Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies
Abstract
:1. Introduction
1.1. Overview
1.2. Historical Perspective
1.3. Goal of Current Review
2. Materials and Methods
2.1. Article Search Strategy
2.2. Eligibility Criteria
2.3. Long COVID Symptom Categories
2.4. Long COVID Symptom Reporting
2.5. Risk of Bias Assessment
2.6. Statistical Methods
3. Results
3.1. Population Characteristics
3.2. Definitions of Long COVID
3.3. Study Designs and COVID-19 Case Definitions
3.4. Most Common Symptoms Reported across 59 Studies
3.5. Data Collection Methods
3.6. Risk of Bias Comparisons
3.7. Low-to-Moderate Risk of Bias, EHR Versus Survey Collection
3.8. Low-to-Moderate Risk of Bias, Hospitalized Versus Hospitalized and Non-Hospitalized among Survey Studies
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Publication Date | Study Population | Sample Size/Location(s) | Top 25 Symptoms (Most to Least Common) | Time Since Infection or Discharge (n = Responders) | Exclusion Criteria | Design | Case Definition | Control | Matching |
---|---|---|---|---|---|---|---|---|---|---|
Anastascio et al. [27] | September 2021 | Patients at Eugenio Morelli Hospital (pulmonary function test, 6MWT, survey) | 379 (Italy) | Dyspnea; weakness; joint or muscular pain; thoracic pain; anosmia or aguesia; depression; cough; heart palpitations; headache; sleeping disorders; hair loss; memory disorders; dizziness | 4 mo. (n = 379) | Previous pulmonary disease excluding ashma | Longitudinal cohort | Patients 18–80 with COVID-19 diagnosis | n/a | n/a |
Arnold et al. [28] | December 2020 | Patients admitted with COVID-19 in Bristol (radiographs, pulmonary function testing, blood, survey) | 163 (UK) | Breathlessness; fatigue; insomnia; myalgia; chest pain; cough; anosmia; arthralgia; fever; headache; abdominal pain; diarrhea; nausea | 12 weeks since hospital admission (n = 110) | n/a | Cohort | PCR positive or clinico-radiological diagnosis | n/a | Age-matched with population norms for survey |
Baruch et al. [29] | November 2022 | PCR positive patients in Malta (survey) | 2665 (Malta) | Shortnesss of breath; anxiety; sadness; fatigue; memory loss; cough | 3–6 mo. range (n = 2665) | Had COVID-19 more than once, did not have working email, asylum seekers/refugees, deceased | Cross-sectional | PCR positive in 2020, had COVID-19 only once | n/a | n/a |
Becker et al. [30] | October 2021 | Patients hospitalized at two Swiss tertiary-care hospitals (phone interview and surveys) | 126 (Switzerland) | Fatigue; concentration difficulties; shortness of breath; post-exertional malaise; joint pain; sleep disorder; dysosmia; muscle pain; anxiety; dysgeusia; chest pain/tightness; palpitations; depression; headache; paraesthesia; cough; loss of appetite/nausea; vomiting/diarrhea; skin disorders; PTSD symptoms; fever | 30 (n = 126) and 90 days (n = 90) | Insufficient proficiency in local languages, cognitive impairment | Prospective cohort | Patients with COVID-19 admitted for inpatient care, discharged | n/a | n/a |
Bellan et al. [31] | January 2021 | Patients at Azienda Ospedaliero-Universitaria Maggiore della Carita University Hospital (phone interview, pulmonary function and physical performance tests, psychological inventory) | COVID-19 = 238 (Italy) | Arthralgia; myalgia; dyspnea; ageusia; anosmia | 4 mo. (n = 238) | n/a | Cohort | Positive PCR or serotological test, clinical diagnosis | n/a | n/a |
Bliddal et al. [20] | June 2021 | Patients in Danish Civil Registration System (online survey) | 198 symptomatic (Denmark) | Fatigue; concentration or memory difficulties; shortness of breath; reduced sense of smell; headache; other; muscle and joint pain; taste loss; coughing; chest pain; sore throat; runny or stuffy nose; sneezing; diarrhea; lack of appetite; stomach pain; nausea; chills; colored sputum; fever; red runny eyes | 4 weeks (n = 198) and 12 weeks (n = 129) | Symptoms started less than 12 weeks before survey | Cohort | Positive PCR, non-hospitalized, samples available in biobank | n/a | n/a |
Blomberg et al. [32] | September 2021 | Patients diagnosed at testing facility in Bergen, patients hospitalized at Haukeland University Hospital or Haraldsplass Deaconess Hospital (clinic interview) | 267 home-isolated patients (Norway) | Fatigue; disturbed taste/smell; concentration problems; memory problems; dyspnea; headache; dizziness; palpitations; stomach upset; cough; sleep problems; tingling in arms or fingers; fever | 2 (n = 267) and 6 months (n = 247) | Address outside Bergen, admitted to hospital | Prospective cohort, longitudinal | Diagnosed and/or hospitalized with COVID-19 | Patients’ household members who were seronegative | n/a |
Buttery et al. [33] | October 2021 | Respondents to UK national online post-COVID support survey, n = 3290 | 3290 (UK) | Breathing problems; fatigue; joint stiffness; problems with mental abilities including anxiety and depression; sleep problems; mood changes/anxiety/depression; cough; loss of taste or smell; loss of appetite/weight loss; PTSD symptoms; nightmares or flashbacks; hair loss | 4–8 weeks (n = 494); 8–12 weeks (n = 641); >12 weeks (n = 1865) | Missing data, duplicates | Mixed-methods analysis | People who considered themselves to have long COVID | n/a | n/a |
Carfi et al. [8] | July 2020 | Patients at Fondazione Policlinico Universitario Agostino Gemelli IRCCS (survey) | 143 (Italy) | Fatigue; dyspnea; joint pain; chest pain; cough; anosmia; sicca syndrome; rhinitis; red eyes; dysguesia; headache; sputum production; lack of appetite; sore throat; vertigo; myalgia; diarrhea | Mean 60.3 days (n = 143) | Refused participation, current positive test | Case series | Discharged from hospital after recovery from COVID-19, negative test at time of enrollment | n/a | n/a |
Carvalho-Schneider et al. [34] | October 2020 | Patients at Centre Hospitalier Universitaire (EHR, phone call) | 150 (France) | Other respiratory signs; flulike symptoms; anosmia/ageusia; fever; abnormal auscultation; dyspnoea/shortness of breath; diarrhea; chest pain | 2 months (n = 130) | Admitted to intensive care, deceased, resident of retirement/nursery home or long-term care facility, transferred to another facility, unable to answer phone questionnaire, lost to follow-up at Day 30 | Case series | PCR positive | n/a | n/a |
Chopra et al. [35] | April 2021 | Patients admitted to any of 38 hospitals in Michagin/MI-COVID 19 Initiative (EHR) | 488 (USA) | Breathlessness walking up stairs; shortness of breath/chest tightness/wheezing; cough; continued loss of taste and/or smell; difficulty ambulating due to chest problems; new use of CPAP or other breathing machine while asleep; oxygen use | 60 days post-discharge (n = 488) | n/a | Cohort | Admitted with COVID-19, discharged, alive at 60 days | n/a | n/a |
