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50+ long-term effects of COVID-19 – Systematic review and meta-analysis

More studies are emerging that are revealing increasingly disturbing information about the long-term consequences of even mild cases of COVID. A new meta-analysis found that 80% of patients diagnosed with COVID have lingering symptoms at least 14 days after the acute infection.

More than 50 symptoms tied to SARS-CoV-2 infection persisted, most commonly fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), dyspnea (24%), and anosmia (24%) were identified, according to Dr Sonia Villapol, of Houston Methodist Research Institute in Texas, and colleagues.

“We estimated that a total 80% of the patients infected with SARS-CoV-2 developed one or more long-term symptoms,” Villapol said. “Preventive measures, rehabilitation techniques, and clinical management strategies designed to address prevalent long-term effects of COVID-19 are urgently needed,” she is quoted as saying.

To date, there’s no established diagnosis for the slow, persistent condition that people with lasting effects of COVID-19 experience; terms like “long COVID,” “long haulers,” and “post-acute COVID-19” have been used, Villapol and colleagues noted. In their review, they referred to lingering symptoms and signs as “long-term effects of COVID-19.”

Persistent severe fatigue, headache, “brain fog,” and mild cognitive impairment are some of the most commonly presenting symptoms, and patients tend to present more than 4 weeks after illness…these symptoms can be independent of disease severity and can be newly occurring or recurring symptoms….one in five patients not requiring supplemental oxygen during hospitalisation reported decreased lung function after 6 months.

Over one third had abnormal chest x-rays or CT scans. All this is worrisome for long term recovery.

 

Study details
More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis

Sandra Lopez-Leon, Talia Wegman-Ostrosky, Carol Perelman, Rosalinda Sepulveda, Paulina A Rebolledo, Angelica Cuapio, Sonia Villapol

Issued in medRxiv in January 2021

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. The Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) reporting guideline was followed. 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 15 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.

 

[link url="https://www.uphe.org/2021/02/01/80-of-covid-19-patients-may-have-lingering-symptoms/"]UPHE material[/link]

 

[link url="https://www.medrxiv.org/content/10.1101/2021.01.27.21250617v1"]medRxiv study (Restricted access)[/link]

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