Systematic review of the prevalence of Long Covid
Systematic review of the prevalence of Long Covid
Background: Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection.
Methods: we searched key registers and databases from January 1, 2020 to November 2, 2021, limited to publications in English and studies with at least 100 participants. Studies in which all participants were critically ill were excluded. Long COVID was extracted as prevalence of at least 1 symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across predefined subgroups (PROSPERO ID CRD42020218351).
Results: one hundred twenty studies in 130 publications were included. Length of follow-up varied between 12 weeks and 12 months. Few studies had low risk of bias. All complete and subgroup analyses except 1 had I2 ≥90%, with prevalence of persistent symptoms range of 0%-93% (pooled estimate [PE], 42.1%; 95% prediction interval [PI], 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE, 13.6%; PI, 1.2% to 68%) of persistent symptoms/pathology than self-report (PE, 43.9%; PI, 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all 3 (PE, 51.7%; PI, 12.3% to 89.1%). Studies of hospitalized cases had generally higher estimates than community-based studies.
Conclusions: the way in which Long COVID is defined and measured affects prevalence estimation. Given the widespread nature of SARS-CoV-2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates.
Long COVID, SARS-CoV-2, prevalence, systematic review
Woodrow, Mirembe Claire
41f1b209-aeb8-4213-98ca-3b93394859e2
Carey, Charles
f918a196-d346-48d8-ad40-359a73df9409
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Thomas, Rebecca
d516b183-388a-4dab-98d4-5077715fdb4d
Akrami, Athena
b88caf6f-531c-45a0-b6d4-d7a826b7ddad
Lutje, Vittoria
5c6657e0-4caf-4109-a463-e18fe3703c41
Greenwood, Darren C.
eb1a8eca-2608-4cd6-baeb-e2ecf8b4cf50
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
3 May 2023
Woodrow, Mirembe Claire
41f1b209-aeb8-4213-98ca-3b93394859e2
Carey, Charles
f918a196-d346-48d8-ad40-359a73df9409
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Thomas, Rebecca
d516b183-388a-4dab-98d4-5077715fdb4d
Akrami, Athena
b88caf6f-531c-45a0-b6d4-d7a826b7ddad
Lutje, Vittoria
5c6657e0-4caf-4109-a463-e18fe3703c41
Greenwood, Darren C.
eb1a8eca-2608-4cd6-baeb-e2ecf8b4cf50
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
Woodrow, Mirembe Claire, Carey, Charles, Ziauddeen, Nida, Thomas, Rebecca, Akrami, Athena, Lutje, Vittoria, Greenwood, Darren C. and Alwan, Nisreen A.
(2023)
Systematic review of the prevalence of Long Covid.
Open Forum Infectious Diseases, 10 (7), [ofad233].
(doi:10.1093/ofid/ofad233).
Abstract
Background: Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection.
Methods: we searched key registers and databases from January 1, 2020 to November 2, 2021, limited to publications in English and studies with at least 100 participants. Studies in which all participants were critically ill were excluded. Long COVID was extracted as prevalence of at least 1 symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across predefined subgroups (PROSPERO ID CRD42020218351).
Results: one hundred twenty studies in 130 publications were included. Length of follow-up varied between 12 weeks and 12 months. Few studies had low risk of bias. All complete and subgroup analyses except 1 had I2 ≥90%, with prevalence of persistent symptoms range of 0%-93% (pooled estimate [PE], 42.1%; 95% prediction interval [PI], 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE, 13.6%; PI, 1.2% to 68%) of persistent symptoms/pathology than self-report (PE, 43.9%; PI, 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all 3 (PE, 51.7%; PI, 12.3% to 89.1%). Studies of hospitalized cases had generally higher estimates than community-based studies.
Conclusions: the way in which Long COVID is defined and measured affects prevalence estimation. Given the widespread nature of SARS-CoV-2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates.
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SR_prevalence_of_Long_Covid_OFID_clean_2_4_23
- Accepted Manuscript
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ofad233
- Accepted Manuscript
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ofad233
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More information
Accepted/In Press date: 28 April 2023
e-pub ahead of print date: 3 May 2023
Published date: 3 May 2023
Additional Information:
Funding Information:
Financial support. There was no specific funding source for this study. MW was supported by an NIHR Pre-doctoral Local Authority Fellowship (Ref. no. 302098). RT and VL are supported by the Research, Evidence and Development Initiative (READ-It: project number 300342-104), which is funded by UK aid from the UK government. NZ is supported by NIHR Applied Research Collaboration Wessex.
Keywords:
Long COVID, SARS-CoV-2, prevalence, systematic review
Identifiers
Local EPrints ID: 477294
URI: http://eprints.soton.ac.uk/id/eprint/477294
ISSN: 2328-8957
PURE UUID: ea5021a5-1a3e-4e92-9755-4617b346d3e9
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Date deposited: 02 Jun 2023 16:37
Last modified: 26 Jul 2024 02:07
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Contributors
Author:
Mirembe Claire Woodrow
Author:
Charles Carey
Author:
Rebecca Thomas
Author:
Athena Akrami
Author:
Vittoria Lutje
Author:
Darren C. Greenwood
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