Six years after the COVID-19 pandemic began, its economic aftershocks continue to ripple across Europe. A new study from the OECD, covering 21 EU member states and other OECD countries, projects that long COVID could cost between €58.54 billion and €115.3 billion each year through 2035. These figures reflect both direct healthcare expenditures and broader macroeconomic losses from reduced labour participation and productivity.
Under optimistic assumptions, GDP losses could shrink to negligible levels by the mid-2030s. But more realistic scenarios suggest persistent annual losses of 0.1% to 0.2% of GDP — sums comparable to the entire annual health budget of the Netherlands or Spain. Direct healthcare costs alone are expected to remain around €9.5 billion per year until at least 2035.
Beyond the Core Symptoms
Long COVID is not merely a lingering respiratory illness. Infection with SARS-CoV-2 increases the risk of developing a range of chronic conditions, including cardiovascular disease, diabetes, neurological impairments, and autoimmune disorders. These secondary effects will place additional strain on health systems and drive up costs in the years ahead, the report warns. The full impact may take considerable time to become visible.
The condition also threatens children's development and educational attainment — factors not yet captured in current economic projections. While less than 1% of the population in EU and OECD countries is expected to suffer from long COVID over the next decade, around 75 million people globally had the illness in 2021.
In 2021, parts of Eastern and Central Europe were the most affected. This year, approximately 1.1 million people in Bulgaria, 1.4 million in Hungary, and 1.2 million in Czechia were living with long COVID.
Workforce Disruption and Policy Gaps
Patients with long COVID are dropping out of the workforce, taking sick leave, or working at reduced capacity. Studies show that employment disruption occurs in about one in five affected workers. Only six EU countries — Austria, Belgium, France, Germany, Luxembourg, and the Netherlands — have structured clinical care plans for long COVID patients.
The report calls for strengthening diagnosis, treatment, and social welfare support to improve patients' health and facilitate their reintegration into the workforce. Research from the UK, for example, highlights that workplace flexibility — such as flexible hours, remote work, and a supportive culture — is key to helping employees manage the condition.
For context, the socio-economic burden of long COVID dwarfs that of other chronic conditions. If compared to the national burden of multiple sclerosis, it would cost France about €2.7 billion and Italy about €4.8 billion annually. If compared to stroke, the cost to Europe would be around €60 billion per year. However, the study notes a crucial difference: while stroke and multiple sclerosis generate most costs through healthcare and informal care, long COVID's burden arises mainly from reduced labour participation and productivity losses — a broader macroeconomic impact rather than medical expenditure alone.
As European economies grapple with persistent labour shortages and rising healthcare costs, the findings underscore the need for coordinated policy responses. The Katowice Economic Congress recently highlighted the importance of self-sufficiency in health and social systems, a theme that resonates with the long COVID challenge. Meanwhile, the Polish G20 presidency has amplified calls for Central European voices in global economic governance, including health resilience.
The full economic toll of long COVID will depend on how quickly diagnosis, treatment, and workplace accommodations improve. Without decisive action, the condition could become a persistent drag on European productivity and public finances for years to come.
