Long-Term Consequences of COVID-19 at 6 Months and Above: A Systematic Review and Meta-Analysis

Int J Environ Res Public Health. 2022 Jun 3;19(11):6865. doi: 10.3390/ijerph19116865.

Abstract

We aimed to review the data available to evaluate the long-term consequences of coronavirus disease 2019 (COVID-19) at 6 months and above. We searched relevant observational cohort studies up to 9 February 2022 in Pubmed, Embase, and Web of Science. Random-effects inverse-variance models were used to evaluate the Pooled Prevalence (PP) and its 95% confidence interval (CI) of long-term consequences. The Newcastle−Ottawa quality assessment scale was used to assess the quality of the included cohort studies. A total of 40 studies involving 10,945 cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were included. Of the patients, 63.87% had at least one consequence at the 6 month follow-up, which decreased to 58.89% at 12 months. The most common symptoms were fatigue or muscle weakness (PP 6−12 m = 54.21%, PP ≥ 12 m = 34.22%) and mild dyspnea (Modified Medical Research Council Dyspnea Scale, mMRC = 0, PP 6−12 m = 74.60%, PP ≥ 12 m = 80.64%). Abnormal computerized tomography (CT; PP 6−12 m = 55.68%, PP ≥ 12 m = 43.76%) and lung diffuse function impairment, i.e., a carbon monoxide diffusing capacity (DLCO) of < 80% were common (PP 6−12 m = 49.10%, PP ≥ 12 m = 31.80%). Anxiety and depression (PP 6−12 m = 33.49%, PP ≥ 12 m = 35.40%) and pain or discomfort (PP 6−12 m = 33.26%, PP ≥ 12 m = 35.31%) were the most common problems that affected patients’ quality of life. Our findings suggest a significant long-term impact on health and quality of life due to COVID-19, and as waves of ASRS-CoV-2 infections emerge, the long-term effects of COVID-19 will not only increase the difficulty of care for COVID-19 survivors and the setting of public health policy but also might lead to another public health crisis following the current pandemic, which would also increase the global long-term burden of disease.

Keywords: COVID-19; long-term consequence; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Dyspnea / epidemiology
  • Dyspnea / etiology
  • Humans
  • Pandemics
  • Quality of Life
  • SARS-CoV-2

Grants and funding

This study was funded by the National Natural Science Foundation of China (72122001; 71934002) and the National R&D Key project (2021ZD0114101, 2021ZD0114104, 2021ZD0114105). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the paper. No payment was received by any of the co-authors for the preparation of this article.