Cirulli et al. [17] | December 2020 | Participants in Healthy Nevada Project and Helix DNA Discovery Project (online survey); 21,359 respondents, COVID+ 357, COVID− 5497, 19,095 not tested | 21,359 (USA) | Dry cough; difficulty breathing; anosmia; difficulty concentrating; ageusia; weak muscles; chest pain; pain deep breaths; tachycardia; heart palpitations; memory loss; confusion; headache; dizziness; notice heartbeat; acid reflux; back or joint pain; insomnia; fatigue; decreased alertness; tingling; diarrhea; tinnitus; nocturnal dyspnea; difficulty balancing; nausea | >30 days (n = 357 COVID+) | Contradictory questionnaire entries, symptoms starting before 2020, diagnosis of COVID-19 despite negative test; symptoms less than 30 days | Prospective | Self-report COVID-19 positive | Self-report COVID-19 negative | n/a |
Daitch et al. [36] | September 2022 | Multinational COVID positive patients (visit or survey) | 2333 (Israel, Switzerland, Spain, Italy) | Fatigue; dyspnea; emotional distress; myalgia; memory impairment; concentration impairment; anosmia; chest pain; cough; arthralgia; headache; hair loss; palpitations | Mean 5 mo. (n = 2333) | n/a | Prospective cohort | PCR positive at least 30 days before visit or interview | n/a | n/a |
Daher [9] | October 2020 | Hospitalized patients (physical and laboratory tests, questionnaires) | 33 (Germany) | Fatigue; tiredness; cough; dyspnea; angina pectoria; cognitive disorders; myalgia; headache; rhinorrhea; loss of smell; loss of taste; diarrhea; nausea; stomach pains; fever | 6 weeks after discharge (n = 33) | Nonsymptomatic, not hospitalized, ARDS patients who needed mechanical ventilation | Prospective | Hospitalized patients not requiring mechanical ventilation, positive PCR | n/a | n/a |
Danesh et al. [37] | November 2022 | Patients seeking COVID-19 recovery care clinic (medical assessments) | 441 (USA) | Dyspnea; brain fog; headache; anxiety; palpitations; impaired concentration; insomnia; memory loss; cough; anosmia; chest pain; depressed mood; ageusia; other neurological; dizziness; nausea; word finding difficulty; other otolaryngologic; diarrhea; other pulmonary; anorexia; confusion; paresthesia; congestion; other cardiovascular | Median 58 days (n = 441) | n/a | Cohort | Laboratory-confirmed COVID 19 | n/a | n/a |
Darcis et al. [38] | August 2021 | Patients hospitalized at University Hospital of Liège (survey, biological data, pulmonary function tests, CT scans of chest) | 199 (Belgium) | Exertional dyspnea; fatigue; dry cough; chest pain; memory impairment; productive cough; myalgia; rhinorrhea; headaches; loss of appetite; dyspnea at rest; anosmia; ageusia; parasthesia; diarrhea; pharyngeal pain; confusion | 1 mo. (n = 59), 3 mo. (n = 101), and 6 months (n = 78) | Died before follow-up | Prospective cohort | Confirmed COVID-19 infection, discharged between March-October 2020 | n/a | n/a |
Davis et al. [24] | July 2021 | COVID-19 support groups, social media (online survey) | 3762 (Global/56 countries) | Fatigue; post exertional malaise; elevated temperature; shortness of breath; tightness in chest; muscle aches; palpitations; dry cough; tachycardia; breathing difficulty normal O level; sore throat; diarrhea; chills/flushing/sweats; joint pain; pain or burning in chest; loss of appetite; nausea; skin sensations; weakness; temperature lability; night sweats; stiff neck; abdominal pain; blurred vision; extreme thirst | >6 months (n = 3762) | Incomplete survey, no onset date, onset before December 2019 or after May 2020, ≤28 days of symptoms | Cohort | Confirmed (diagnosed or antibody positive) or suspected COVID-19 | n/a | n/a |
Dryden et al. [39] | September 2022 | COVID patients discharged from hospital (phone interview with ISARIC questionnaire), random sample of 241,159 eligible, 8309 invited, 3094 contacted, 2410 enrolled | 2410 (South Africa) | Fatigue; shortness of breath; confusion or lack of concentration; headache; problems seeing or blurred vision; joint pain; muscle aches; chest pain; dizziness or lightheadedness; dry cough; loss of taste; abdominal pain; loss of smell; back pain or backache; cough with sputum; diarrhea; skin rash; fever; nausea or vomiting; nasal congestion or sinusitis; bleeding; loss of appetite or anorexia; body pain or body ache; seizures | 3 mo. (n = 1873) | Self-report that they are fully recovered or neutral about being fully recovered | Prospective observational cohort | Hospitalized patients infected with COVID-19 | n/a | n/a |
Elkan et al. [40] | August 2021 | Patients hospitalized with COVID-19 (survey) | 66 (Israel) | Fatigue; myalgia; dyspnea; decreased stamina; weakness; memory and concentration impairment; headaches; hair loss; sleep disturbance; anxiety or depression | Median 9 mo. (n = 66) | Could not complete questionnaire due to physical or cognitive impairment | Retrospective cross-sectional case-control | Positive PCR test, discharged from hospital | Hospitalized pneumonia patients | Age and gender |
FAIR Health White [41] | June 2021 | Patients in FAIR Health database (EHR) | 1,959,982 (USA) | Pain; breathing difficulties; hyperlipidemia; malaise and fatigue; hypertension; anxiety; intestinal issues; skin issues; high levels of glucose/cholesterol/BP; abnormal heart results; migraine and/or headache; GERD; sleep disorders; depression; abnormal organ tests | ≥30 days (n = 1,959,982) | Cancer (breast, colorectal, enometrial, leukemia and lymphoma, lung, prostate), chronic kidney disease, COPD, cycstic fibrosis, viral hepatitis A/B/C/D or E, HIV/AIDS, liver disease, spina bifida and other congenital anomalies of the nervous system, stroke | Case series | Diagnosed with COVID-19 | n/a | n/a |
Frontera et al. [42] | July 2021 | US residents Prolific.co 148,000 US residents (online survey “Prevalence of Medical Conditions among Community Dwellers”) | 999 survey respondents (50 US states); COVID-19 = 76; Prolonged symptoms = 19 | Anxiety; brain fog; headache; post-exertional brain fog; fatigue; depression; chest pain; joint pain; muscle aches and pains; difficulty sleeping; vision abnormalities; shortness of breath; dizziness/lightheadedness; post-exertional malaise/fatigue; persistent loss taste/smell; wheezing; irregular heart beat; cough; fever | Median = 4 mo. (n = 999) | n/a | Cross-sectional | Diagnosed with COVID-19 by laboratory test or developed typical symptoms after being exposed to COVID-19 | n/a | n/a |
