Abstract
Background: COVID-19, caused by SARS-CoV-2, can involve sequelae that last weeks to months after initial recovery. The objective of this systematic review and meta-analysis is to identify studies assessing the long-term effects of COVID-19 and estimate the prevalence of each symptom, sign, or laboratory parameters of patients at a post-COVID-19 stage.Methods: In this systematic review and meta-analysis, LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. Studies published before 1st of January 2021 and with a minimum of 100 patients were included. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. Heterogeneity was assessed using the I2 statistics. PRISMA guidelines were followed.Findings: A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 15 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). In order to have a better understanding, there is a need for studies to stratify by sex, age, previous comorbidities, severity of COVID-19 (including asymptomatic), and duration of each symptom.Interpretation: From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address after-COVID-19 care.Funding: National Institute for Neurological Disorders and Stroke (NINDS), and Houston Methodist Research Institute, Houston, TX.Declaration of Interests: SLL is an employee of Novartis Pharmaceutical Company; the statements presented in the paper do not necessarily represent the position of the company. The remaining authors have no competing interests to declare.
Highlights
COVID-19, caused by Severe acute respiratory syndrome (SARS)-CoV-2, can involve sequelae and other medical complications that last weeks to months after initial recovery, which has come to be called Long-COVID or COVID long-haulers
It was estimated that 80% of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms
Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care
Summary
COVID-19, caused by SARS-CoV-2, can involve sequelae and other medical complications that last weeks to months after initial recovery, which has come to be called Long-COVID or COVID long-haulers. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in China in December 2019. Unprecedented efforts from the scientific and medical community have been directed to sequence, diagnose, treat, and prevent COVID-19, individuals' lasting effects after the acute phase of the disease are yet to be revealed. There is no established term to coin the slow and persistent condition in individuals with lasting sequelae of COVID-19. Different authors have used the terms “Long-COVID-19”, “Long Haulers”, “Post-acute COVID-19”, “Persistent COVID-19 Symptoms”, “Post COVID-19 manifestations”, “Longterm COVID-19 effects”, “Post COVID-19 syndrome", among others. In the absence of an agreed definition, we convened for this review to refer to "Long-term effects of COVID-19”
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