Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis
Abstract
:1. Background
2. Methods
2.1. Protocol and Registration
2.2. Literature Search and Study Selection
2.3. Data Extraction and Synthesis
3. Results
3.1. Lung Imaging
3.2. Lung Function
3.3. Fatigue and Respiratory Symptoms
3.4. Functional Capacity, HRQoL, and Return to Work/No Work Impairment
4. Discussion
4.1. Implications and Considerations
4.2. Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Author Year | Country | Study Design | Follow-Up Time | Post COVID-19 Participants | Disease Severity at Baseline ¥ | ||
---|---|---|---|---|---|---|---|
N | Age (Years) | Male (%) | Severe Cases n (%) | ||||
Abdallah, S. 2021 [46] | Canada | Cross-sectional | 119.9 (SD 16.2) days after positive COVID-19 test for hospitalized patients and 129.8 (SD 16.5) for non-hospitalized patients | 63 | 59.1 (SD 13.5) for hospitalized 42.4 (SD 12.9) days non-hospitalized | 57% | 25 (40%) hospitalized |
Anastasio, F. 2021 [47] | Italy | Cross-sectional | 135 (IQR 102–175) days after symptoms onset | 379 | 56.0 (IQR 49–63) | 46% | 222 (58.6%) pneumonia |
Baricich, A. 2021 [48] | Italy | Cross-sectional | 124 (SD 17.5) days after hospital discharge | 204 | 57.9 (SD 12.8) | 60% | 27 (13%) ICU |
Bellan, M. 2021 [27] | Italy | Prospective | 4 months after hospital discharge | 238 | 61.0 (IQR 50–71) | 60% | 28 (12%) ICU |
Cao, J. 2021 [43] | China | Prospective | 3 months after hospital discharge | 61 | 43.5 (SD 15.9) | 54% | 57 (94%) pneumonia severe pneumonia critical illness |
Garrigues, E. 2020 [44] | France | Cross-sectional | 110.9 (SD 11.1) days following admission | 120 | 63.2 (SD 15.7) | 63% | 24 (20%) ICU |
Guler, S. 2021 [34] | Switzerland | Prospective | 128 (IQR 108–144) days from initial symptoms | 113 | 60.3 (SD 12) Severe/critical COVID 52.9 (SD 11) Mild/moderate COVID-19 | 59% | 66 (58.4%) severe/ critical disease |
Han, X. 2021 [28] | China | Prospective | 175 (SD 20) days after symptoms onset | 114 | 54.0 (SD 12) | 70% | 114 (100%) severe disease |
Huang, Ch. 2020 [29] | China | Ambi-directional | 186 (175–199) days after symptom onset | 1733 | 57.0 (IQR 47–65) | 52% | 1294 (75%) required supplemental oxygen (n = 1172) or HFNC, NIV, or IMV (n = 122) |
Jacobson, K. 2021 [49] | USA | Cross-sectional | 119.3 (SD 33) days after COVID-19 diagnosis | 118 | 43.3 (SD 14.4) | 53% | 22 (18.6%) hospitalized |
Lerum, T. 2020 [30] | Norway | Prospective | 83 (73–90) days after hospital admission | 103 | 59.0 (IQR 49–72) | 52% | 15 (14.6%) ICU |
Liang, L. 2020 [31] | China | Prospective | 3 months after hospital discharge | 76 | 41.3 (SD 13.8) | 28% | 7 (9.2%) ICU |
Logue, J. 2021 [39] | USA | Prospective | 169 (SD 39.5) days after illness onset | 177 | 48.0 (SD 15.2) | 43% | 16 (10%) hospitalized |
Morin, L. 2021 [36] | France | Prospective | 4 months after hospital or ICU discharge | 478 | 60.9 (SD 16.1) | 58% | 142 (30%) ICU |
* Shah, A. 2020 [37] | Canada | Prospective | 11.7 weeks after symptoms onset | 60 | 67.0 (IQR 54–74) | 68% | 46 (76.7%) required supplemental oxygen |
Sonnweber, T. 2020 [32] | Austria | Prospective | 103 (SD 21) days after diagnosis for second visit (100 days after onset) | 145 | 57.0 (14) | 55% | 109 (75%) hospitalized |
Sykes, D. 2021 [50] | UK | Cross-sectional | 113 days (46–167) days post discharge | 134 | 59.6 (SD 14.0) | 66% | 27 (20.1%) ICU |
Tabatabaei, S. 2020 [33] | Iran | Retrospective | 91 (SD 15.5) days after initial CT | 52 | 50.2 (SD 13.1) | 62% | NR |
van den Borst, B. 2020 [45] | the Netherlands | Prospective | 13.0 (SD 2.2) weeks after symptoms onset | 124 | 59.0 (SD 14) | 60% | 46 (37%) severe/ critical disease |
