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One-year temporal changes in long COVID prevalence and characteristics: a systematic review and meta-analysis

  • Qiangru Huang
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Mengmeng Jia
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Yanxia Sun
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Binshan Jiang
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Dan Cui
    Affiliations
    Department of Pulmonary and Critical Care Medicine, The 2nd Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, China

    Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
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  • Luzhao Feng
    Correspondence
    Corresponding author: Luzhao Feng PhD, [email protected], #9 Dong Dan San Tiao, Dongcheng District Beijing 100730, P.R.China
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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  • Weizhong Yang
    Correspondence
    Corresponding author: Weizhong Yang MD, , #9 Dong Dan San Tiao, Dongcheng District Beijing 100730, P.R.China
    Affiliations
    School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Published:November 24, 2022DOI:https://doi.org/10.1016/j.jval.2022.11.011
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      Highlights

      • 1.
        What is already known about this topic?
        • Long COVID shows multiorgan symptoms and persists for a long period in some post-acute patients.
      • 2.
        What does the paper add to existing knowledge?
        • Our findings highlight the temporal change in prevalence of 44 specific long COVID symptoms. About two-thirds of the symptoms did not reduce during the 1-year follow-up. The influence of acute phase-related factors for long COVID gradually decreases over time.
      • 3.
        What insights does the paper provide for informing health care-related decision making?
        • Long COVID may persist longer than expected and more attention should be paid to neuropsychiatric symptoms.

      Abstract

      Objectives

      This study aimed to explore the 1-year temporal change in prevalence, variety, and potential risk factors of long COVID symptoms, and to further predict the prognostic trends of long COVID.

      Methods

      We searched electronic databases for related studies published from January 2020 to February 2022, and conducted one group meta-analysis and locally weighted regression explore the monthly temporal change in the prevalence of each long COVID symptom in 1-year follow-up period.

      Results

      A total of 137 studies were included in meta-analysis, including 134,093 participants. The temporal change of any long COVID symptom showed a steep decrease initially (from 92% at acute phase to 55% at 1-month follow-up), followed by stabilization at approximately 50% during 1-year follow-up. Six months or more after the acute phase, the odds ratio (OR) of population characteristic factors increased, such as female gender (from 1.62 to 1.82), while the OR value of acute phase-related factors (severe/critical and hospitalization) decreased. As for specific symptoms, about two-thirds of the symptoms did not significantly reduce during the 1-year follow-up, and the neuropsychiatric symptoms showed a higher long-term prevalence (approximately 25%) and longer persistence than physical-symptoms.

      Conclusions

      The temporal changes in the prevalence and characteristics speculate that long COVID may persist longer than expected. In particular, we should pay more attention to neuropsychiatric symptoms and other symptoms for which there is no significant downward trend in prevalence. The influence of acute phase-related factors for long COVID gradually decreases over time, while the influence of population characteristic-related gradually increases.

      Keywords

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