Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Registration and Search Strategy
2.2. Study Selection
2.3. Data Extraction
2.4. Quality Assessment of Included Studies
2.5. Statistical Analysis
3. Results
3.1. Characteristics of Included Studies
3.2. Primary Meta-Analysis and Sensitivity Analysis
3.3. Subgroup Analysis
3.4. Meta-Analysis for Long COVID Symptoms
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study ID | Study Design | Nationality of Population | Age (Mean ± SD or Range) (Years) | Vaccination Time | Type of Vaccine | Definition of Long COVID * | Sample Size for Meta-Analysis | Quality Assessment |
---|---|---|---|---|---|---|---|---|
Nehme 2022 [21] | Cross-sectional study | Switzerland | 43.5 ± 13.7 | After SARS-CoV-2 infection | mRNA-1273, BNT162b2 | Presence of fatigue, difficulty concentrating or memory loss, loss of or change in smell, loss of or change in taste, shortness of breath, and headache more than 6 months after an infection | 1596 | Low risk |
Ayoubkhani 2022 [7] | Cohort study | UK | 18–69 | Before SARS-CoV-2 infection | ChAdOx1 nCoV-19, BNT162b2, mRNA-1273 | Presence of symptoms more than 4 weeks after the first having COVID-19, that are not explained by something else | 6180 | Moderate risk |
Kuodi 2022 [32] | Cross-sectional study | Israel | ≥19 | Before and after SARS-CoV-2 infection | Mainly BNT162b2 | No clear definition | 951 | Low risk |
Alghamdi 2022 [22] | Cross-sectional study | Saudi Arabia | 12–70 | NA | ChAdOx1 nCoV-19, BNT162b2 | No clear definition | 2218 | Moderate risk |
Simon 2021 [34] | Cohort study | USA | NA | Before and after COVID-19 diagnosis | NA | Presence of one or more COVID-associated symptoms between 12 and 20 weeks after the initial COVID-19 diagnosis | 240,648 | Low risk |
Taquet 2022 [24] | Cohort study | USA | 57.0 ± 17.9 | Before SARS-CoV-2 infection | BNT162b2, mRNA-1273, Ad26.COV2.S, other COVID-19 vaccines | Presence of chest/throat pain, abnormal breathing, abdominal symptoms, fatigue/malaise, anxiety/depression, pain, headache, cognitive dysfunction, and myalgia between 90 and 120 days after COVID-19 diagnosis | 9953 | Low risk |
Otmani 2022 [23] | Case-control study | Morocco | NA | After contracting the COVID-19 infection | NA | Guideline published by the NICE | 118 | Low risk |
Azzolini 2022 [15] | Cohort study | Italy | 44.3 ± 10.7 (with long COVID); 41.2 ± 11.4 (without long COVID) | Before SARS-CoCV-2 infection | BNT162b2 | Prescence at least 1 SARS-CoV-2-related symptom with a duration of more than 4 weeks | 739 | Moderate risk |
Wynberg 2022 [16] | Cohort study | Netherlands | 53.5 (IQR: 41.0–64.0) | After SARS-CoV-2 infection | BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, Ad26.COV2.S | Criteria published by the WHO | 315 | Low risk |
Al-Aly 2022 [33] | Cohort study | USA | 66.63 ± 13.84 | Before SARS-CoV-2 infection | BNT162b2, mRNA-1273, Ad26.COV2.S | The symptoms starting from 30 days after the first positive SARS-CoV-2 test | 147,414 | Low risk |
Fernández 2022 [25] | Cohort study | Spain | 41.0 ± 16.8 | Before or after COVID-19 diagnosis | BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, Ad26.COV2.S | Prescence of symptoms that persisted for more than 3 weeks after the initial infection and cannot be explained by other causes | 110,726 | Low risk |
Messiah 2022 [26] | Cohort study | USA | 5–19 | NA | NA | Guideline published by the NICE | 1748 | Low risk |
Meza-Torres 2022 [27] | Cohort study | UK | 44.5 ± 21.77 | Before or after COVID-19 diagnosis | NA | Presence of fatigue, breathlessness, cognitive dysfunction, and a variety of other symptoms occurring more than 28 days after COVID-19 infection | 408,882 | Low risk |
