Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar-Apr:40:101995.
doi: 10.1016/j.tmaid.2021.101995. Epub 2021 Feb 22.

COVID-19 sequelae in adults aged less than 50 years: A systematic review

Sandra Willi  1 , Renata Lüthold  2 , Adam Hunt  2 , Nadescha Viviane Hänggi  2 , Donikë Sejdiu  2 , Camila Scaff  2 , Nicole Bender  2 , Kaspar Staub  3 , Patricia Schlagenhauf  4
Affiliations

COVID-19 sequelae in adults aged less than 50 years: A systematic review

Sandra Willi et al. Travel Med Infect Dis. 2021 Mar-Apr.

Abstract

Background: There is emerging evidence of long-term sequelae in a considerable proportion of COVID-19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed. This review aims to evaluate the available evidence of all intermediate and long-term COVID-19 sequelae affecting formerly healthy adults.

Methods: A systematic literature search of Embase, WHO, Scopus, Pubmed, Litcovid, bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO (CRD42020208725). Search terms included "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "sequelae" and "consequence*". Publications on adult participants, with a confirmed SARS-CoV-2 infection were included. Elderly (>50 years old) and children (<18 years old) were excluded. Bias assessment was performed using a modified Newcastle-Ottawa Scale.

Results: A total of 31 papers were included. Study types included prospective and retrospective cohort studies, cross-sectional studies and case reports. Sequelae persistence since infection spanned 14 days to three months. Sequelae included persistent fatigue (39-73% of assessed persons), breathlessness (39-74%), decrease in quality of life (44-69%), impaired pulmonary function, abnormal CT findings including pulmonary fibrosis (39-83%), evidence of peri-/perimyo-/myocarditis (3-26%), changes in microstructural and functional brain integrity with persistent neurological symptoms (55%), increased incidence of psychiatric diagnoses (5.8% versus 2.5-3.4% in controls), incomplete recovery of olfactory and gustatory dysfunction (33-36% of evaluated persons).

Conclusions: A variety of organ systems are affected by COVID-19 in the intermediate and longer-term after recovery. Main sequelae include post-infectious fatigue, persistent reduced lung function and carditis. Careful follow-up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality.

Keywords: COVID-19; Consequences; Coronavirus; Long-term; SARS-CoV-2; Sequelae.

PubMed Disclaimer

Conflict of interest statement

All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
See this image and copyright information in PMC

References

    1. Rubin R. As their numbers grow, COVID-19 “long haulers” stump experts. J Am Med Assoc. 2020;324:1381–1383. doi: 10.1001/jama.2020.17709. - DOI - PubMed
    1. Veritas Health Innovation . 2020. Covidence systematic review software.
    1. World Health Organization COVID-19: vulnerable and high risk groups. 2020. https://www.who.int/westernpacific/emergencies/covid-19/information/high...
    1. Wells G., Shea B., O'Connell D., Peterson je, Welch V., Losos M., et al. 2000. The newcastle–ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis.
    1. JAMA Instructions for authors. 2020. https://jamanetwork.com/journals/jama/pages/instructions-for-authors#Sec...

Publication types