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Global Burden of Persistent Symptoms Following COVID-19

Modeled estimates using large international databases and results of 54 studies show that about 1 in 20 people with symptomatic SARS-CoV-2 infections in 2020–21 self-reported at least 1 of 3 Long COVID symptoms clusters. These included persistent fatigue with bodily pain or mood swings, cognitive problems, and ongoing respiratory problems.

The study used Bayesian meta-regression to analyze pooled data from 54 studies and medical records for 1.2 million individuals from 22 countries. In the modeled estimates, 6.2% of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters, including 3.2% with persistent fatigue with bodily pain or mood swings, 3.7% with ongoing respiratory problems, and 2.2% with cognitive problems after adjusting for health status before COVID-19. Women aged 20 years or older were affected more than men (10.6% and 5.4%, respectively). A smaller proportion of patients younger than 20 reported symptom clusters (5.4%). The duration of symptom clusters averaged 9.0 months for people who were hospitalized and 4.0 months for nonhospitalized patients. An estimated 15.1% of people with symptom clusters at 3 months continued to experience these at 12 months.

“The estimated decline in reporting for any of the 3 Long COVID symptom clusters during follow-up among individuals not hospitalized suggests that the majority of Long COVID cases resolve,” write the authors. “It is not yet clear if there is a smaller proportion of individuals, especially among those hospitalized for the acute episode of SARS-CoV-2 infection, who develop a more chronic course of Long COVID. Given that the longest follow-up among the included studies was 12 months, the true long-term pattern of symptom persistence for Long COVID will only be revealed as studies conduct longer follow-up. The time-limited course of Long COVID in most people has led to some recommendations to provide rehabilitative support in the community, with specialist rehabilitation services required only for those with protracted and more severe problems, particularly when compounded by postintensive care syndrome.”

Source: JAMA