Post-COVID-19 condition in individuals infected with COVID in the Netherlands: a prospective cohort study with pre-and post-infection data,2025,Bruijn

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Full title: Post-COVID-19 condition in individuals infected with SARS-CoV-2 in autumn 2023 in the Netherlands: a prospective cohort study with pre- and post-infection data

https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00264-9/fulltext

Spoiler: Authors

Siméon de Bruijn ∙ Anne J. Huibertsa ∙ Stijn P. Andewega ∙ Christina E. Hoevea ∙ Maarten Schipperb ∙ Diederick E. Grobbeec ∙ Hester E. de Melkera ∙ Janneke H.H.M. van de Wijgertc ∙ Susan van den Hofa ∙ Mirjam J. Knola ∙ Cees C. van den Wijngaard

Summary​

Background​

Post-COVID-19 condition (PCC) risk may have changed due to vaccination status, virus variants, prior infections, and other factors. We aimed to estimate PCC prevalence for one year in individuals infected with SARS-CoV-2 during autumn 2023, controlling for pre-infection symptoms and prevalence in recently uninfected participants.

Methods​

VASCO, a Dutch ongoing prospective cohort, collects three-monthly questionnaires and six-monthly SARS-CoV-2 serology. Participants indicated severity of 23 symptoms on a five-point Likert scale, and of fatigue and concentration problems on the Checklist Individual Strength. We matched participants who did with those who did not report a SARS-CoV-2 infection between September 25, 2023 and January 7, 2024, and censored follow-up time for both upon serological or antigen test evidence of infection. We estimated PCC-prevalence as the excess prevalence of at least one PCC-related symptom between matched infected and uninfected participants at 90, 180, 270, and 360 days post-infection. Additionally, participants could self-attribute long-term symptoms to SARS-CoV-2.

Findings​

We 1:1 matched 5621 infected to 5621 uninfected participants. The PCC prevalence, estimated as the marginal mean excess prevalence of PCC-related symptoms between infected and uninfected participants, was 0.2% (95% confidence interval: −1.9 to 2.3, p = 0.84) at 90 days, 0.5% (−1.6 to 2.6, p = 0.63) at 180 days, 0.7% (−1.3 to 2.8, p = 0.48) at 270 days, and 0.0% (−2.1 to 2.1, p = 0.99) at 360 days. Excess prevalence of new mild and severe long-term symptoms self-attributed to SARS-CoV-2 between infected and uninfected participants were both elevated at 90 days (mild: 7.2% (5.1–9.2), severe: 0.6% (0.4–0.8)) and 180 days (mild: 3.2% (2.0–4.4), severe: 0.3% (0.2–0.4)) post-infection (all p-values <0.0001), but no longer thereafter.

Interpretation​

This double-controlled study, incorporating pre- versus post-infection and uninfected symptom data, found a low risk of PCC among a community-dwelling adult population infected during the autumn 2023 SARS-CoV-2 wave. The prevalence of PCC-related symptoms in infected and uninfected individuals was not significantly different at 90–360 days post-infection. The excess prevalences of self-attributed long-term symptoms were elevated at 90 and 180 days post-infection but no longer from 270 days onwards. These findings suggest that the 2023 wave inferred a lower PCC risk than during the pandemic period.

Funding​

Funded by the Dutch Ministry of Health, Welfare and Sport.

 

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Sean Mullen on BlueSky:

November 12, 2025

Sean Mullen, Ph.D.​

@drseanmullen.bsky.social

Nine of 11 authors of a new Lancet paper are from the Dutch National Institute RIVM.They claim “Post-COVID-19 Condition (PCC)” — aka Long Covid — after 2023 is < 1 %.Sounds reassuring, right? It’s not.
They changed the definition.“PCC” = any one of 25 new mild symptoms crossing a survey threshold.No measure of worsening, fatigue crashes, or functional loss.That’s like redefining heart disease as “any new chest twinge lasting 3 months.”
Even with that narrow test, infected people in autumn 2023 still showed +7.2 % mild / +0.6 % severe at 3 mo, +3.2 % mild / +0.3 % severe at 6 mo.They still called that “low.”
Design bias everywhere:• Older, healthier volunteers• “Uninfected” defined by tests that miss cases• Those reinfected were “censored out.”“If either person in a matched pair got reinfected, both were removed from follow-up.”That erases the group most likely to develop Long Covid.
Even so, confidence intervals allow ~1–2 % true excess risk = thousands per wave.
The Netherlands is already using this to justify inaction. That’s not science. That’s spin.
Lower average risk ≠ zero risk.Keep clean air, paid sick leave, Long Covid clinics, and real surveillance (function, vascular & immune metrics, return-to-work). Lancet Regional Health – Europe (2025) www.sciencedirect.com#LongCovid #CleanAir #PublicHealth #COVIDisNotOver
https://www.sciencedirect.com/science/article/pii/S2666776225002649