Walle-Hansen, M. 2021 [38] | Norway | Prospective | 186 days after discharge | 106 | 74.3 (range 60–96) | 57% | 27 (25.4%) ICU or intermediary ward |
* Wong, A. 2020 [35] | Canada | Prospective | 13 (IQR 11–14) weeks after symptoms onset | 78 | 62.0 (SD 16) | 64% | NR |
Wu, Q. 2021 [41] | China | Prospective | 6 months after discharge | 54 | 47.0 (IQR 36–57) | 59% | 23 (42.5%) severe disease |
Xiong, Q. 2021 [42] | China | Prospective | 97 (95–102) days after hospital discharge | 538 | 52.0 (SD 41–62) | 46% | 207 (38.5%) severe/ critical disease |
Zhao, Y. 2020 [40] | China | Retrospective | 3 months after symptom onset (64–93 days after discharged from hospitals) | 55 | 47.7 (SD 15.49) | 58% | 4 (7.3%) severe disease |
Outcome | No. of Studies | No. of Patients Analyzed | Mean (SD) Follow-Up Time (Months) | Pooled Prevalence (95% CI) | I2 % | p-Value |
---|---|---|---|---|---|---|
Chest CT [28,29,30,31,32,33,34,36,37,40,41,43,45] | ||||||
Chest CT abnormalities | 10 | 987 | 3.9 (1.4) | 59% (44–73%) | 96 | <0.001 |
GGO | 13 | 1313 | 3.9 (1.3) | 39% (26–52%) | 97 | <0.001 |
Interstitial thickening or interlobular septal thickening | 7 | 885 | 3.8 (1.2) | 33% (13–52%) | 98 | <0.001 |
Parenchymal band or fibrous stripe | 6 | 815 | 3.8 (1.2) | 31% (17–44%) | 95 | <0.001 |
Bronchovascular bundle distortion or bronchiectasis | 5 | 437 | 4.5 (1.3) | 26% (9–43%) | 97 | <0.001 |
Thickening or adjacent pleura | 4 | 573 | 5.5 (0.8) | 11% (2–20%) | 94 | <0.001 |
Consolidation | 4 | 652 | 4.9 (1.3) | 6% (2–11%) | 89 | <0.001 |
Crazy paving | 1 | 55 | 3.0 | 5% (1–11%) | NA | NA |
Pulmonary function [27,28,29,30,31,32,36,37,40,41,43,45,46] | ||||||
Pulmonary function abnormalities | 6 | 439 | 3.5 (1.2) | 39% (24–55%) | 94 | <0.001 |
Diffusion pattern | 12 | 1490 | 4.0 (1.3) | 31% (24–38%) | 89 | <0.001 |
Restrictive Pattern | 8 | 921 | 3.8 (1.5) | 12% (8–17%) | 82 | <0.001 |
Obstructive pattern | 7 | 858 | 3.6 (1.3) | 8% (6–9%) | 7 | <0.001 |
Fatigue [29,31,32,35,36,39,40,41,43,44,45,46,47,49,50] and respiratory symptoms [27,28,29,30,31,32,33,35,36,40,41,42,43,44,46,47,49,50] | ||||||
Fatigue | 15 | 4118 | 4.0 (1.3) | 38% (27–49%) | 98 | <0.001 |
Dyspnea | 16 | 3526 | 4.0 (1.1) | 32% (24–40%) | 98 | <0.001 |
Chest pain/Tightness | 10 | 3728 | 3.9 (0.9) | 16% (12–21%) | 94 | <0.001 |
Cough | 14 | 2539 | 3.8 (0.9) | 13% (9–17%) | 94 | <0.001 |
Sputum | 4 | 783 | 3.8 (1.4) | 12% (3–21%) | 94 | <0.001 |
Sore Throat | 6 | 2554 | 4.4 (1.3) | 4% (2–7%) | 66 | 0.02 |
Functional capacity [27,29,45,48], Health-related quality of live (HRQoL) [35,38,39,45], and return to work/work impairment [31,40,44,49] | ||||||
* Decreased functional capacity | 5 | 2364 | 4.2 (1.3) | 36% (22–49%) | 97 | <0.001 |
Decreased HRQoL | 4 | 474 | 4.4 (1.6) | 52% (33–71%) | 94 | <0.001 |
¥ Return to work/No work impairment | 4 | 259 | 3.4 (0.4) | 80% | NA | NA |
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Sanchez-Ramirez, D.C.; Normand, K.; Zhaoyun, Y.; Torres-Castro, R. Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis. Biomedicines 2021, 9, 900. https://doi.org/10.3390/biomedicines9080900
Sanchez-Ramirez DC, Normand K, Zhaoyun Y, Torres-Castro R. Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis. Biomedicines. 2021; 9(8):900. https://doi.org/10.3390/biomedicines9080900
Chicago/Turabian StyleSanchez-Ramirez, Diana C., Kaylene Normand, Yang Zhaoyun, and Rodrigo Torres-Castro. 2021. "Long-Term Impact of COVID-19: A Systematic Review of the Literature and Meta-Analysis" Biomedicines 9, no. 8: 900. https://doi.org/10.3390/biomedicines9080900