Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis.
COVID-19
Coronavirus
PACS
Post-acute COVID-19 syndrome
SARS-CoV-2
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
02
07
2021
revised:
13
01
2022
accepted:
17
01
2022
pubmed:
7
2
2022
medline:
4
5
2022
entrez:
6
2
2022
Statut:
ppublish
Résumé
Post-acute coronavirus 2019 (COVID-19) syndrome is now recognized as a complex systemic disease that is associated with substantial morbidity. To estimate the prevalence of persistent symptoms and signs at least 12 weeks after acute COVID-19 at different follow-up periods. Searches were conducted up to October 2021 in Ovid Embase, Ovid Medline, and PubMed. Articles in English that reported the prevalence of persistent symptoms among individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection and included at least 50 patients with a follow-up of at least 12 weeks after acute illness. Random-effect meta-analysis was performed to produce a pooled prevalence for each symptom at four different follow-up time intervals. Between-study heterogeneity was evaluated using the I2 statistic and was explored via meta-regression, considering several a priori study-level variables. Risk of bias was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa Scale for prevalence studies and comparative studies, respectively. After screening 3209 studies, a total of 63 studies were eligible, with a total COVID-19 population of 257 348. The most commonly reported symptoms were fatigue, dyspnea, sleep disorder, and difficulty concentrating (32%, 25%, 24%, and 22%, respectively, at 3- to <6-month follow-up); effort intolerance, fatigue, sleep disorder, and dyspnea (45%, 36%, 29%, and 25%, respectively, at 6- to <9-month follow-up); fatigue (37%) and dyspnea (21%) at 9 to <12 months; and fatigue, dyspnea, sleep disorder, and myalgia (41%, 31%, 30%, and 22%, respectively, at >12-month follow-up). There was substantial between-study heterogeneity for all reported symptom prevalences. Meta-regressions identified statistically significant effect modifiers: world region, male sex, diabetes mellitus, disease severity, and overall study quality score. Five of six studies including a comparator group consisting of COVID-19-negative cases observed significant adjusted associations between COVID-19 and several long-term symptoms. This systematic review found that a large proportion of patients experience post-acute COVID-19 syndrome 3 to 12 months after recovery from the acute phase of COVID-19. However, available studies of post-acute COVID-19 syndrome are highly heterogeneous. Future studies need to have appropriate comparator groups, standardized symptom definitions and measurements, and longer follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
Post-acute coronavirus 2019 (COVID-19) syndrome is now recognized as a complex systemic disease that is associated with substantial morbidity.
OBJECTIVES
OBJECTIVE
To estimate the prevalence of persistent symptoms and signs at least 12 weeks after acute COVID-19 at different follow-up periods.
DATA SOURCES
METHODS
Searches were conducted up to October 2021 in Ovid Embase, Ovid Medline, and PubMed.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS
METHODS
Articles in English that reported the prevalence of persistent symptoms among individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection and included at least 50 patients with a follow-up of at least 12 weeks after acute illness.
METHODS
METHODS
Random-effect meta-analysis was performed to produce a pooled prevalence for each symptom at four different follow-up time intervals. Between-study heterogeneity was evaluated using the I2 statistic and was explored via meta-regression, considering several a priori study-level variables. Risk of bias was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa Scale for prevalence studies and comparative studies, respectively.
RESULTS
RESULTS
After screening 3209 studies, a total of 63 studies were eligible, with a total COVID-19 population of 257 348. The most commonly reported symptoms were fatigue, dyspnea, sleep disorder, and difficulty concentrating (32%, 25%, 24%, and 22%, respectively, at 3- to <6-month follow-up); effort intolerance, fatigue, sleep disorder, and dyspnea (45%, 36%, 29%, and 25%, respectively, at 6- to <9-month follow-up); fatigue (37%) and dyspnea (21%) at 9 to <12 months; and fatigue, dyspnea, sleep disorder, and myalgia (41%, 31%, 30%, and 22%, respectively, at >12-month follow-up). There was substantial between-study heterogeneity for all reported symptom prevalences. Meta-regressions identified statistically significant effect modifiers: world region, male sex, diabetes mellitus, disease severity, and overall study quality score. Five of six studies including a comparator group consisting of COVID-19-negative cases observed significant adjusted associations between COVID-19 and several long-term symptoms.
