Systematic Review of the Prevalence of Long COVID

BACKGROUND: Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection. METHODS: We searched key registers and databases from January 1, 2020 to November 2, 2021, limited to publications in English and studies with at least 100 participants. Studies in which all participants were critically ill were excluded. Long COVID was extracted as prevalence of at least 1 symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across predefined subgroups (PROSPERO ID CRD42020218351). RESULTS: One hundred twenty studies in 130 publications were included. Length of follow-up varied between 12 weeks and 12 months. Few studies had low risk of bias. All complete and subgroup analyses except 1 had I2 ≥90%, with prevalence of persistent symptoms range of 0%-93% (pooled estimate [PE], 42.1%; 95% prediction interval [PI], 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE, 13.6%; PI, 1.2% to 68%) of persistent symptoms/pathology than self-report (PE, 43.9%; PI, 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all 3 (PE, 51.7%; PI, 12.3% to 89.1%). Studies of hospitalized cases had generally higher estimates than community-based studies. CONCLUSIONS: The way in which Long COVID is defined and measured affects prevalence estimation. Given the widespread nature of SARS-CoV-2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates

Systematic review of the prevalence of Long Covid

Background Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection. Methods We searched key registers and databases from January 1, 2020 to November 2, 2021, limited to publications in English and studies with at least 100 participants. Studies in which all participants were critically ill were excluded. Long COVID was extracted as prevalence of at least 1 symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across predefined subgroups (PROSPERO ID CRD42020218351). Results One hundred twenty studies in 130 publications were included. Length of follow-up varied between 12 weeks and 12 months. Few studies had low risk of bias. All complete and subgroup analyses except 1 had I2 ≥90%, with prevalence of persistent symptoms range of 0%–93% (pooled estimate [PE], 42.1%; 95% prediction interval [PI], 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE, 13.6%; PI, 1.2% to 68%) of persistent symptoms/pathology than self-report (PE, 43.9%; PI, 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all 3 (PE, 51.7%; PI, 12.3% to 89.1%). Studies of hospitalized cases had generally higher estimates than community-based studies. Conclusions The way in which Long COVID is defined and measured affects prevalence estimation. Given the widespread nature of SARS-CoV-2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates

Systematic review of the prevalence of Long Covid

Background: Long Covid occurs in those infected with SARSCoV2 whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability or pathological changes in adults or children at least 12 weeks post-infection.Methods: we searched key registers and databases from 1st January 2020 to 2nd November 2021, limited to publications in English and studies with at least 100 participants. Studies where all participants were critically ill were excluded. Long Covid was extracted as prevalence of at least one symptom or pathology, or prevalence of the most common symptom or pathology, at 12 weeks or later. Heterogeneity was quantified in absolute terms and as a proportion of total variation and explored across pre-defined subgroups (PROSPERO ID CRD42020218351).Results: 120 studies in 130 publications were included. Length of follow-up varied between 12 weeks - 12 months. Few studies had low risk of bias. All complete and subgroup analyses except one had I2 ≥ 90%, with prevalence of persistent symptoms range of 0% - 93% (pooled estimate (PE) 42.1%, 95% prediction interval (PI): 6.8% to 87.9%). Studies using routine healthcare records tended to report lower prevalence (PE 13.6%, PI: 1.2% to 68%) of persistent symptoms/pathology than self-report (PE 43.9%, PI: 8.2% to 87.2%). However, studies systematically investigating pathology in all participants at follow up tended to report the highest estimates of all three (PE 51.7%, PI: 12.3% to 89.1%). Studies of hospitalised cases had generally higher estimates than community-based studies.Conclusions: the way in which Long Covid is defined and measured affects prevalence estimation. Given the widespread nature of SARSCoV2 infection globally, the burden of chronic illness is likely to be substantial even using the most conservative estimates

Long COVID and Health Inequalities: What's Next for Research and Policy Advocacy?

ABSTRACTIntroductionOrganised by the ‘Qualitative Long Covid Network’, a workshop for qualitative Long COVID (LC) researchers, LC charity representatives and people with LC took place in June 2023, where research on the intersectional inequalities affecting LC prevalence, recognition and care was shared and discussed.MethodsFive key themes were drawn up from presentations, discussions and reflections during the workshop, which are presented in this study.ResultsThe following five themes are discussed: the unfairness of LC, difficulties in accessing care, mistrust of the healthcare system, a lack of understanding of LC and experiences of stigma and discrimination. Factors that widen or narrow inequalities related to LC were identified.ConclusionA call to action is proposed to investigate and address inequalities through a robust LC research agenda that speaks with conviction to policy and decision‐makers. We argue that there needs to be a strong investment in research and evidence‐based policy and practice to mitigate the worst effects of the condition and address the inequalities in experience, treatment and support, which are experienced more often and more acutely by some of society's most vulnerable and disadvantaged individuals.Patient and Public (PPI) ContributionProjects included in this article had PPI ongoing activity to inform their research. A member of the CONVALESCENCE PPI group presented at the QLC Network ‘Long Covid and Health Inequalities’ workshop, as did members of Long COVID Kids, Long COVID Support and Long COVID SOS charities. They were all invited to be co‐authors of this article.</jats:sec

Long Covid and health inequalities:what next for research and policy advocacy?

Introduction: Organised by the Qualitative Long Covid Network, a workshop of qualitative Long Covid (LC) researchers, LC charity representatives and people with LC took place in June 2023 where research on the intersectional inequalities affecting LC prevalence, recognition and care was shared and discussed. Methods: Five key themes were drawn up from presentations, discussions and reflections during the workshop and are presented here. Results: The following five themes are discussed: the unfairness of LC; difficulties accessing care; mistrust of the healthcare system; lack of understanding of LC; and experience of stigma and discrimination. Factors that widen or narrow inequalities in LC were identified. Conclusion: A call for action is proposed on investigating and addressing inequality through a robust LC research agenda that speaks with conviction to policy and decision-makers. We argue there needs to be strong investment in research and evidence-based policy and practice that mitigates the worst effects of the condition and addresses inequalities in experience, treatment and support, which are experienced more often and more acutely by some of society’s most vulnerable and disadvantaged. Patient and Public (PPI) Contribution: Projects included in this article had PPI ongoing activity informing their research. A member of the CONVALESCENCE PPI group presented at the QLC Network ‘Long Covid and Health Inequalities’ workshop, as did members of Long Covid Kids, Long Covid Support and Long Covid SOS charities. All were invited to be co-authors of this articl