Long COVID

Household Pulse Survey

As part of an ongoing partnership with the Census Bureau, the National Center for Health Statistics (NCHS) recently added questions to assess the prevalence of post-COVID-19 conditions (long COVID), on the experimental Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the impact of the coronavirus pandemic in the U.S. Data collection began on April 23, 2020.

Beginning in Phase 3.5 (on June 1, 2022), NCHS included questions about the presence of symptoms of COVID that lasted three months or longer. Beginning in Phase 3.6 (on September 14, 2022), NCHS included a question about whether long-term symptoms among those reporting symptoms lasting three months or longer reduced the ability to carry out day-to-day activities compared with the time before having COVID-19. Phase 3.6 will continue with a two-weeks on, two-weeks off collection and dissemination approach.

Estimates on this page are derived from the Household Pulse Survey and show the following outcomes for adults aged 18 and over:

The percentage of all U.S. adults who EVER experienced post-COVID conditions (long COVID). These adults had COVID and had some symptoms that lasted three months or longer.
The percentage of adults who EVER experienced post-COVID conditions (long COVID) among those who ever had COVID .
The percentage of all U.S. adults who are CURRENTLY experiencing post-COVID conditions (long COVID). These adults had COVID, had long-term symptoms, and are still experiencing symptoms.
The percentage of adults who are CURRENTLY experiencing post-COVID conditions (long COVID) among those who ever had COVID.

Beginning in Phase 3.6:

The percentage of any activity limitations (either ‘yes, a little’ or ‘yes, a lot’ responses) from long COVID, among adults who are currently experiencing long COVID and among all adults
The percentage of significant activity limitations (‘yes, a lot’ response) from long COVID, among adults who are currently experiencing long COVID and among all adults

The percentage of all U.S. adults who ever said they had COVID is also included to provide context for the other percentages. It should be noted that the percentage of adults who said they ever had COVID based on the Household Pulse Survey is lower than other estimates based on seroprevalence studies.

See the technical notes for more information on these measures.

Questions on post-COVID conditions (long COVID) were also included on the National Health Interview Survey (NHIS) in 2022. The NHIS, conducted by NCHS, is the major source for high-quality data used to monitor the nation’s health. NHIS data collection will continue through December 2024.

Pulse Survey Topics

Technical Notes

Survey Questions

Have you ever tested positive for COVID-19 (using a rapid point-of-care test, self-test, or laboratory test) or been told by a doctor or other health care provider that you have or had COVID-19?

Answer Choices: yes, no

How would you describe your coronavirus symptoms when they were at their worst?

Answer choices: I had no symptoms, I had mild symptoms, I had moderate symptoms, I had severe symptoms.

Did you have any symptoms lasting 3 months or longer that you did not have prior to having coronavirus or COVID-19?

Long term symptoms may include: Tiredness or fatigue, difficulty thinking, concentrating, forgetfulness, or memory problems (sometimes referred to as “brain fog”), difficulty breathing or shortness of breath, joint or muscle pain, fast-beating or pounding heart (also known as heart palpitations), chest pain, dizziness on standing, menstrual changes, changes to taste/smell, or inability to exercise.

Answer choices: yes, no

Do you have symptoms now?

Answer choices: yes, no

Do these long-term symptoms reduce your ability to carry out day-to-day activities compared with the time before you had COVID-19?

Answer choices: Yes, a lot; Yes, a little; Not at all

Data Source

The U.S. Census Bureau, in collaboration with multiple federal agencies, launched the Household Pulse Survey to produce data on the social and economic impacts of COVID-19 on American households. The Household Pulse Survey was designed to gauge the impact of the pandemic on employment status, consumer spending, food security, housing, education disruptions, and dimensions of physical and mental wellness.

The survey was designed to meet the goal of accurate and timely weekly estimates. It was conducted by an internet questionnaire, with invitations to participate sent by email and text message. The sample frame is the Census Bureau Master Address File Data. Housing units linked to one or more email addresses or cell phone numbers were randomly selected to participate, and one respondent from each housing unit was selected to respond for him or herself. Estimates are weighted to adjust for nonresponse and to match Census Bureau estimates of the population by age, sex, race and ethnicity, and educational attainment. All estimates shown meet the NCHS Data Presentation Standards for Proportions.

Limitations

The Household Pulse Survey is different from other surveys. NCHS, the Census Bureau, and other federal statistical agencies are considered the preeminent source of the nation’s most important benchmark surveys. Many of these surveys have been in production for decades and provide valuable insight on health, social, and economic trends. However, the production of benchmark data requires a relatively long lead time, and personal interviews (face-to-face or telephone) require additional time. While efforts are underway to introduce COVID-19 questions into these surveys, that process can take months, sometimes years, before data are made available.

The Household Pulse Survey is different: It was designed to go into the field quickly, to be administered via the web, and to disseminate data in near real-time, providing data users with information they can use now to help ease the burden on American households and expedite post-pandemic recovery. The Census Bureau is fielding the Household Pulse Survey as a demonstration project, with data released as part of its Experimental Statistical Products Series.

Confidence intervals included in the tables on this page only reflect the potential for sampling error. Nonsampling errors can also occur and are more likely for surveys that are implemented quickly, achieve low response rates, and rely on online response. Nonsampling errors for the Household Pulse Survey may include:

Measurement error: The respondent provides incorrect information, or an unclear survey question is misunderstood by the respondent. The Household Pulse Survey schedule offered only limited time for testing questions.
Coverage error: Individuals who otherwise would have been included in the survey frame were missed. The Household Pulse Survey only recruited households for which an email address or cell phone number could be identified.
Nonresponse error: Responses are not collected from all those in the sample or the respondent is unwilling to provide information. The response rate for the Household Pulse Survey was substantially lower than most federally sponsored surveys.
Processing error: Forms may be lost, data may be incorrectly keyed, coded, or recoded. The real-time dissemination of the Household Pulse Survey provided limited time to identify and fix processing errors.

For more information on nonresponse bias for the Household Pulse Survey, please visit https://www2.census.gov/programs-surveys/demo/technical-documentation/hhp/2020_HPS_NR_Bias_Report-final.pdf.

For more information on the Household Pulse Survey, please visit https://www.census.gov/data/experimental-data-products/household-pulse-survey.html.

Suggested Citation

National Center for Health Statistics. U.S. Census Bureau, Household Pulse Survey, 2022–2024. Long COVID. Generated interactively: from https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm