Post-COVID-19 symptoms occur in about 30% of patients 2 years after SARS-CoV-2 infection, according to study findings published in the Journal of Infection.
Researchers conducted a systematic review and meta-analysis through October 1, 2023, that included an electronic literature search of the PubMed, MEDLINE, CINAHL, EMBASE, and Web of Science databases as well as the medRxiv/bioRxiv preprint servers. Eligible studies included adults with probable or confirmed SARS-CoV-2 infection among hospitalized and nonhospitalized patients from the general population. The outcome of interest was post-COVID symptoms developed after an acute SARS-CoV-2 infection, which were obtained via personal, telephone, or electronic interview up to 2 years after the infection.
The analysis included 12 studies, of which 7 were conducted in Europe and 1 in the United States. The pooled studies included a total of 7912 individuals who survived COVID-19 (50.7% female; mean [SD] age, 59.5 [16.3] years). Post-COVID symptoms were evaluated after a mean follow-up of 722.9 (51.5) days postinfection. Hypertension (33.95%; 95% CI, 25.95%-41.2%) and obesity (22.35%; 95% CI, 10.65%-36.8%) were the most common comorbidities. The studies had an overall moderate methodologic quality (mean 6 [1.2] points).
The most common post-COVID symptoms 2 years after an acute SARS-CoV-2 infection were fatigue (28.0%; 95% CI, 12.0-47.0; 11 studies), cognitive problems (27.6%; 95% CI, 12.6-45.8; 6 studies), and pain symptoms (8.4%; 95% CI, 4.9-12.8; 11 studies).
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Fatigue, cognitive disorders, and pain were the most prevalent post-COVID symptoms. Psychological disturbances as well as sleep problems were still present two-years after COVID-19.
Psychological problems such as anxiety (13.4%; 95% CI, 6.3-22.5; 7 studies), depression (18.0%; 95% CI, 4.8-36.7; 4 studies), and sleep problems (20.9%; 95% CI, 5.25-43.25; 4 studies) also had increased pooled prevalence rates. All pooled data had a high heterogeneity (I2 ≥75%).
The most frequently occurring post-COVID respiratory and general symptoms were fatigue (28.0%), runny nose (8.2%), and dyspnea (5.7%). Post-COVID neurologic and cognitive symptoms had a similar pooled prevalence rate: dizziness and vertigo (6.7%), anosmia (5.25%), and ageusia (4.85%).
Stomachache was the most common gastrointestinal post-COVID symptom (6.7%), and headache (8.9%) and myalgia (8.1%) were the most frequently occurring post-COVID pain symptoms. Hair loss was the most prevalent dermatologic post-COVID symptom, with a pooled prevalence of 7.35%.
Among several limitations, heterogeneity was observed in most calculations, owing to differences in sample sizes and wide variations in reported prevalence data. Also, the small number of studies for several post-COVID symptoms did not allow pooling data, which limits the generalizability of the finding, and 9 of the included studies collected data by telephone with most symptoms self-reported. Furthermore, no long-term data are available for the Omicron variant, which is the most extended and dominant variant.
“Fatigue, cognitive disorders, and pain were the most prevalent post-COVID symptoms. Psychological disturbances as well as sleep problems were still present two-years after COVID-19,” said the researchers. “This plethora of post-COVID symptoms can be explained by several mechanisms attributed to SARS-CoV-2 such as viral persistence, long-lasting inflammation, autoimmunity, reactivation of latent infections, alteration in gut microbiota, microvascular thrombosis, or others,” stated the study authors.
