More than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis

Abstract

Background. 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. This systematic review and meta-analysis aims to identify studies assessing longterm effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. Methods. LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. All articles with original data for detecting long-term COVID-19 published before 1 st 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 I 2 statistics. This systematic review followed Preferred Reporting Items for Systematic Reviewers and Metaanalysis (PRISMA) guidelines, although the study protocol was not registered. Results. A total of 18,251 publications were identi ed, 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 14 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 long-term symptoms. The ve most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). All meta-analyses showed medium (n=2) to high heterogeneity (n=13). Conclusions. In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, the severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multidisciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care. Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in China in December 2019. Since then, more than 90 million people worldwide have been infected after a year, and over 2 million people have died from the coronavirus disease 2019 (COVID-19)(1). Although unprecedented efforts from the scienti c 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. To date, 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", amon...

Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis

“…In the last months, an increasing number of studies assessing the presence of post-COVID-19 symptoms have been published. In fact, a meta-analysis has been recently published as a preprint [6] . This meta-analysis found that 80% of COVID-19 survivors exhibited at least one post-COVID-19 symptom, being fatigue (58%), headache (44%), attention disorders (27%), hair loss (25%), and dyspnea (24%) the most frequent [6] .…”

“…In fact, a meta-analysis has been recently published as a preprint [6] . This meta-analysis found that 80% of COVID-19 survivors exhibited at least one post-COVID-19 symptom, being fatigue (58%), headache (44%), attention disorders (27%), hair loss (25%), and dyspnea (24%) the most frequent [6] . However, this review pooled prevalence rates without considering follow-up periods after symptoms and did not differentiate between hospitalized and non-hospitalized patients [6] .…”

Symptom Cluster Analysis of long COVID-19 in Patients Discharged from the Temporary COVID-19 Hospital in Mexico City: A Longitudinal Study

“…The ten most frequent individual symptoms at 30-and 90 days post-discharge were fatigue, headache, sadness, alopecia, insomnia, desire to cry, anguish, anger, anhedonia, and back pain, which are similar to those described in previous reports. 5,11,15,19 Most recently, a study on the attributes and predictors of long COVID-19 also reported similar individual symptoms (i.e., fatigue, headache, dyspnoea, and anosmia) that persisted for 12 weeks. 3 Although symptoms like fatigue, cough, and chest pain decreased over time in our study, patients who were discharged from the TCH reported higher frequencies of alopecia, rhinorrhoea, lacrimation, lack of concentration, paraesthesia, arthralgia, and memory loss at 90 days compared with 30 days.…”

Evolutionary Inference Predicts Novel ACE2 Protein Interactions Relevant to COVID-19 Pathologies

“…A severe and often lethal immunoreaction can occur from respiratory and other infection sites, termed a "cytokine storm" (C. Chen, Zhang, Ju, & He, 2020). Even after acute SARS-CoV-2 infection has passed, individuals can suffer a suite of complications for many months, termed "Long Haul" syndrome (López-León et al, 2021), and the causes of these syndromes are not well understood.…”