Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Feb 19;11(2):269.
doi: 10.3390/pathogens11020269.

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of One-Year Follow-Up Studies on Post-COVID Symptoms

Qing Han  1 , Bang Zheng  2   3   4 , Luke Daines  2 , Aziz Sheikh  2
Affiliations
Review

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of One-Year Follow-Up Studies on Post-COVID Symptoms

Qing Han et al. Pathogens. .

Abstract

Emerging evidence has shown that COVID-19 survivors could suffer from persistent symptoms. However, it remains unclear whether these symptoms persist over the longer term. This study aimed to systematically synthesise evidence on post-COVID symptoms persisting for at least 12 months. We searched PubMed and Embase for papers reporting at least one-year follow-up results of COVID-19 survivors published by 6 November 2021. Random-effects meta-analyses were conducted to estimate pooled prevalence of specific post-COVID symptoms. Eighteen papers that reported one-year follow-up data from 8591 COVID-19 survivors were included. Fatigue/weakness (28%, 95% CI: 18-39), dyspnoea (18%, 95% CI: 13-24), arthromyalgia (26%, 95% CI: 8-44), depression (23%, 95% CI: 12-34), anxiety (22%, 95% CI: 15-29), memory loss (19%, 95% CI: 7-31), concentration difficulties (18%, 95% CI: 2-35), and insomnia (12%, 95% CI: 7-17) were the most prevalent symptoms at one-year follow-up. Existing evidence suggested that female patients and those with more severe initial illness were more likely to suffer from the sequelae after one year. This study demonstrated that a sizeable proportion of COVID-19 survivors still experience residual symptoms involving various body systems one year later. There is an urgent need for elucidating the pathophysiologic mechanisms and developing and testing targeted interventions for long-COVID patients.

Keywords: long-COVID; meta-analysis; post-acute sequelae of COVID-19; prevalence; symptom.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Forest plot for prevalence of post-COVID fatigue and respiratory symptoms. Note: There were missing values for dyspnoea and fatigue in papers of Huang et al. [25] and Latronico et al. [26].
Figure 3
Figure 3
Forest plot for prevalence of post-COVID mental health and cognitive symptoms. Note: There were missing values for depression and insomnia in the paper of Latronico et al. [26].
Figure 4
Figure 4
Forest plot for prevalence of other post-COVID symptoms.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization World Health Organization (WHO) Coronavirus (COVID-19) Dashboard. [(accessed on 17 January 2022)]. Available online: https://covid19.who.int/
    1. Lopez-Leon S., Wegman-Ostrosky T., Perelman C., Sepulveda R., Rebolledo P.A., Cuapio A., Villapol S. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Sci. Rep. 2021;11:16144. doi: 10.1038/s41598-021-95565-8. - DOI - PMC - PubMed
    1. National Institute for Health and Care Excellence COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19. [(accessed on 17 January 2022)]. Available online: https://www.nice.org.uk/guidance/ng188. - PubMed
    1. Fernandez-de-Las-Penas C., Palacios-Cena D., Gomez-Mayordomo V., Florencio L.L., Cuadrado M.L., Plaza-Manzano G., Navarro-Santana M. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. Eur. J. Intern. Med. 2021;92:55–70. doi: 10.1016/j.ejim.2021.06.009. - DOI - PMC - PubMed
    1. Michelen M., Manoharan L., Elkheir N., Cheng V., Dagens A., Hastie C., O’Hara M., Suett J., Dahmash D., Bugaeva P., et al. Characterising long COVID: A living systematic review. BMJ Glob. Health. 2021;6:e005427. doi: 10.1136/bmjgh-2021-005427. - DOI - PMC - PubMed

LinkOut - more resources