Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis

Alkodaymi, Mohamad Salim; Omrani, Osama; Fawzy, Nader Ashraf; Shaar, Bader Abou; Almamlouk, Raghed; Riaz, Muhammad; Obeidat, Mustafa A; Obeidat, Yasin; Gerberi, Dana; Taha, Rand M.; Kashour, Zakaria; Kashour, Tarek; Berbari, Elie F.; Alkattan, Khaled; Tleyjeh, Imad M.

doi:10.1016/j.cmi.2022.01.014

Cited by 344 publications

(346 citation statements)

References 96 publications

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“…Heart abnormalities, cognitive impairment, sleep disturbances, post-traumatic stress disorder (PTSD), and concentration problems have also been reported ( Aiyegbusi et al., 2021 ). Table 1 summarizes other reviews on long COVID symptoms ( Ahmad et al., 2021 ; Cabrerai Martimbianco et al., 2021 ; Ceban et al., 2021 ; Groff et al., 2021 ; Long et al., 2021 ; Lopez-Leon et al., 2021 ; Michelen et al., 2021 ; Alkodaymi et al., 2022 ; Malik et al., 2022 ; Nguyen et al., 2022 ). There have also been recent studies on the pathophysiological mechanism of long COVID.…”

Section: Introductionmentioning

confidence: 99%

Long COVID: The Nature of Thrombotic Sequelae Determines the Necessity of Early Anticoagulation

Wang

Jing

et al. 2022

Front. Cell. Infect. Microbiol.

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Many discharged COVID-19 patients affected by sequelae experience reduced quality of life leading to an increased burden on the healthcare system, their families and society at large. Possible pathophysiological mechanisms of long COVID include: persistent viral replication, chronic hypoxia and inflammation. Ongoing vascular endothelial damage promotes platelet adhesion and coagulation, resulting in the impairment of various organ functions. Meanwhile, thrombosis will further aggravate vasculitis contributing to further deterioration. Thus, long COVID is essentially a thrombotic sequela. Unfortunately, there is currently no effective treatment for long COVID. This article summarizes the evidence for coagulation abnormalities in long COVID, with a focus on the pathophysiological mechanisms of thrombosis. Extracellular vesicles (EVs) released by various types of cells can carry SARS-CoV-2 through the circulation and attack distant tissues and organs. Furthermore, EVs express tissue factor and phosphatidylserine (PS) which aggravate thrombosis. Given the persistence of the virus, chronic inflammation and endothelial damage are inevitable. Pulmonary structural changes such as hypertension, embolism and fibrosis are common in long COVID. The resulting impaired lung function and chronic hypoxia again aggravates vascular inflammation and coagulation abnormalities. In this article, we also summarize recent research on antithrombotic therapy in COVID-19. There is increasing evidence that early anticoagulation can be effective in improving outcomes. In fact, persistent systemic vascular inflammation and dysfunction caused by thrombosis are key factors driving various complications of long COVID. Early prophylactic anticoagulation can prevent the release of or remove procoagulant substances, thereby protecting the vascular endothelium from damage, reducing thrombotic sequelae, and improving quality of life for long-COVID patients.

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Section: Introductionmentioning

confidence: 99%

Long COVID: The Nature of Thrombotic Sequelae Determines the Necessity of Early Anticoagulation

Wang

Jing

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Although the majority of individuals infected with SARS-CoV-2 recover, there is a significant subpopulation of patients with persistent symptoms 4 weeks after infection, even among those who suffered from mild-to-moderate COVID-19. Some of that symptomatology include brain fog, exertional fatigue, dyspnea, chest tightness, gastrointestinal disturbances, and vertigo ( Alkodaymi et al, 2022 ). Those symptoms and their resultant clinical signs (e.g., glucose intolerance, sleep disorders, postural hypotension, and cardiac arrythmias) may also represent prodromes to future health threats (e.g., development of autoimmune diseases).…”

Section: Introductionmentioning

confidence: 99%

Post-acute sequelae of COVID-19: A metabolic perspective

Scherer

Kirwan

Rosen

2022

eLife

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The SARS-CoV-2 pandemic continues to rage around the world. At the same time, despite strong public health measures and high vaccination rates in some countries, a post-COVID-19 syndrome has emerged which lacks a clear definition, prevalence, or etiology. However, fatigue, dyspnea, brain fog, and lack of smell and/or taste are often characteristic of patients with this syndrome. These are evident more than a month after infection, and are labeled as Post-Acute Sequelae of CoV-2 (PASC) or commonly referred to as long-COVID. Metabolic dysfunction (i.e., obesity, insulin resistance, and diabetes mellitus) is a predisposing risk factor for severe acute COVID-19, and there is emerging evidence that this factor plus a chronic inflammatory state may predispose to PASC. In this article, we explore the potential pathogenic metabolic mechanisms that could underly both severe acute COVID-19 and PASC, and then consider how these might be targeted for future therapeutic approaches.