García-Abellán et al. [43] | July 2021 | Patients hospitalized with COVID-19 (phone and clinic surveys, blood and nasopharyngeal samples) | 146 (Spain) | Fatigue; myalgia; dyspnea; cough; nasal congestion | 2 (n = 104) and 6 months (n = 116) | n/a | Prospective longitudinal | Positive PCR test | n/a | n/a |
Garrigues et al. [11] | December 2020 | Hospitalized patients at Beaujon Hospital (phone survey) | 120 (France) | Fatigue; dyspnoea; memory loss; sleep disorder; attention disorder; hair loss; cough; anosmia; chest pain; aguesia | >100 days since onset (n = 120) | Deceased, unreachable, bedridden, demented, non-French speaking | Cross-sectional comparative | PCR positive or chest computed tomography diagnosis, hospitalized (ward group and ICU group) | n/a | n/a |
Goërtz et al. [12] | August 2020 | Two Facebook groups for COVID-19 patients with persistent symptoms, website panel registrants (online survey) | 2113 (The Netherlands, Belgium) | Fatigue; dyspnoea; chest tightness; headache; muscle pain; pain between shoulder blades; heart palpitations; cough; increased resting HR; dizziness; sore throat; pain/burning feeling in lungs; increased body temp; joint pain; burning feeling in trachea; nose cold; mucus; anosmia; hot flushes; nausea; sneezing; eye problems; aguesia; diarrhea; ear pain | >3 weeks (n = 2113) | Missing data, onset before 1 January 2020, symptoms for <3 weeks | Prospective observational | People who considered themselves to have long COVID | n/a | n/a |
Halpin et al. [44] | July 2020 | Patients at Leeds Teaching Hospitals NHS Trust who were residents of Leeds Metropolitan District (phone survey) | 100 (UK) | Fatigue; breathlessness; worse usual activites; worse mobility; PTSD symptoms related to illness; worse anxiety/depression; new or worse concentration problem; voice change; worse pain/discomfort; new or worse short-term memory problem; laryngeal sensitivity; worse self-care; new bladder control problem; swallowing problem; appetite problem; communication difficulty; new bowel control problem | Mean = 48 days from discharge (n = 100) | No contact details, under 18, dementia, learning disability, or other cognitive or communication impairment | Screening tool evaluation | Positive PCR test during inpatient hospital admission, 4 weeks or more since discharge date, not currently inpatient | n/a | n/a |
Heesakkers et al. [45] | January 2022 | Multicetner ICU patients (questionnaires, online or paper) | 301 (The Netherlands) | Weakened condition; joint stiffness; joint pain; muscle weakness; myalgia; dyspnea; tingling or numbness in limbs; lung disease; neuropathic pain; voice problems; dizziness or balance problems; hypotension or hypertension; sexual problems; skin problems; hair loss; loss of smell; loss of taste; headache; heart disease/chest pain; vision problems; loss of hearing; bowel problems; urinary problems; wound pain; pressure ulcers | 1 year (n = 246) | ICU admission <12 h, life expectancy <48 h, receiving pallative care | Exploratory prospective | Admitted to ICU with laboratory or clinical diagnosis of COVID-19 | n/a | n/a |
Horberg et al. [46] | October 2022 | Patients at Kaiser Permanente Mid-Atlantic States (EHR) | PCR positive = 28,118; PCR negative matched controls = 70,293 (USA) | Abdominal pain; gastrointestinal disease; nonspecific chest pain; conditions associated with dizziness or vertigo; genitourinary symptoms and ill-definited conditions; malaise and fatigue; anxiety disorders; other lower respiratory disease; mental health; cardiac dysrhymias; diabetes; other nervous system disorders; nausea and vomiting; other nutritional/endocrine/and metabolic disorders; fluid and electrolyte disorders; anosmia; respiratory failure/insufficiency/arrest | Acute/Persistent: 0–30 days; Late: 30–120 days (n’s unclear) | Patients not enrolled in KPMAS 120 days post-PCR test date | Case-control | PCR positive | PCR negative | 3:1 negative to positive by age, sex, testing month, service area |
Horwitz et al. [47] | August 2021 | Patients discharged from hospital (survey) | 1 mo. = 152; 6 mo. = 126 (USA) | Fatigue; weakness; memory changes; muscle/body ache; brain fog; difficulty sleeping; joint pain; diarrhea; lightheadedness/dizziness; numbness/tingling; headache; dry mouth; burning or pins/needles sensation; chest pain; dry eyes; palpitations; altered/loss of smell; ringing in ears; altered/loss of taste; GI; tremors; rash; nausea; hair loss; vision changes | 1 (n = 152) and 6 mo. (n = 126) | Incomplete surveys | Prospective cohort | Hospitalized for COVID-19 at single health system who required minimum 6 1 of supplemental oxygen during admission, intact baseline functional status, discharged | n/a | n/a |
Huang et al. [48] | January 2021 | Patients discharged from Jin Yin-tan Hospital (surveys, physical exams, blood, pulmonary function test, chest CT, ultrasonography) | 1733 (China) | Fatigue or muscle weakness; pain or discomfort; sleep difficulties; anxiety or depression; hair loss; smell disorder; palpitations; joint pain; decreased appetite; taste disorder; mobility problems; dizziness; diarrhea or vomiting; chest pain; sore throat or difficulty swallowing; skin rash; myalgia; headache; usual activity problems; personal care problems; low grade fever | Median 186 days (n = 1655) | Psychosis, dementia, hospital re-admission, serious mobility issues, could not be contacted, nursing/welfare home residents, live outside Wuhan, deceased | Cohort | Laboratory diagnosis of COVID-19 | n/a | n/a |
Huang et al. [21] | November 2022 | University of California COVID Research Data Set (EHR) | 1441 (USA) | Chest pain; dyspnea; anxiety; abdominal pain; cough; low back pain; fatigue; insomnia; diarrhea; joint pain; headache; nausea; tachycardia; muscle pain; alopecia; fever; heart palpitations; syncope; heartburn; dysgeusia; amnesia; skin lesions; tinnitus; sore throat or pain in throat; hypotension | 0–30 days (n = 1441) and 180+ days (n = 227) | Hospitalized | Cohort | Patients with at least 5 year history with UC system, positive PCR test, healthcare interaction after diagnosis | n/a | n/a |
Jacobson et al. [49] | February 2021 | Patients with COVID-19 (surveys, walk test) | 118 (USA) | Fatigue; dyspnea; loss of taste/smell; myalgias; memory problems; chest pain; hair loss; cough; congestion/rhinorrhea; nausea/vomiting/diarrhea; headache; palpitations; sore throat; fever/chills | 3–4 mo. (n = 118) | n/a | Cohort | Positive PCR test | n/a | n/a |
Kayaaslan et al. [50] | December 2021 | Patients with COVID-19 in Ankara City Hospital (questionnaire by phone or in clinic); 1092 invited | 1007 (Turkey) | Fatigue; dyspnea; hair loss; concentration or memory deficit; myalgia; insomnia; chest pain; headache; cough; wheezing; hypersomnia; loss of weight; loss of smell; loss of taste; new anxiety; new depression; rash; nightmare; genitourinary issues; abdominal pain; constipation; diarrhea | >12 weeks (n = 1007) | n/a | Prospective | Laboratory or imaging confirmation of COVID-19 | n/a | n/a |
