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 May 24:36:100899.
doi: 10.1016/j.eclinm.2021.100899. eCollection 2021 Jun.

Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis

Fahad M Iqbal  1   2 , Kyle Lam  1   2 , Viknesh Sounderajah  1   2 , Jonathan M Clarke  2   3 , Hutan Ashrafian  1   2 , Ara Darzi  1   2
Affiliations

Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis

Fahad M Iqbal et al. EClinicalMedicine. .

Abstract

Background: A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome.

Methods: A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855.

Findings: A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design.

Interpretation: In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.

Keywords: COVID-19; Coronavirus; Long covid; Post covid syndrome; SARS-CoV 2; Systematic review.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig 1:
Fig. 1
Study selection.
Fig 2:
Fig. 2
Forest plot of studies describing clinical features in acute post-COVID syndrome.
Fig 3:
Fig. 3
Forest plot of studies describing clinical features in chronic post-COVID syndrome.
Fig 4:
Fig. 4
Forest plot of pooled prevalence of clinical features reported in acute post-COVID syndrome.
Fig 5:
Fig. 5
Forest plot of pooled prevalence of clinical features reported in chronic post-COVID syndrome.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organisation. WHO Coronavirus Disease (COVID-19) Dashboard. 2020. https://covid19.who.int/?gclid=CjwKCAjw2Jb7BRBHEiwAXTR4jTyiJ83RwLwaLTHzk... (accessed Sept 19, 2020).
    1. Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020;370 doi: 10.1136/bmj.m3026. - DOI - PubMed
    1. Nabavi N. Long covid: How to define it and how to manage it. BMJ. 2020;370:m3489. - PubMed
    1. Office for National Statistics (ONS). Coronavirus (COVID-19) Infection Survey. 2020. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/... (accessed Dec 23, 2020).
    1. Updated estimates of the prevalence of long COVID symptoms - Office for National Statistics. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/... (accessed March 9, 2021).

LinkOut - more resources