Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of One-Year Follow-Up Studies on Post-COVID Symptoms

Qing Han, Bang Zheng, Luke Daines, Aziz Sheikh, Qing Han, Bang Zheng, Luke Daines, Aziz Sheikh

Abstract

Emerging evidence has shown that COVID-19 survivors could suffer from persistent symptoms. However, it remains unclear whether these symptoms persist over the longer term. This study aimed to systematically synthesise evidence on post-COVID symptoms persisting for at least 12 months. We searched PubMed and Embase for papers reporting at least one-year follow-up results of COVID-19 survivors published by 6 November 2021. Random-effects meta-analyses were conducted to estimate pooled prevalence of specific post-COVID symptoms. Eighteen papers that reported one-year follow-up data from 8591 COVID-19 survivors were included. Fatigue/weakness (28%, 95% CI: 18-39), dyspnoea (18%, 95% CI: 13-24), arthromyalgia (26%, 95% CI: 8-44), depression (23%, 95% CI: 12-34), anxiety (22%, 95% CI: 15-29), memory loss (19%, 95% CI: 7-31), concentration difficulties (18%, 95% CI: 2-35), and insomnia (12%, 95% CI: 7-17) were the most prevalent symptoms at one-year follow-up. Existing evidence suggested that female patients and those with more severe initial illness were more likely to suffer from the sequelae after one year. This study demonstrated that a sizeable proportion of COVID-19 survivors still experience residual symptoms involving various body systems one year later. There is an urgent need for elucidating the pathophysiologic mechanisms and developing and testing targeted interventions for long-COVID patients.

Keywords: long-COVID; meta-analysis; post-acute sequelae of COVID-19; prevalence; symptom.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Forest plot for prevalence of post-COVID fatigue and respiratory symptoms. Note: There were missing values for dyspnoea and fatigue in papers of Huang et al. [25] and Latronico et al. [26].
Figure 3
Figure 3
Forest plot for prevalence of post-COVID mental health and cognitive symptoms. Note: There were missing values for depression and insomnia in the paper of Latronico et al. [26].
Figure 4
Figure 4
Forest plot for prevalence of other post-COVID symptoms.

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Source: PubMed

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