Kuodi et al. [51] | August 2022 | Patients at Ziv Medical Centre, Padeh-Poriya Medical Centre, Galilee Medical Centre (online survey): of 79,482 invitations to participate in the study, 3572 (4.5%) individuals > age 18 agreed to participate: 2447 who reported no previous SARS-CoV-2 infection and 1125 who did; excluded 174 infected individuals without vaccination status. | COVID-19 = 951; Control = 2447 (Israel) | Fatigue; headache; weakness in arms or legs; persistent muscle pain; loss of concentration; hair loss; problem sleeping; dizziness; persistent cough; shortness of breath; loss of taste; chest pains; pins and needles sensation; palpitations; depression and anxiety; abdominal pain; problems with balance; inability to control body movement; joint pain or swelling; loss of smell; loss of appetite; pain on breathing; nausea and vomiting; constipation; erectile dysfunction | Not specified beyond “not fully recovered” | Not reporting vaccination status | Cross-sectional nested in Prospective Longitudinal Cohort Study | Self-reported previous COVID-19 infection | Self-reported no COVID-19 infection | n/a |
Larsen et al. [52] | April 2022 | COVID support groups and social media (online survey) | Test-confirmed = 1249; Test-unconfirmed = 1065 (Global/34 countries) | Fatigue; Brain fog; headache; shortness of breath with exertion; body aches; palpitations; lightheadedness; tachycardia; difficulty sleeping; pre-syncope; loss of taste; loss of smell | Symptoms for >30 days, n = 1249 test-confirmed and 1065 test-unconfirmed | Incomplete, symptom duration < 30 days, onset before November 2019, age ≥ 65 | Cross-sectional | Adults with self-suspected, clinician-diagnosed or test-confirmed COVID-19 | n/a | n/a |
LaVergne et al. [53] | July 2021 | Participants from community and hospital settings in Colorado (survey, saliva, blood, breast milk, stool) | 119 (USA) | Fatigue; forgetful/absent minded; difficulty concentrating; exercise intolerance; difficulty sleeping; loss of smell; joint pain; confusion; difficulty breathing; loss of taste; change in taste; rapid heartrate; depression | 25–89 days (n = 56), 90–174 (days n = 55), >175 days (n = 42) | n/a | Case-control, longitudinal | PCR positive | PCR Negative | n/a |
Liang et al. [13] | December 2020 | Hospitalized patients at Wuhan Union Hospital (questionnaires, laboratory tests, physical exams) | 76 (China) | Chest tightness and palpitations; cough; fatigue; increased sputum; diarrhea; fever | 3 mo. (n = 76) | History of pulmonary resection, psychiatric or neurological disease | Prospective observational | PCR positive, discharged from hospital | n/a | n/a |
Mandal et al. [54] | November 2020 | Patients discharged from three London hospitals (clinical assessment) | 384 (UK) | Fatigue; breathlessness; cough; depression | Median 54 days (n = 384) | Could not be reached, could not complete assessment | Cross-sectional | Tested positive for COVID-19 | n/a | n/a |
Mizrahi et al. [22] | November 2022 | Nationwide healthcare services members with a PCR test for COVID-19 (EHR) | COVID+ = 299,870; COVID− = 299,870 (Israel) | Anosmia/dysgeusia; concentration/memory; weakness; dyspnea; convulsions; muscle atrophy; voice disorder; dizziness; sore throat; palpitations; arthralgia; myalgia; cough; chest pain; visual disturbances; bloody stool; tremor; headache; abdominal pain; rhinorrhea; menstruation abnormalities; skin rash; nausea/vomiting; insomnia; respiratory disorders | Single follow-up between 2nd-12th month after PCR test, n = 299,870 | Incomplete data, vaccinated >3 mo. before positive test, admitted to hospital with COVID 30 days after infection, patients with chronic outcomes that predated COVID infection (ever), patients with temporary outcomes that predated COVID infection (1 year) | Retrospective nationwide cohort | Positive PCR test in medical record | Negative PCR test/no previous positive PCR test | Age, sex, month of test, immune status (unvaccinated, partially vaccinated, second dose vaccine, booster) |
Moreno-Perez et al. [55] | January 2021 | Patients at the Emergency Dept of Alicante General University Hospital (clinical exam, blood, chest x-ray, pulmonary function test, survey) | 277; 141 with Post-COVID syndrome (Spain) | Fatigue; persistent dyspnea; anosmia/dysgeusia; persistent cough; myalgias/arthralgias; headache; mnesic complaints; diarrhea; skin features; visual loss; fever | 77 days (follow-up n unclear) | “Severe comorbidity” | Prospective cohort | PCR or antibody positive | n/a | n/a |
Munblit et al. [56] | July 2021 | Hospitalized patients at Sechenov University Hospital network (phone interview with ISARIC questionnaire) | PCR+ = 1358; Clinical COVID = 1291 (Russia) | Chronic fatigue; respiratory; neurologic; mood and behavior changes; dermatologic | Median 218 days after discharge (PCR+ n = 1358, Clinical COVID+ n = 1291) | Death, no contact info, survey not collected | Longitudinal cohort | Confirmed or suspected COVID-19 | n/a | n/a |
Naik et al. [57] | November 2021 | COVID patients discharged from hospital (phone or clinic questionnaire); 2243 invited, 1234 responded | 1234 (India) | Myalgia; dyspnea; fatigue; cough; insomnia; chest pain; anxiety; mood disturbance/depression; anosmia | <1 mo. (140), 1–3 mo. (n = 398), 3–6 mo. (n = 264), >6 mo. (n = 276) | Under 18 | Longitudinal cohort | Laboratory-confirmed COVID 19 | n/a | n/a |
Peghin et al. [58] | June 2021 | Patients attending Infectious Disease Department (phone interview) | 599 (Italy) | Fatigue; anosmia/dysgeusia; neurological disorders; rheumatological disorders; dyspnea; psychiatric disorders; hair loss; cutaneous lesions; URTI sympoms; headache; cough; GI disorders; chest pain; ocular symptoms | 6 mo. (n = 599) | Seronegative patients | Bidirectional prospective | Diagnosis of COVID-19 | n/a | n/a |
Petersen et al. [59] | November 2020 | Patients diagnosed with COVID-19 (questionnaire, phone interview) | 180 (Faroe Islands) | Fatigue; loss of smell; loss of taste; arthralgia; rhinorrhea; dyspnea; myalgia; headache; cough with expectoration; chest tightness; chills; dry cough; nausea; diarrhea; rashes; anorexia; sore throat | ≥2 mo. (n = 179) | n/a | Longitudinal cohort | Positive PCR test | n/a | n/a |