Peghin 2022 [28] | Cohort study | Italy | ≥18 | After COVID-19 diagnosis | BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, Ad26.COV2.S | Guideline published by the NICE | 479 | Low risk |
Pinato 2022 [29] | Cohort study | UK, Italy, Spain | ≥18 | Before SARS-CoV-2 infection | BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, Ad26.COV2.S | Presence of long-term effects start at least 4 weeks after infection | 1228 | Low risk |
Zisis 2022 [30] | Cohort study | USA | ≥18 | After COVID-19 diagnosis | NA | Prescence of new, continuing, or recurrent symptoms that occur 4 or more weeks after the initial SARS-CoV-2 infection | 50,450 | Low risk |
Budhiraja 2022 [35] | Cross-sectional study | India | <18-≥75 | Before COVID-19 diagnosis | ChAdOx1nCoV-19, a whole-virion inactivated vero cell derived vaccine (available as Covaxin in India) | Presence of any symptoms after discharge from the hospital | 5529 | Low risk |
Hajjaji 2022 [31] | Cross-sectional study | France | ≥18 | NA | NA | Persistent symptoms of SARS-CoV-2 infection lasting more than 6 months | 168 | Moderate risk |
Subgroups | The Number of Studies | The Number of People | I2 (%) | RR (95% CI) | p Value of Meta-analysis |
---|---|---|---|---|---|
The number of vaccine doses | |||||
1 dose | 6 | 655,962 | 99 | 0.83 (0.65–1.07) | 0.14 |
2 doses | 7 | 420,402 | 90 | 0.83 (0.74–0.94) | <0.01 |
Age | |||||
<60 years | 3 | 12,415 | 89 | 0.76 (0.54–1.06) | 0.11 |
≥60 years | 2 | 9509 | 55 | 0.87 (0.60–1.24) | 0.43 |
Vaccination time | |||||
Before SARS-CoV-2 infection/COVID-19 | 6 | 180,996 | 97 | 0.82 (0.74–0.91) | <0.01 |
After SARS-CoV-2 infection/COVID-19 | 4 | 2508 | 24 | 0.83 (0.74–0.92) | <0.01 |
Definition of long COVID | |||||
Presence of symptoms more than 4 weeks after SARS-CoV-2 infection/COVID-19 diagnisis * | 7 | 419,374 | 87 | 0.68 (0.53–0.87) | <0.01 |
Other definitions | 8 | 526,302 | 99 | 0.75 (0.64–0.88) | <0.01 |
Long COVID Symptom | The Number of Studies | The number of People | I2 (%) | RR (95% CI) | p Value of Meta-Analysis |
---|---|---|---|---|---|
Anxiety and/or depression | 4 | 28,604 | 70 | 0.83 (0.67–1.03) | 0.08 |
Chest or throat pain | 3 | 26,386 | 0 | 1.01 (0.95–1.08) | 0.67 |
Cognitive dysfunction/symptoms | 2 | 22,124 | 8 | 0.89 (0.83–0.96) | <0.01 |
Fatigue | 6 | 225,478 | 97 | 0.77 (0.58–1.02) | 0.07 |
Hair loss | 2 | 6480 | 50 | 0.86 (0.62–1.19) | 0.37 |
Headache/migraine | 4 | 76,836 | 99 | 0.95 (0.50–1.79) | 0.87 |
Kidney diseases/problems | 2 | 148,365 | 0 | 0.68 (0.64–0.73) | <0.01 |
Loss of concentration | 2 | 6480 | 71 | 0.65 (0.35–1.19) | 0.16 |
Loss of smell | 3 | 8698 | 75 | 0.67 (0.36–1.26) | 0.21 |
Loss of taste | 3 | 8698 | 68 | 0.71 (0.48–1.07) | 0.10 |
Myalgia | 2 | 25,435 | 15 | 0.68 (0.62–0.74) | <0.01 |
Nausea and/or vomiting | 2 | 6480 | 87 | 0.80 (0.31–2.02) | 0.63 |
Respiratory symptoms/sequelae | 5 | 78,064 | 98 | 0.91 (0.60–1.40) | 0.68 |
Sleeping disorders/problem sleeping | 3 | 8698 | 25 | 0.74 (0.64–0.86) | <0.01 |
Weight loss | 2 | 6480 | 95 | 1.24 (0.22–7.05) | 0.81 |
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Gao, P.; Liu, J.; Liu, M. Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 12422. https://doi.org/10.3390/ijerph191912422
Gao P, Liu J, Liu M. Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(19):12422. https://doi.org/10.3390/ijerph191912422
Chicago/Turabian StyleGao, Peng, Jue Liu, and Min Liu. 2022. "Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 19, no. 19: 12422. https://doi.org/10.3390/ijerph191912422