Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021.

Journal: Jama

Published: October 10, 2022

Abstract

Importance: Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).

Objective: To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration. Design, setting, and participants: Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022. Exposures: Symptomatic SARS-CoV-2 infection. Main outcomes and measures: Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age.

Results: A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months. Conclusions and relevance: This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

Authors

Cristiana Abbafati, Joachim Aerts, Ziyad Al Aly, Charlie Ashbaugh, Tala Ballouz, Oleg Blyuss, Polina Bobkova, Gouke Bonsel, Svetlana Borzakova, Danilo Buonsenso, Denis Butnaru, Austin Carter, Helen Chu, Cristina De Rose, Mohamed Diab, Emil Ekbom, Maha El Tantawi, Victor Fomin, Robert Frithiof, Aysylu Gamirova, Petr Glybochko, Juanita Haagsma, Shaghayegh Haghjooy Javanmard, Erin Hamilton, Gabrielle Harris, Majanka Heijenbrok Kal, Raimund Helbok, Merel Hellemons, David Hillus, Susanne Huijts, Michael Hultström, Waasila Jassat, Florian Kurth, Ing-marie Larsson, Miklós Lipcsey, Chelsea Liu, Callan Loflin, Andrei Malinovschi, Wenhui Mao, Lyudmila Mazankova, Denise Mcculloch, Dominik Menges, Noushin Mohammadifard, Daniel Munblit, Nikita Nekliudov, Osondu Ogbuoji, Ismail Osmanov, José Peñalvo, Maria Petersen, Milo Puhan, Mujibur Rahman, Verena Rass, Nickolas Reinig, Gerard Ribbers, Antonia Ricchiuto, Sten Rubertsson, Elmira Samitova, Nizal Sarrafzadegan, Anastasia Shikhaleva, Kyle Simpson, Dario Sinatti, Joan Soriano, Ekaterina Spiridonova, Fridolin Steinbeis, Andrey Svistunov, Piero Valentini, Brittney Van De Water, Rita Van Den Berg Emons, Ewa Wallin, Martin Witzenrath, Yifan Wu, Hanzhang Xu, Thomas Zoller, Christopher Adolph, James Albright, Joanne Amlag, Aleksandr Aravkin, Bree Bang Jensen, Catherine Bisignano, Rachel Castellano, Emma Castro, Suman Chakrabarti, James Collins, Xiaochen Dai, Farah Daoud, Carolyn Dapper, Amanda Deen, Bruce Duncan, Megan Erickson, Samuel Ewald, Alize Ferrari, Abraham Flaxman, Nancy Fullman, Amiran Gamkrelidze, John Giles, Gaorui Guo, Simon Hay, Jiawei He, Monika Helak, Erin Hulland, Maia Kereselidze, Kris Krohn, Alice Lazzar Atwood, Akiaja Lindstrom, Rafael Lozano, Deborah Malta, Johan Månsson, Ana Mantilla Herrera, Ali Mokdad, Lorenzo Monasta, Shuhei Nomura, Maja Pasovic, David Pigott, Robert Reiner, Grace Reinke, Antonio Luiz Ribeiro, Damian Santomauro, Aleksei Sholokhov, Emma Spurlock, Rebecca Walcott, Ally Walker, Charles Wiysonge, Peng Zheng, Janet Bettger, Christopher J Murray, Theo Vos

Relevant Conditions

Severe Acute Respiratory Syndrome (SARS), COVID-19, Long Haul COVID

Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021.

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