Reese et al. [60] | May 2022 | U.S. N3C patients (EHR)/RECOVER EHR PASC: cluster analysis | N3C N = 12,443,936, COVID N = 2,909,292, U09.9 (Long COVID) N = 5645, Included in analysis N = 2464 | Cough; pain; fatigue; hyperglycemia; chest pain; hypoxemia; fever; myalgia; headache; insomnia; hypocalcemia; lymphopenia; asthenia; nausea; abdominal pain; vertigo; nasal congestion; diarrhea; abnormal movement; elevated ASAT; elevated creatinine; elevated ALP; thrombocytopenia; hypotension; tachycardia | ≥4 weeks (n = 2464) | n/a | Retrospective observational | Patients with U09.9 (Long COVID) diagnosis | n/a | n/a |
Roessler et al. [61] | November 2022 | Insured patients (Health insurance data); COVID patients matched 1:5 with non-COVID patients | 145,184 adults; 11,950 children/adolescents (Germany) | Fever; dyspnea; cough; respiratory insufficiency; throat/chest pain; hair loss; malaise/fatigue/exhaustion; dysphagia; headache | Mean = 254 days (n = 145,184) | COVID-19 diagnosis without PCR, patients not continuously insured | Retrospective matched cohort study | Documented COVID-19 diagnosis with PCR detection | No COVID-19 diagnosis | 1:5 by index date, age, sex and propensity score matching on preexisting medical conditions |
Romero-Duarte et al. [62] | May 2021 | Patients at four Spanish hospitals (primary care records) | 797 (Spain) | Dyspnea; fatigue; cough; musculoskeletal pain; diarrhea; pharyngeal symptoms; anosmia or dysgeusia; fever; anxiety symptoms; thoracic pain; abdominal pain; headache; sleep disturbances; opthalmological problems; rib pain; depressive symptoms; general malaise; UTI; muscle weakness; paraesthesia; movement disturbances; ICU-related polyneuropathy; thromboic manifestations; exanthema; arrythmia or palpitations | 6 mo. (n = 797) | Negative PCR | Retrospective observational | Confirmed positive PCR | n/a | n/a |
Sarrafzadegan et al. [63] | August 2022 | Previously hospitalized patients in Isfahan urban and rural areas (questionnaires) | 819 (Iran) | Joint pain or myalgia; dry cough or dyspnea; hair loss; fatigue or muscle weakness; GI disorders; mental health problems; headache; palpitations; low grade fever; dizziness; ocular problems; chest pain; skin rash/pruritus; smell disorder; body tremor or tingling; renal disorders; decreased appetite; sore throat/difficulty swallowing/sputum productions; ear problems; taste disorders; sleep difficulties | 1 year (n = 819) | Patients hospitalized before 10 March 2020, no PCR test, negative PCR test | Multicenter prospective cohort | Positive PCR test | n/a | n/a |
Sigfrid et al. [64] | August 2021 | Patients hospitalized with COVID-19 (questionnaire by mail, phone, or clinic) | 327 (UK) | Fatigue; breathlessness; problems sleeping; headache; limb weakness; persistent muscle pain; joint pain or swelling; dizziness/lightheadedness; problems with balance; swollen ankle; palpitations; vision problems; constipation; stomach pain; diarrhea; cough; chest pains; pain on breathing; loss of smell; persistent fevers; loss of taste; nausea/vomiting; loss of appetite; problems swallowing; skin rash | ≥3 mo. (n = 327) | No positive PCR test recorded | Longitudinal cohort | Patients admitted to hospital with confirmed or highly suspected COVID-19 | n/a | n/a |
Søraas et al. [23] | August 2021 | Non-hospitalized patients (online surveys) | COVID+ = 794; COVID− = 7229 (Norway) | Fatigue; changed smell or taste; headache; nasal symptoms; dyspnea; cough; body ache/muscular pain; sore throat; abdominal pain/nausea/diarrhea; fever | 3–8 mo. (n = 672) | Hospitalized | Longitudinal cohort | Laboratory-confirmed COVID 19 | COVID 19 negative patients | n/a |
Suárez-Robles et al. [14] | December 2020 | Patients discharged from hospital (phone survey) | 134 (Spain) | Fatigue; dyspnea; loss of weight; loss of appetite; cough; anosmia; arthritis; headaches; palpitations; dysgeusia; general malaise; dysphonia; sensitivity disorders; sputum; walking disturbances; cutaneous manifestations | 90 days (n = 134) | n/a | Observational descriptive | Positive PCR test | n/a | n/a |
Sudre et al. [65] | April 2021 | Participants using Zoe COVID Symptom Study App (survey) | 4182 cases/4182 controls (UK) | Fatigue; headache; palpitations/tachycardia; memory issues; tinnitus/earache; peripheral neuropathy symptoms | ≥28 days (n = 558); ≥ 8 weeks (n = 189); ≥12 weeks (n = 95) | Admitted to ICU | Prospective observational cohort | Users of the COVID Symptom Study App | Symptomatic test-negative | Age, sex, BMI |
Tabacof et al. [66] | January 2022 | Patients at Mount Sinai post-acute COVID-19 syndrome clinic (online survey) | 156 (USA) | Fatigue; brain fog; headache; sleep disturbance; dizziness; dyspnea; memory loss; palpitations; confusion; general weakness; chest pain; neuropathic pain; muscle pain; temperature dysregulation; indigestion; mood alteration; sweating; joint pain; tinnitus; nausea; tachypnoea; vision impairment; bloating; sore throat; hair loss | Median = 351 days (n = 156) | Incomplete survey | Cohort | PCR or antibody positive or diagnosis by medical doctor for COVID-19, diagnosis of PACS (>12 weeks of symptoms since onset) | n/a | n/a |
Morin et al. [67] | April 2021 | Patients hospitalized in Bicêtre Hospital (telephone assessment) | COVID+ = 478 (France) | Fatigue; memory difficulties; dyspnea; persistent paresthesia; mental slowness; concentration problems; weight loss > baseline; chest discomfort/pain; anorexia; anosmia; headaches; cough | 4 months after discharge (n = 478) | Death, persistent hospitalization, end-stage cancer, dementia, nosocomial COVID-19 infection, incidental positive result during hospital stay for another condition | Cohort | Adults patients hospitalized for COVID-19 between March 1 and 29 May 2020 | n/a | n/a |
Tleyjeh et al. [68] | December 2021 | Patients discharged from King Fahad Medical City Hospital (phone interview) | 222 (Saudi Arabia) | Shortness of breath; fatigue; cough; lasting muscle/body pain; difficult concentrating; headaches; joint pain; memory impairment; insomnia; loss of appetite; chest pain; abdominal pain; nausea/vomiting; constipation; diarrhea; loss of smell; sore throat; fever; loss of taste | Median 4 mo. (n = 222) | Death, still hospitalized, mental illness, did not respond | Prospective cohort | Positive PCR test | n/a | n/a |
Venturelli et al. [69] | January 2021 | Patients discharged from Papa Giovanni XXIII Hospital (clinical assessment, blood tests, chest x-ray, electrocardiogram, full pulmonary function testing, psychological evaluation, assessment of rehabilitation needs) | 767 (Italy) | Asthenia; dyspnea; palpitations; myalgia; chest pain; confusion; cough; anosmia/dysguesia; lower GI problems; fever; headache; syncope; upper GI problems | Median 81 days (n = 767) | Pregnant and admitted for delivery, under 18, asymptomatic | Cohort | Admitted to or discharged from hosptial with any condition possibly related to COVID-19, then a double negative nasopharyngeal swab | n/a | n/a |