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“…The prevalence of post-acute symptoms varies widely across studies. [6][7][8][9] The available epidemiological study results have been challenging and difficult to interpret given the variety and heterogeneity of methodologies used, including the differences in selection of patient populations, availability of comparison groups, different follow-up periods, and inconsistent terms used to describe symptoms and adverse health conditions. Fatigue, respiratory and neurological sequelae, however, were the most frequent concerns in most previous work 13 , and the present study strongly suggests that this symptom complex affects even subjects with mild COVID-19 and younger populations more than half a year after acute infection.…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms can last for weeks and represent delayed reconvalescence or can persist or recur even three months or longer into the post-acute phase. [6][7][8][9] While "long covid" has been defined as ongoing symptoms beyond four weeks after acute infection, post-COVID-19 condition or post-COVID syndrome (PCS) is considered in individuals with symptoms lasting for at least two months, being unexplained by an alternative diagnosis, and occurring three months from the acute infection. 10 So far, very few larger-scaled studies have examined the symptomatology and prevalence of PCS beyond six months after acute infection and its association with health-related quality of life, well-being, and working capacity in a populationbased, non-clinical sample.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, determinants, and impact on general health and working capacity of post-acute sequelae of COVID-19 six to 12 months after infection: a population-based retrospective cohort study from southern Germany

Peter

Nieters

Kraeusslich

et al. 2022

Preprint

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Background: Post-acute sequelae of SARS-CoV-2 infection have commonly been described after COVID-19, but few population-based studies have examined symptoms six to 12 months after acute SARS-CoV-2 infection and their associations with general health recovery and working capacity. Methods: This population-based retrospective cohort study in four geographically defined regions in southern Germany included persons aged 18-65 years with PCR confirmed SARS-CoV-2 infection between October 2020 and March 2021. Symptom frequencies (six to 12 months after versus before acute infection, expressed as prevalence differences [PD] and ratios [PR]), symptom severity and clustering, risk factors and associations with general health recovery, and working capacity were analysed. Findings: Among a total of 11,710 subjects (mean age 44.1 years, 59.8% females, 3.5% previously admitted with COVID-19, mean follow-up time 8.5 months) the most prevalent symptoms with PDs >20% and PRs >5% were rapid physical exhaustion, shortness of breath, concentration difficulties, chronic fatigue, memory disturbance, and altered sense of smell. Female sex and severity of the initial infection were the main risk factors. Prevalence rates, however, appeared substantial among both men and women who had a mild course of acute infection, and PCS considerably affected also younger subjects. Fatigue (PD 37.2%) and neurocognitive impairment (PD 31.3%) as symptom clusters contributed most to reduced health recovery and working capacity, but chest symptoms, anxiety/depression, headache/dizziness and pain syndromes were also prevalent and relevant for working capacity, with some differences according to sex and age. When considering new symptoms with at least moderate impairment of daily life and ≤80% recovered general health or working capacity, the overall estimate for post-COVID syndrome was 28.5% (age- and sex-standardised rate 26.5%). Interpretation The burden of self-reported post-acute symptoms and possible sequelae, notably fatigue and neurocognitive impairment, remains considerable six to 12 months after acute infection even among young and middle-aged adults after mild acute SARS-CoV-2 infection, and impacts general health and working capacity.

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Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis

Cited by 344 publications

References 96 publications

Long COVID: The Nature of Thrombotic Sequelae Determines the Necessity of Early Anticoagulation

Long COVID: The Nature of Thrombotic Sequelae Determines the Necessity of Early Anticoagulation

Post-acute sequelae of COVID-19: A metabolic perspective

Prevalence, determinants, and impact on general health and working capacity of post-acute sequelae of COVID-19 six to 12 months after infection: a population-based retrospective cohort study from southern Germany

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