Review The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies, 2025, O’Mahoney et al.

SNT Gatchaman

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The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies
O’Mahoney, Lauren L.; Routen, Ash; Gillies, Clare; Jenkins, Sian A.; Almaqhawi, Abdullah; Ayoubkhani, Daniel; Banerjee, Amitava; Brightling, Chris; Calvert, Melanie; Cassambai, Shabana; Ekezie, Winifred; Funnell, Mark P.; Welford, Anneka; Peace, Arron; Evans, Rachael A.; Jeffers, Shavez; Kingsnorth, Andrew P.; Pareek, Manish; Seidu, Samuel; Wilkinson, Thomas J.; Willis, Andrew; Shafran, Roz; Stephenson, Terence; Sterne, Jonathan; Ward, Helen; Ward, Tom; Khunti, Kamlesh

The global evidence on the risk of symptoms of Long Covid in general populations infected with SARS-CoV-2 compared to uninfected comparator/control populations remains unknown.

We conducted a systematic literature search using multiple electronic databases from January 1, 2022, to August 1, 2024. Included studies had ≥100 people with confirmed or self-reported COVID-19 at ≥28 days following infection onset, and an uninfected comparator/control group. Results were summarised descriptively and meta-analyses were conducted to derive pooled risk ratio estimates.

50 studies totaling 14,661,595 people were included. In all populations combined, there was an increased risk of a wide range of 39 out of 40 symptoms in those infected with SARS‑CoV‑2 compared to uninfected controls. The symptoms with the highest pooled relative risks were loss of smell (RR 4.31; 95% CI 2.66, 6.99), loss of taste (RR 3.71; 95% CI 2.22, 7.26), poor concentration (RR 2.68; 95% CI 1.66, 4.33), impaired memory (RR 2.53; 95% CI 1.82, 3.52), and hair loss/alopecia (RR 2.38; 95% CI 1.69, 3.33).

This evidence synthesis, of 50 controlled studies with a cumulative participant count exceeding 14 million people, highlights a significant risk of diverse long-term symptoms in individuals infected with SARSCoV-2, especially among those who were hospitalised.

Link | PDF (Nature Communications) [Open Access]
 
Fifty studies totaling 14,661,595 people were included (controls n = 13,247,625 and COVID-19 n = 1,413,970), with thirteen studies conducted in those <18 years of age. Most studies were conducted in Europe (n = 25), Asia (n = 13) or North America (n = 9) the remaining studies were conducted in Africa (n = 1), South America (n = 1) or across multiple continents (n = 1). The time to follow-up ranged from an average of 28 to 685 days. Eleven studies reported data on hospitalised patients, 14 non-hospitalised, and 25 on hospitalised and nonhospitalised combined (mixed). The most reported symptom outcomes across all cohorts were fatigue (n = 34), headache/migraine (n = 36), breathlessness (n = 33), chest pain/tightness (n = 27), and affected sleep (n = 25).
 
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