Wang et al. [15] | September 2020 | Hospitalized patients at Tongji Hospital (hospital records, follow-up with patients/method unspecified) | 131 (China) | Cough; dyspnea; pharyngeal pain; nausea; chest tightness | Follow-up at 1–2, 3–4 weeks (all n = 131) | Could not be contacted | Prospective cohort | Confirmed COVID-19 cases discharged from hospital | n/a | n/a |
Wanga et al. [70] | September 2021 | US nationwide CDC sample of adults (online survey) | Self-reported positive test = 698; negative test = 2437 (USA) | Fatigue/tired/weakness; change in smell or taste; shortness of breath or breathlessness; cough; headache; problems sleeping; joint or muscle pain; cognitive dysfunction; chest pain or pressure; change in mood; post-exertional malaise; stomach pain; hair loss; diarrhea; sore throat; fever or chills; palpitations; nausea/vomiting | >4 weeks (n = 698) | n/a | Retrospective observational | Positive test result | n/a | n/a |
Xiong et al. [71] | September 2020 | Hospitalized patients at Renmin Hospital of Wuhan University (phone survey) | COVID survivors = 538; residents of local area not hospitalized = 184 (China) | Alopecia; fatigue; sweating; postactivity polypnoea; somnipathy; chest distress; chest pain; resting heart rate increase; arthralgia; cough; anxiety; discontinuous flushing; nonmotor polypnoea; chills; myalgia; depression; throat pain; sputum; limb edema; dizziness; dysphoria; new hypertension; feelings of inferiority | >3 mo. (n = 538 COVID survivors) | Pregnant or breastfeeding, severe underlying disease, receiving invasive treatment | Longitudinal cohort | Inpatients 20–80 years old who were diagnosed with COVID-19 | Residents living in urban area at same time as outbreak | n/a |
Zhao et al. [16] | August 2020 | Hospitalized patients at 3 tertiary hospitals in Henan Province (Physical and imaging tests) | 55 (China) | GI symptoms; headache; fatigue; exertional dyspnea; decreased sense of taste; cough and sputum | 3 mo. (n = 55) | Critical pneumonia | Retrospective cohort | Confirmed PCR positive, discharged from hospital | n/a | n/a |
Table 2. Prevalence of Post-COVID Symptoms | ||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Author/Year | Population/Methods/Sample Summary | Fatigue | Fever, Chills, Sweats or Flushing † | Dizziness | Post-Exertional Malaise | Sleep Problems | Weakness in Arms or Legs | Headache | Joint/Muscle Pain † | Loss of or Change in Smell or Taste † | Shortness of Breath | Persistant Cough † | Cardiac Symptoms Including Chest Pain † | GI Symptoms Including Abdominal Pain † | Urinary Symptoms | Mental Health Concerns † | Nerve Problems, Seizures † | Problems Thinking or Concentrating | Skin Rash | Hair Loss | Vision Problems | Hearing Problems | Dry Mouth | Excessive Thirst |
Anastacio et al., 2021 [27] | Previously hospitalized and non-hospitalized patients (pulmonary function test, 6MWT, survey), n = 379 | n/a | n/a | 2.4% | n/a | 4.2% | n/a | 5.3% | 13.7% | 10.3% | 42.7% | 6.1% | 6.1% | n/a | n/a | 8.2% | n/a | n/a | n/a | 3.2% | n/a | n/a | n/a | n/a |
Arnold et al., 2020 [28] * | Previously hospitalized patients (radiographs, pulmonary function testing, blood, survey), n = 163 | 39.0% | 2.0% | n/a | n/a | 26.0% | n/a | 2.0% | 5.0% | 11.0% | 39.0% | 11.0% | 12.0% | 2.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Baruch et al., 2022 [29] | Previously hospitalized and non-hospitalized patients (survey), n = 2665 | 9.7% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 14.2% | 5.3% | n/a | n/a | n/a | 11.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Becker et al., 2021 [30] | Previously hospitalized patients (phone interview and surveys), n = 90 | 46.0% | 2.0% | n/a | 20.0% | 17.0% | n/a | 9.0% | 18.0% | 16.0% | 21.0% | 7.0% | 12.0% | 6.0% | n/a | 13.0% | 8.0% | 31.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Bellan et al., 2021 [31] | Previously hospitalized patients (phone interview, pulmonary function and physical performance tests, psychological inventory), n = 238 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 5.9% | 5.0% | 5.5% | 2.5% | 0.4% | 1.3% | n/a | n/a | 5.9% | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Bliddal et al., 2021 [20] * | Non-hospitalized patients in Danish Civil Registration System (online survey), n = 198 | 16.0% | 1.0% | n/a | n/a | n/a | n/a | 6.5% | 5.5% | 7.5% | 12.0% | 4.5% | n/a | 2.3% | n/a | n/a | n/a | 13.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Blomberg et al., 2021 [32] | Home isolated or hospitalized patients (clinic interview), n = 247 | 30.0% | 2.0% | 10.0% | n/a | 5.0% | n/a | 11.0% | n/a | 27.0% | 15.0% | 6.0% | 6.0% | 6.0% | n/a | n/a | 4.0% | 19.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Buttery et al., 2021 [33] | Respondents to UK national online post-COVID support survey, n = 3290 enrolled, n = 1865 at 12 weeks. | 84.1% | n/a | n/a | n/a | 47.6% | n/a | n/a | 52.8% | 26.2% | 91.5% | 40.3% | n/a | n/a | n/a | 45.1% | n/a | 50.9% | n/a | 13.3% | n/a | n/a | n/a | n/a |
Carfi et al., 2020 [8] * | Previously hospitalized patients (survey), n = 143 | 55.0% | n/a | n/a | n/a | n/a | n/a | 9.0% | n/a | 15.0% | 42.0% | 17.0% | 21.0% | 2.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Carvalho-Schneider et al., 2020 [34] | Previously hospitalized and non-hospitalized patients (EHR, phone call), n = 150 enrolled, n = 130 at 2 months | n/a | 0.0% | n/a | n/a | n/a | n/a | n/a | 16.3% | 22.7% | 7.7% | n/a | 13.1% | 11.5% | n/a | n/a | n/a | n/a | 11.5% | n/a | n/a | n/a | n/a | n/a |
Chopra et al., 2021 [35] | Previously hospitalized patients/MI-COVID 19 Initiative (EHR), n = 488 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 13.1% | 16.6% | 15.4% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Cirulli et al., 2020 [17] * | Participants in Healthy Nevada Project and Helix DNA Discovery Project (online survey); 21,359 respondents, COVID+ 357, COVID− 5497, 19,095 not tested, n = 21,359 | 4.0% | n/a | 5.0% | n/a | 4.0% | n/a | 5.0% | 5.0% | 10.0% | n/a | 10.0% | 6.0% | 4.0% | n/a | n/a | 4.0% | 8.0% | n/a | n/a | n/a | 3.0% | n/a | n/a |
Daitch et al., 2022 [36] | Patients at COVID-19 recovery clinics (visit or survey), n = 2333 | 39.0% | n/a | n/a | n/a | n/a | n/a | 6.8% | n/a | 15.5% | 28.0% | 11.4% | 11.8% | n/a | n/a | n/a | n/a | 19.1% | n/a | 5.3% | n/a | n/a | n/a | n/a |
