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

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.

Role of Microbiota in Viral Infections and Pathological Progression

“…In a recent cross-sectional analysis using public databases from 10 countries worldwide, it was reported that the genus Collinsella could prevent severe illness after infection through bile acids [ 81 ]. The characteristic symptoms of COVID-19 are gastrointestinal disturbance, mood disorder, and extreme malaise, which persist for a long time after healing [ 82 , 83 ]. These are called long-term complications of COVID-19, and it has been suggested that these symptoms are related to dysbiosis [ 84 , 85 , 86 , 87 , 88 ].…”

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

“…An important percentage of subjects has important clinical, functional or radiological sequelae (long-term COVID-19 syndrome) months after the acute infection, especially those who suffered from a severe pneumonia admitted to the intensive care unit (ICU). 12 , 13 , 14 , 15 , 16 Finally, many treatments both pharmacological (especially antivirals, immunomodulators and anti-inflammatories) and non-pharmacological treatments has been used during this pandemic era at different moments and severities of the disease, sometimes with controversial results. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 …”

Neurological and Mental Health Symptoms Associated with Post-COVID-19 Disability in a Sample of Patients Discharged from a COVID-19 Ward: A Secondary Analysis

“…Data from a meta-analysis showed that 63.2%, 71.9%, and 45.9% of patients experienced at least one persistent symptom at 30, 60, and 90 days after infection, respectively [ 10 ]. Moreover, the persistence of sequelae in survivors of COVID-19 has been highlighted by another meta-analysis at 7 months [ 11 ] and a year after infection [ 12 ]. Neurological and mental health symptoms, herein broadly defined as brain-related symptoms, have been suggested to constitute a relevant health problem in COVID-19 survivors and can potentially affect patients’ perceptions of their level of health, disability, and functioning.…”