CONCLUSIONS
CONCLUSIONS
This systematic review found that a large proportion of patients experience post-acute COVID-19 syndrome 3 to 12 months after recovery from the acute phase of COVID-19. However, available studies of post-acute COVID-19 syndrome are highly heterogeneous. Future studies need to have appropriate comparator groups, standardized symptom definitions and measurements, and longer follow-up.
Identifiants
pubmed: 35124265
pii: S1198-743X(22)00038-6
doi: 10.1016/j.cmi.2022.01.014
pmc: PMC8812092
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
657-666Informations de copyright
Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Références
Control Clin Trials. 1986 Sep;7(3):177-88
pubmed: 3802833
Eur Respir J. 2020 Nov 26;56(5):
pubmed: 33008936
Lancet. 2021 Aug 28;398(10302):747-758
pubmed: 34454673
J Intern Med. 2021 Aug;290(2):444-450
pubmed: 33904618
J Infect. 2021 Nov;83(5):581-588
pubmed: 34400219
BMJ. 2021 May 19;373:n1098
pubmed: 34011492
Infect Dis (Lond). 2022 Jan;54(1):53-62
pubmed: 34410220
Virol J. 2021 Apr 12;18(1):73
pubmed: 33845839
Lancet Psychiatry. 2021 May;8(5):416-427
pubmed: 33836148
Br J Anaesth. 2021 Mar;126(3):e110-e113
pubmed: 33413976
Front Med (Lausanne). 2021 May 07;8:617689
pubmed: 34026775
J Neurol. 2021 Dec;268(12):4422-4428
pubmed: 33932157
Radiology. 2021 Nov;301(2):E396-E405
pubmed: 34313468
Nat Med. 2021 Sep;27(9):1607-1613
pubmed: 34163090
EClinicalMedicine. 2020 Aug;25:100484
pubmed: 32838240
Int J Diabetes Dev Ctries. 2022 Jan;42(1):49-52
pubmed: 34456528
Psychiatry Res. 2020 Sep;291:113230
pubmed: 32593067
Clin Infect Dis. 2022 Apr 9;74(7):1191-1198
pubmed: 34223884
BMJ. 2015 Jan 02;350:g7647
pubmed: 25555855
JAMA Netw Open. 2020 Jan 3;3(1):e1919325
pubmed: 31922554
Infect Chemother. 2021 Sep;53(3):463-476
pubmed: 34405592
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4831-4837
pubmed: 33774737
Mayo Clin Proc Innov Qual Outcomes. 2021 Oct;5(5):907-915
pubmed: 34396048
Can Respir J. 2021 Feb 13;2021:6692409
pubmed: 33628349
Int Forum Allergy Rhinol. 2021 Dec;11(12):1685-1688
pubmed: 34109765
Int J Gen Med. 2021 Aug 26;14:4829-4836
pubmed: 34471377
Int J Environ Res Public Health. 2021 Feb 19;18(4):
pubmed: 33669714
Lancet. 2021 Jan 16;397(10270):220-232
pubmed: 33428867
Eur Respir J. 2021 Jul 22;58(1):
pubmed: 33574077
Nature. 2021 Jun;594(7862):259-264
pubmed: 33887749
PLoS One. 2021 Aug 26;16(8):e0256142
pubmed: 34437579
Brain Sci. 2021 Jun 08;11(6):
pubmed: 34201087
Am J Otolaryngol. 2021 Sep-Oct;42(5):102648
pubmed: 33799139
JAMA Intern Med. 2013 Nov 11;173(20):1857-8
pubmed: 23921959
Lancet. 2020 Mar 21;395(10228):e52
pubmed: 32171074
J Infect. 2021 Jul;83(1):1-16
pubmed: 33992686
Respir Res. 2021 May 21;22(1):157
pubmed: 34020644
PLoS One. 2021 Jul 12;16(7):e0254523
pubmed: 34252157
J Neurol Sci. 2021 Jul 15;426:117486
pubmed: 34000678
Int J Cardiol. 2021 Oct 1;340:113-118