Daher et al., 2020 [9] | Previously hospitalized patients (physical and laboratory tests, questionnaires), n = 33 | 45.0% | 3.0% | n/a | n/a | n/a | n/a | 15.0% | 15.0% | 12.0% | 33.0% | 33.0% | n/a | 9.0% | n/a | n/a | n/a | 18.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Danesh et al., 2022 [37] | Patients seeking COVID-19 recovery care clinic (medical assessments), n = 441 | n/a | n/a | 3.4% | n/a | 15.6% | n/a | 19.3% | n/a | 14.1% | 63.7% | 26.9% | 17.2% | 5.9% | n/a | 11.6% | 2.3% | 20.2% | n/a | n/a | 2.0% | 1.1% | n/a | n/a |
Darcis et al., 2021 [38] | Previously hospitalized patients (survey, biological data, pulmonary function tests, CT scans of chest), n = 199 enrolled, n = 78 at 6 month follow-up | 32.0% | n/a | n/a | n/a | n/a | n/a | 1.0% | n/a | 1.0% | 1.0% | 9.0% | 5.0% | 1.0% | n/a | n/a | 1.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Davis 2021 [24] * | COVID-19 support groups, social media (online survey), n = 3762 | 97.0% | 56.0% | n/a | 88.0% | n/a | n/a | n/a | 70.0% | n/a | 77.0% | 66.0% | 67.0% | 60.0% | n/a | n/a | n/a | n/a | n/a | n/a | 36.0% | n/a | n/a | 36.0% |
Dryden et al., 2022 [39] | Previously hospitalized patients (phone interview), 3 month follow-up, n = 2410 surveyed, n = 1873 responders at 3 months | 50.3% | 1.5% | 6.2% | n/a | n/a | n/a | 13.8% | 9.3% | 2.7% | 23.4% | 4.2% | 7.0% | 2.3% | n/a | n/a | n/a | 17.5% | 1.9% | n/a | 10.1% | n/a | n/a | n/a |
Elkan et al., 2021 [40] * | Previously hospitalized patients (survey), n = 66 | 27.0% | n/a | n/a | n/a | 8.0% | n/a | 8.0% | n/a | n/a | 11.0% | n/a | n/a | n/a | n/a | 7.0% | n/a | n/a | n/a | 8.0% | n/a | n/a | n/a | n/a |
FAIR Health White 2021 [41] * | Previously hospitalized and non-hospitalized patients in FAIR Health database (EHR), n = 1,959,982 | 2.9% | n/a | n/a | n/a | 1.3% | n/a | 1.6% | 5.1% | n/a | n/a | n/a | n/a | 2.2% | n/a | 2.3% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Frontera et al., 2021 [42] | US community research platform (online survey), n = 999 respondents; COVID-19 = 76; Prolonged symptoms = 19 | 42.0% | 11.0% | 26.0% | 26.0% | 32.0% | n/a | 47.0% | 37.0% | 21.0% | 26.0% | 16.0% | 37.0% | n/a | n/a | 53.0% | n/a | 47.0% | n/a | n/a | 26.0% | n/a | n/a | n/a |
García-Abellán et al., 2021 [43] | Previously hospitalized patients (phone and clinic surveys, blood and nasopharyngeal samples), n = 146 | 10.3% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 4.3% | 4.3% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Garrigues et al., 2020 [11] | Previously hospitalized patients (phone survey), n = 120 | 55.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 13.3% | 41.7% | 16.7% | 10.8% | n/a | n/a | n/a | n/a | n/a | n/a | 20.0% | n/a | n/a | n/a | n/a |
Goërtz et al., 2020 [12] | Two Facebook groups for COVID-19 patients with persistent symptoms, website panel registrants (online survey), n = 2113 | 87.0% | 22.0% | 27.0% | n/a | n/a | n/a | 38.0% | 66.7% | 13.0% | 71.0% | 29.0% | 32.0% | 41.1% | n/a | n/a | n/a | n/a | n/a | n/a | 25.7% | n/a | n/a | n/a |
Halpin et al., 2020 [44] | Previously hospitalized patients (phone survey), n = 100 | 64.0% | n/a | n/a | n/a | n/a | n/a | n/a | 19.0% | n/a | 50.0% | n/a | n/a | n/a | n/a | 31.0% | n/a | 22.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Heesakkers et al., 2022 [45] | Previously hospitalized patients (questionnaires, online or paper), n = 301 surveyed, n = 246 responders at 1 year | n/a | n/a | 11.5% | n/a | n/a | n/a | 5.3% | 25.5% | 6.9% | 20.8% | n/a | 5.3% | 3.7% | 3.3% | n/a | 20.6% | n/a | n/a | 7.0% | 4.9% | 4.1% | n/a | n/a |
Horberg et al., 2022 [46] | Previously hospitalized and non-hospitalized patients (EHR), PCR positive = 28,118; PCR negative matched controls = 70,293 | 1.4% | n/a | 1.7% | n/a | n/a | n/a | n/a | n/a | 0.3% | 1.1% | n/a | 1.7% | 1.8% | 1.5% | 1.1% | 1.8% | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Horwitz et al., 2021 [47] | Previously hospitalized patients (survey), 1 mo. n = 152, 6 mo. n = 126 | 85.0% | n/a | 29.0% | n/a | 35.0% | n/a | 26.0% | 33.0% | 15.0% | n/a | n/a | 21.0% | 33.0% | n/a | n/a | 28.0% | 37.0% | 9.0% | 7.0% | 3.0% | 12.0% | 25.0% | n/a |
Huang et al., 2021 [48] | Previously hospitalized patients (surveys, physical exams, blood, pulmonary function test, chest CT, ultrasonography), n = 1733 | 63.0% | <1% | 6.0% | n/a | 26.0% | n/a | 2.0% | 9.0% | 11.0% | n/a | n/a | 9.0% | 5.0% | n/a | 23.0% | n/a | n/a | 3.0% | 22.0% | n/a | n/a | n/a | n/a |
Huang et al., 2022 [21] * | Non-hospitalized patients (EHR), n = 1407 | 9.0% | 3.0% | n/a | n/a | 7.0% | n/a | 12.0% | 4.0% | n/a | 16.0% | 7.0% | 13.0% | 12.0% | n/a | 8.0% | 1.0% | n/a | n/a | 1.0% | 1.0% | 2.0% | n/a | n/a |
Jacobson et al., 2021 [49] | Previously hospitalized and non-hospitalized patients (surveys, walk test), n = 118 | 30.8% | 0.9% | n/a | n/a | n/a | n/a | 6.0% | n/a | 21.4% | 26.5% | 8.5% | 13.7% | 6.8% | n/a | n/a | n/a | n/a | n/a | 12.0% | n/a | n/a | n/a | n/a |
Kayaaslan et al., 2021 [50] | Previously hospitalized and non-hospitalized patients (questionnaire by phone or in clinic); 1092 invited, n = 1007 | 24.3% | n/a | n/a | n/a | n/a | n/a | 5.7% | n/a | 3.1% | 20.5% | 4.5% | 5.8% | 0.4% | 0.8% | 1.5% | n/a | 16.2% | 1.0% | 16.5% | n/a | n/a | n/a | n/a |
Kuodi et al., 2022 [51] | Previously hospitalized and non-hospitalized patients (online survey), COVID-19 = 951; Control = 2447 | 21.9% | n/a | 7.8% | n/a | 8.9% | 13.5% | 20.0% | 10.3% | 6.6% | 7.2% | 7.4% | 6.4% | 6.0% | n/a | 5.8% | 6.3% | 9.5% | n/a | 9.3% | n/a | n/a | n/a | n/a |
Larsen et al., 2022 [52] | COVID support groups and social media (online survey), Test-confirmed = 1249; Test-unconfirmed = 1065 | 89.4% | n/a | 68.6% | n/a | 65.4% | n/a | 77.9% | n/a | 61.3% | n/a | n/a | 65.0% | n/a | n/a | n/a | n/a | 81.3% | n/a | n/a | n/a | n/a | n/a | n/a |
LaVergne et al., 2021 [53] * | Previously hospitalized and non-hospitalized patients (survey, saliva, blood, breast milk, stool), n = 119 | 23.0% | n/a | n/a | n/a | 18.0% | n/a | n/a | 18.0% | 17.0% | n/a | n/a | 5.0% | n/a | n/a | 18.0% | n/a | 18.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Liang et al., 2020 [13] | Previously hospitalized patients (questionnaires, laboratory tests, physical exams), n = 76 | 60.0% | 20.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 60.0% | 62.0% | 26.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Mandal et al., 2020 [54] | Previously hospitalized patients (clinical assessment), n = 384 | 69.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 53.0% | 34.0% | n/a | n/a | n/a | 15.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Mizrahi et al., 2022 [22] | Non-hospitalized patients (EHR), n = 299,870 | n/a | n/a | 0.9% | n/a | 0.02% | 2.5% | 2.1% | 0.9% | 0.3% | 2.0% | 2.9% | 2% | 3.4% | n/a | 0.5% | 0.5% | 0.3% | 0.8% | 0.7% | 0.3% | 0.4% | n/a | n/a |
