University of Leicester
Browse
1-s2.0-S2589537022004916-main.pdf (1.02 MB)

The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis

Download (1.02 MB)
journal contribution
posted on 2024-01-23, 11:28 authored by LL O'Mahoney, A Routen, C Gillies, W Ekezie, A Welford, A Zhang, U Karamchandani, N Simms-Williams, S Cassambai, A Ardavani, TJ Wilkinson, G Hawthorne, F Curtis, AP Kingsnorth, A Almaqhawi, T Ward, D Ayoubkhani, A Banerjee, M Calvert, R Shafran, T Stephenson, J Sterne, H Ward, RA Evans, F Zaccardi, S Wright, K Khunti
Background: The aim of this study was to systematically synthesise the global evidence on the prevalence of persistent symptoms in a general post COVID-19 population. Methods: A systematic literature search was conducted using multiple electronic databases (MEDLINE and The Cochrane Library, Scopus, CINAHL, and medRxiv) until January 2022. Studies with at least 100 people with confirmed or self-reported COVID-19 symptoms at ≥28 days following infection onset were included. Patient-reported outcome measures and clinical investigations were both assessed. Results were analysed descriptively, and meta-analyses were conducted to derive prevalence estimates. This study was pre-registered (PROSPERO-ID: CRD42021238247). Findings: 194 studies totalling 735,006 participants were included, with five studies conducted in those <18 years of age. Most studies were conducted in Europe (n = 106) or Asia (n = 49), and the time to follow-up ranged from ≥28 days to 387 days. 122 studies reported data on hospitalised patients, 18 on non-hospitalised, and 54 on hospitalised and non-hospitalised combined (mixed). On average, at least 45% of COVID-19 survivors, regardless of hospitalisation status, went on to experience at least one unresolved symptom (mean follow-up 126 days). Fatigue was frequently reported across hospitalised (28.4%; 95% CI 24.7%–32.5%), non-hospitalised (34.8%; 95% CI 17.6%–57.2%), and mixed (25.2%; 95% CI 17.7%–34.6%) cohorts. Amongst the hospitalised cohort, abnormal CT patterns/x-rays were frequently reported (45.3%; 95% CI 35.3%–55.7%), alongside ground glass opacification (41.1%; 95% CI 25.7%–58.5%), and impaired diffusion capacity for carbon monoxide (31.7%; 95% CI 25.8%–3.2%). Interpretation: Our work shows that 45% of COVID-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at ∼ 4 months. Current understanding is limited by heterogeneous study design, follow-up durations, and measurement methods. Definition of subtypes of Long Covid is unclear, subsequently hampering effective treatment/management strategies. Funding: No funding.

History

Author affiliation

Diabetes Research Centre, University of Leicester

Version

  • VoR (Version of Record)

Published in

eClinicalMedicine

Volume

55

Pagination

101762

Publisher

Elsevier BV

issn

2589-5370

eissn

2589-5370

Copyright date

2022

Available date

2024-01-23

Spatial coverage

England

Language

eng

Usage metrics

    University of Leicester Publications

    Categories

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC