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medRxiv preprint
doi: https://doi.org/10.1101/2021.01.27.21250617;
this version posted January 30, 2021.
Sandra Lopez-Leon MD, PhD1,*, Talia Wegman-Ostrosky MD, PhD2, Carol Perelman, BSc3, Rosalinda Sepulveda MD PhD 4, Paulina A Rebolledo, MD, MSc5,6, Angelica Cuapio MD, Dr. Med7, Sonia Villapol, PhD8,9,*
ABSTRACT
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 long- term effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. 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 1st 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 I2 statistics. This systematic review followed Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) guidelines, although the study protocol was not registered. A total of 18,251 publications were identified, 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 five 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). In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi- disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID- 19 care.
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Figure 2. Long-term effects of coronavirus disease 2019 (COVID-19). The meta-analysis of the studies included an estimate for one symptom or more reported that 80% of the patients with COVID-19 have long-term symptoms. Abbreviations: C-reactive protein (CRP), computed tomography (CT), Interleukin-6 (IL-6), N-terminal (NT)-pro hormone BNP (NT-proBNP), Obsessive Compulsive Disorder (OCD), Post-traumatic stress disorder (PTSD)
doi: https://doi.org/10.1101/2021.01.27.21250617;
this version posted January 30, 2021.
Sandra Lopez-Leon MD, PhD1,*, Talia Wegman-Ostrosky MD, PhD2, Carol Perelman, BSc3, Rosalinda Sepulveda MD PhD 4, Paulina A Rebolledo, MD, MSc5,6, Angelica Cuapio MD, Dr. Med7, Sonia Villapol, PhD8,9,*
ABSTRACT
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 long- term effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. 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 1st 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 I2 statistics. This systematic review followed Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) guidelines, although the study protocol was not registered. A total of 18,251 publications were identified, 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 five 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). In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi- disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID- 19 care.
...
Figure 2. Long-term effects of coronavirus disease 2019 (COVID-19). The meta-analysis of the studies included an estimate for one symptom or more reported that 80% of the patients with COVID-19 have long-term symptoms. Abbreviations: C-reactive protein (CRP), computed tomography (CT), Interleukin-6 (IL-6), N-terminal (NT)-pro hormone BNP (NT-proBNP), Obsessive Compulsive Disorder (OCD), Post-traumatic stress disorder (PTSD)
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