pubmed: 34311011
Ann Transl Med. 2021 Aug;9(15):1231
pubmed: 34532368
BMJ. 2020 Dec 23;371:m4938
pubmed: 33361141
JAMA Netw Open. 2021 May 3;4(5):e2111417
pubmed: 34037731
Nat Med. 2021 Jul;27(7):1129-1130
pubmed: 34140704
BMJ Glob Health. 2021 Sep;6(9):
pubmed: 34580069
Int J Infect Dis. 2021 Aug;109:209-216
pubmed: 34273510
JAMA Netw Open. 2021 Oct 1;4(10):e2128568
pubmed: 34643720
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
J Neurovirol. 2021 Feb;27(1):154-159
pubmed: 33528827
Clin Microbiol Infect. 2021 Jun;27(6):931-932
pubmed: 33418020
J Infect. 2020 Dec;81(6):e4-e6
pubmed: 32853602
Front Immunol. 2021 Jun 30;12:686029
pubmed: 34276671
High Blood Press Cardiovasc Prev. 2021 Jul;28(4):373-381
pubmed: 33909284
EClinicalMedicine. 2021 May 24;36:100899
pubmed: 34036253
Lancet Reg Health Eur. 2021 Jul;6:100122
pubmed: 34027514
Int J Evid Based Healthc. 2015 Sep;13(3):147-53
pubmed: 26317388
Open Forum Infect Dis. 2021 Sep 09;8(10):ofab440
pubmed: 34631916
Respir Med. 2021 May;181:106383
pubmed: 33839588
Emerg Radiol. 2020 Dec;27(6):711-719
pubmed: 33165674
Lancet Reg Health Eur. 2021 Dec;11:100242
pubmed: 34746909
Radiology. 2021 Apr;299(1):E177-E186
pubmed: 33497317
Clin Microbiol Infect. 2022 Mar;28(3):315-318
pubmed: 34826619
J Clin Nurs. 2021 Jun;30(11-12):1742-1750
pubmed: 33656210
Ann Intern Med. 2021 Jul;174(7):999-1003
pubmed: 33780290
Eur Respir J. 2021 Aug 26;58(2):
pubmed: 34385265
Acta Anaesthesiol Scand. 2021 Oct;65(9):1285-1292
pubmed: 34097753
Clin Infect Dis. 2021 Aug 2;73(3):e826-e829
pubmed: 33624010
Am J Otolaryngol. 2021 Jul-Aug;42(4):103065
pubmed: 33894627
J Korean Med Sci. 2020 Dec 07;35(47):e418
pubmed: 33289374
Infection. 2021 Oct;49(5):1007-1015
pubmed: 34091869
Mayo Clin Proc Innov Qual Outcomes. 2021 Feb;5(1):137-150
pubmed: 33163895
J Infect. 2021 Aug;83(2):237-279
pubmed: 33984399
Chest. 2021 Jul;160(1):187-198
pubmed: 33676998
BMJ Open. 2021 Jun 2;11(6):e049488
pubmed: 34083350
Lung. 2021 Jun;199(3):249-253
pubmed: 33993321
J Epidemiol Community Health. 2013 Nov 1;67(11):974-8
pubmed: 23963506
Cureus. 2021 Aug 15;13(8):e17189
pubmed: 34422503
Microorganisms. 2021 Aug 12;9(8):
pubmed: 34442798
Nat Med. 2021 Apr;27(4):601-615
pubmed: 33753937
J Clin Med. 2021 Jun 30;10(13):
pubmed: 34209085
Open Forum Infect Dis. 2021 Jul 16;8(8):ofab384
pubmed: 34386546
Sci Rep. 2021 Aug 9;11(1):16144
pubmed: 34373540
PLoS One. 2021 Dec 7;16(12):e0260568
pubmed: 34874962
Pan Afr Med J. 2020 Dec 01;37:289
pubmed: 33654513
Clin Exp Med. 2020 Nov;20(4):493-506
pubmed: 32720223
Respir Med Res. 2021 Nov;80:100822
pubmed: 34242974
Infection. 2022 Feb;50(1):157-168
pubmed: 34322859
Front Med (Lausanne). 2021 Nov 01;8:750378
pubmed: 34790680
Lancet Reg Health Eur. 2021 Sep;8:100186
pubmed: 34386785
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Eur Respir J. 2021 Apr 29;57(4):
pubmed: 33303539