Abstract
Objectives: To synthesize existing evidence on prevalence as well as clinical and socio-economic aspects of Long COVID. Methods: An umbrella review of reviews and a targeted evidence synthesis of their primary studies, including searches in four electronic databases, reference lists of included reviews, as well as related article lists of relevant publications. Results: Synthesis included 23 reviews and 102 primary studies. Prevalence estimates ranged from 7.5% to 41% in non-hospitalized adults, 2.3%–53% in mixed adult samples, 37.6% in hospitalized adults, and 2%–3.5% in primarily non-hospitalized children. Preliminary evidence suggests that female sex, age, comorbidities, the severity of acute disease, and obesity are associated with Long COVID. Almost 50% of primary studies reported some degree of Long COVID-related social and family-life impairment, long absence periods off work, adjusted workloads, and loss of employment. Conclusion: Long COVID will likely have a substantial public health impact. Current evidence is still heterogeneous and incomplete. To fully understand Long COVID, well-designed prospective studies with representative samples will be essential.
Highlights
Long COVID is a novel syndrome that is broadly defined by the persistence of physical and/or psychological and cognitive symptoms following a probable or confirmed SARS-CoV-2 infection, usually 3 months from acute infection and lasting longer than 2 months, with no probable alternative diagnosis [1, 2]
We only provided a detailed report of prevalence estimates derived from studies with population-based samples and/or control participants, as these studies are more likely to yield more robust and less biased estimates
Given the recent emergence of Long COVID and the premature state of ongoing research, the current literature inevitably provides a still patchy, heterogeneous, and inconclusive picture of its overall burden and broader public health implications. This heterogeneity is well reflected in currently reported prevalence estimates for adults, which range from 7.5% to 41% for samples of non-hospitalized participants, and 2.3%–53% for samples with hospitalized and non-hospitalized participants
Summary
Long COVID is a novel syndrome that is broadly defined by the persistence of physical and/or psychological and cognitive symptoms following a probable or confirmed SARS-CoV-2 infection, usually 3 months from acute infection and lasting longer than 2 months, with no probable alternative diagnosis [1, 2]. Some of the commonly used terms include “long haulers,” “post-acute COVID-19,” “persistent COVID-19 symptoms,” “post COVID-19 manifestations,” “post COVID-19 syndrome,” “chronic COVID-19 syndrome,” “post-infectious COVID-19,” “post-acute sequelae of SARS-CoV-2 infection,” and “post COVID-19 recovery syndrome” [1, 3–7]. The National Institute for Health and Care Excellence (NICE) guidelines classifies Long COVID in two categories: 1) “ongoing symptomatic COVID-19” for symptoms lasting from four to 12 weeks and 2) “Post-COVID-19 syndrome” for persisting symptoms beyond 12 weeks after disease onset; both categories only hold if symptoms cannot be explained by alternative diagnoses [1, 6, 8, 9].
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