Moreno-Perez et al., 2021 [55] | Previously hospitalized and non-hospitalized patients (clinical exam, blood, chest x-ray, pulmonary function test, survey), n = 277 | 34.8% | <1% | n/a | n/a | n/a | n/a | 17.8% | n/a | 21.4% | 34.4% | 21.3% | n/a | 10.5% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Munblit et al., 2021 [56] | Previously hospitalized patients (phone interview with ISARIC questionnaire), PCR+ = 1358; Clinical COVID = 1291 | 21.2% | n/a | n/a | n/a | 7.0% | n/a | n/a | n/a | n/a | 14.5% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 7.6% | 7.1% | n/a | n/a |
Naik et al., 2021 [57] | Previously hospitalized and non-hospitalized patients (phone or clinic questionnaire); n = 1234 | 5.5% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 0.2% | 6.1% | 2.1% | 1.2% | n/a | n/a | 0.6% | n/a | 1.2% | n/a | n/a | n/a | n/a | n/a | n/a |
Peghin et al., 2021 [58] | Previously hospitalized and non-hospitalized patients (phone interview), n = 599 in study, n = 596 | 13.1% | n/a | n/a | n/a | n/a | n/a | 2.7% | n/a | 10.4% | 6.0% | 2.0% | 0.8% | 1.5% | n/a | n/a | n/a | n/a | n/a | 3.7% | n/a | n/a | n/a | n/a |
Petersen et al., 2020 [59] * | Non-hospitalized patients (questionnaire, phone interview), n = 180 | 23.0% | 4.0% | n/a | n/a | n/a | n/a | 7.0% | n/a | 23.0% | 9.0% | 5.0% | n/a | 3.0% | n/a | n/a | n/a | n/a | 2.0% | n/a | n/a | n/a | n/a | n/a |
Reese et al., 2022 [60] | Previously hospitalized and non-hospitalized patients (EHR)/RECOVER PASC N3C N = 12,443,936, COVID N = 2,909292, U09.9 (Long COVID) N = 5645, Included in analysis N = 2464 | 30.9% | 12.3% | 3.7% | n/a | 5.6% | n/a | 8.3% | 43.9% | n/a | 28.0% | 61.8% | 3.1% | 3.7% | n/a | n/a | 1.3% | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Roessler et al., 2022 [61] | Previously hospitalized and non-hospitalized patients (Health insurance data); COVID patients matched 1:5 with non-COVID patients, 145,184 adults | 4.3% | 1.2% | n/a | n/a | n/a | n/a | 4.1% | n/a | 1.2% | 4.4% | 3.0% | 3.5% | n/a | n/a | n/a | n/a | n/a | n/a | 1.4% | n/a | n/a | n/a | n/a |
Romero-Duarte et al., 2021 [62] | Previously hospitalized patients (EHR, phone), n = 797 | 22.1% | 7.0% | n/a | n/a | 4.9% | n/a | 5.3% | 15.3% | 7.2% | n/a | 19.2% | 3.1% | 10.3% | n/a | 6.8% | 3.4% | n/a | 3.1% | n/a | 4.6% | n/a | n/a | n/a |
Sarrafzadegan et al., 2022 [63] | Previously hospitalized patients (questionnaires), n = 819 | 11.7% | 3.7% | 3.2% | n/a | 0.2% | n/a | 5.7% | 19.7% | 1.3% | 18.7% | 18.7% | 5.1% | 7.1% | n/a | n/a | 1.3% | n/a | 2.2% | 14.7% | 2.7% | 1.1% | n/a | n/a |
Sigfrid et al., 2021 [64] * | Previously hospitalized patients (questionnaire by mail, phone, or clinic), n = 327 | 83.0% | 15.0% | 36.0% | n/a | 42.0% | 37.0% | 38.0% | 36.0% | 16.0% | 54.0% | 17.0% | 25.0% | 20.0% | n/a | n/a | n/a | n/a | 14.0% | n/a | 20.0% | n/a | n/a | n/a |
Søraas et al., 2021 [23] | Non-hospitalized patients (online surveys), COVID+ = 794, n = 676 at 3 months; COVID− = 7229 | 23.0% | 3.0% | n/a | n/a | n/a | n/a | 13.0% | 8.0% | 14.0% | 10.0% | 8.0% | n/a | 6.0% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Suárez-Robles et al., 2020 [14] | Previously hospitalized patients (phone survey), n = 134 | 54.5% | n/a | n/a | n/a | n/a | n/a | 24.6% | n/a | 26.1% | 40.3% | 26.1% | 21.6% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Sudre et al., 2020 [65] | Participants using Zoe COVID Symptom Study App (survey): 4182 COVID cases, 4182 matched non-COVID controls | 97.7% | n/a | n/a | n/a | n/a | n/a | 91.2% | n/a | n/a | n/a | n/a | 6.1% | n/a | n/a | n/a | 2.0% | n/a | n/a | n/a | n/a | 3.6% | n/a | n/a |
Tabacof et al., 2022 [66] * | Patients at COVID-19 syndrome clinic (online survey), n = 156 | 82.0% | 29.0% | 54.0% | n/a | 59.0% | n/a | 60.0% | 33.0% | n/a | 53.0% | n/a | 44.0% | n/a | n/a | 30.0% | n/a | 67.0% | n/a | 19.0% | 25.0% | 27.0% | n/a | n/a |
Morin et al., 2021 [67] | Previously hospitalized patients (telephone assessment), n = 478 | 31.1% | n/a | n/a | n/a | n/a | n/a | 5.5% | 8.1% | 6.0% | 16.3% | 5.0% | n/a | n/a | n/a | n/a | 12.1% | 10.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Tleyjeh et al., 2021 [68] * | Previously hospitalized patients (phone interview), n = 222 | 30.0% | 2.0% | n/a | n/a | 5.0% | n/a | 8.0% | 8.0% | 2.0% | 40.0% | 27.5% | 4.0% | 3.0% | n/a | n/a | n/a | 8.0% | n/a | n/a | n/a | n/a | n/a | n/a |
Venturelli et al., 2021 [69] | Previously hospitalized patients (clinical assessment, blood tests, chest x-ray, electrocardiogram, full pulmonary function testing, psychological evaluation, assessment of rehabilitation needs), n = 767 | n/a | 0.5% | 0.1% | n/a | n/a | n/a | 0.5% | n/a | 3.4% | 22.6% | 3.0% | 3.9% | 0.7% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Wang et al., 2020 [15] | Previously hospitalized patients (hospital records, follow-up with patients/method unspecified), n = 131 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 1.5% | 9.2% | n/a | 0.8% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
Wanga et al., 2021 [70] | Previously hospitalized and non-hospitalized (online survey), Self-reported positive test = 698; negative test = 2437 | 34.2% | 7.5% | n/a | n/a | 18.1% | n/a | 20.9% | 16.9% | 26.2% | 23.6% | 22.0% | 11.0% | 8.0% | n/a | 10.1% | n/a | 15.5% | n/a | 8.5% | n/a | n/a | n/a | n/a |
Xiong et al., 2020 [71] | Previously hospitalized patients (phone survey), COVID survivors = 538; residents of local area not hospitalized = 184 | 28.3% | 23.8% | 2.6% | n/a | 17.7% | n/a | n/a | n/a | n/a | n/a | 7.1% | 12.3% | n/a | n/a | 6.5% | n/a | n/a | n/a | 28.6% | n/a | n/a | n/a | n/a |
Zhao et al., 2020 [16] | Previously hospitalized (Physical and imaging tests), n = 55 | 16.4% | n/a | n/a | n/a | n/a | n/a | 18.2% | n/a | 4.0% | n/a | 1.8% | n/a | 30.9% | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a | n/a |
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Atchley-Challenner, R.; Strasser, Z.; Krishnamoorthy, A.; Pant, D.; Chibnik, L.B.; Karlson, E.W. Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies. COVID 2024, 4, 1513-1545. https://doi.org/10.3390/covid4100106
Atchley-Challenner R, Strasser Z, Krishnamoorthy A, Pant D, Chibnik LB, Karlson EW. Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies. COVID. 2024; 4(10):1513-1545. https://doi.org/10.3390/covid4100106
Chicago/Turabian StyleAtchley-Challenner, Rachel, Zachary Strasser, Aparna Krishnamoorthy, Deepti Pant, Lori B. Chibnik, and Elizabeth W. Karlson. 2024. "Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies" COVID 4, no. 10: 1513-1545. https://doi.org/10.3390/covid4100106