Long COVID Affects Thousands of People in Catalonia but the Response Remains Insufficient

Around 250,000 people could be affected by Long COVID, although the true number is likely to be higher. Yet only around 14,000 cases are currently recorded in the healthcare system, pointing to substantial underdiagnosis and gaps in the follow-up of affected people. These are among the conclusions of a new report by the Multidisciplinary Collaborative Group for the Scientific Monitoring of COVID-19 (GCMSC), an initiative promoted by the Barcelona Institute for Global Health (ISGlobal) and the Barcelona Medical Association (CoMB), with the collaboration of the Catalan Association of Research Centres (ACER).

The report provides an overview of the current situation in Catalonia from three complementary perspectives: research, healthcare and the lived experience of people affected by the condition through the Long COVID patient association. By bringing these perspectives together, the document identifies some of the main bottlenecks and proposes concrete priorities to improve knowledge, care and support for people living with Long COVID.

A burden that remains difficult to measure

Long COVID can affect multiple organs and manifest through a wide range of symptoms, including fatigue, cognitive difficulties or “brain fog”, problems regulating functions such as heart rate and blood pressure, and worsening of symptoms after exercise. Its heterogeneity, combined with the absence of specific diagnostic tools, makes the condition particularly difficult to diagnose and manage.

Data from the population-based COVICAT cohort show that around 23% of people infected with SARS-CoV-2 during the early stages of the pandemic developed symptoms lasting at least three months. Among those affected in 2021, 56% continued to report symptoms two years later.

Based on confirmed cases and the prevalence observed in the COVICAT cohort, the expert group estimates that at least 92,000 people had developed Long COVID in Catalonia by January 2021. As infections increased, this figure is estimated to have reached at least 176,000 cases by July 2022, although only around 14,000 cases are recorded in the healthcare system. Considering estimates of subsequent infections, the incidence of Long COVID associated with Omicron variants, and the partial recovery of some cases, more than 250,000 people could currently be experiencing symptoms compatible with Long COVID. The expert group cautions that the available data make it possible to estimate the order of magnitude of the problem, but not to determine its current scale with precision.

“Although the risk of developing Long COVID has decreased with vaccination and the emergence of Omicron, tens of thousands of people continue to live with its consequences. The large gap between estimated and recorded cases also shows how much we still need to improve diagnosis and surveillance,” says Lourdes Mateu, director of the Long COVID program at Hospital Germans Trias i Pujol, and co-author of the report.

Limited care and fragmented research

The report identifies important gaps in both research and healthcare. Research in Spain has largely depended on general competitive or European funding calls rather than a dedicated national programme. This limits the ability to establish large cohorts, conduct long-term follow-up and undertake clinical trials.

Access to specialised care is also limited. According to the report, Catalonia currently has only one multidisciplinary Long COVID unit, at Hospital Germans Trias i Pujol in Badalona. Other specialised services established earlier in the pandemic have been discontinued, while some successful local models have not been scaled up. This contributes to territorial inequalities in access to care.

Beyond the health consequences

The report also incorporates the experiences of people living with the condition, through the Long COVID patient group. They highlight difficulties in obtaining recognition of the condition and appropriate care, geographical and financial barriers, challenges in remaining in or returning to work, and difficulties accessing disability benefits and social protection. They also point to the psychological impact of prolonged uncertainty and the lack of recognition of their symptoms.

Since the early stages of the pandemic, organisations representing people affected by Long COVID have played an important role in supporting those affected, helping to define research priorities, recruiting participants for studies, disseminating scientific findings, and engaging with healthcare professionals and policymakers. “For many people, Long COVID affects their ability to work, care for their families and participate in everyday life. Adequate social and workplace support must therefore also be part of the response,” says Silvia Soler, a representative of the patient group and co-author of the report.

Priority actions

The report proposes concrete measures that can begin to be implemented now, such as strengthening research and the identification of biomarkers; improving diagnosis, registration and follow-up through primary care; and facilitating the recognition of disability and workplace accommodations for people affected by Long COVID.

“It is clear that the challenges in research, healthcare and social support are closely interconnected. The aim of this report is not only to describe the gaps, but also to identify realistic priorities that can help improve the response to Long COVID in Catalonia,” says Silvia de Sanjosé, ISGlobal researcher and coordinator of the GCMSC.

Reference:

Long COVID: State of the Art, Challenges, and Perspectives from the Field in Catalonia 2026. Multidisciplinary Collaborative Group for the Scientific Monitoring of COVID-19. September 2026.