 19 percent of uninfected people.

Based on those percentages, the study authors calculated that nearly 21 percent of the younger group and nearly 27 percent of the older group developed health problems that could be attributed to long Covid.

The study did not look at the vaccination status of the patients and did not report characteristics like race, ethnicity, sex or geographic location. It also did not identify which coronavirus variants were linked to each case.

The C.D.C. authors concluded that post-Covid conditions might “affect a patient’s ability to contribute to the work force and might have economic consequences for survivors and their dependents.” They added that “care requirements might place a strain on health services” in “communities that experience heavy Covid-19 case surges.”

Dr. Al-Aly said he agreed that people who had Covid should be medically evaluated for potential new health problems.

“Now that we are in possession of knowledge that Covid-19 can lead to serious long-term consequences,” he added, “we need to develop additional tools to reduce the risk of long Covid.”

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