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 Dec;49(6):1163-1186.
doi: 10.1007/s15010-021-01666-x. Epub 2021 Jul 28.

Long COVID, a comprehensive systematic scoping review

Hossein Akbarialiabad #  1 , Mohammad Hossein Taghrir #  1 , Ashkan Abdollahi  2 , Nasrollah Ghahramani  3 , Manasi Kumar  4   5 , Shahram Paydar  6 , Babak Razani  7   8   9 , John Mwangi  10 , Ali A Asadi-Pooya  11   12 , Leila Malekmakan  2 , Bahar Bastani  13
Affiliations

Long COVID, a comprehensive systematic scoping review

Hossein Akbarialiabad et al. Infection. 2021 Dec.

Abstract

Purpose: To find out what is known from literature about Long COVID until January 30, 2021.

Methods: We undertook a four-step search with no language restriction. A preliminary search was made to identify the keywords. A search strategy of all electronic databases resulted in 66 eligible studies. A forward and backward search of the references and citations resulted in additional 54 publications. Non-English language articles were translated using Google Translate. We conducted our scoping review based on the PRISMA-ScR Checklist.

Results: Of 120 papers, we found only one randomized clinical trial. Of the 67 original studies, 22 were cohort, and 28 were cross-sectional studies. Of the total 120 publications, 49.1% focused on signs and symptoms, 23.3% on management, and 10.8% on pathophysiology. Ten publications focused on imaging studies. The results are also presented extensively in a narrative synthesis in separated sections (nomenclature, diagnosis, pathophysiology, risk factors, signs/symptoms, management).

Conclusions: The controversies in its definition have impaired proper recognition and management. The predominant symptoms were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness.

Keywords: COVID-19; Corona virus; Long COVID-19; Long haulers COVID; Novel Corona Virus 2019; PASC post-acute sequela SARS-COV-2; Post COVID-19 Syndrome; Post-acute COVID-19; Post-acute SARS-CoV-2; SARS-Cov-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Fig. 1
Fig. 1
PRISMA flow chart, the process of study selection. WOS Web of Science
Fig. 2
Fig. 2
Distribution of included papers based on types of publication
Fig. 3
Fig. 3
Distribution of included papers based on their methodology. RCT Randomized Clinical Trial
Fig. 4
Fig. 4
Categories and main topics of included papers; Inner doughnut illustrates the categorization of documents, and the outer doughnut illustrates the main topics of each category. MIS Multisystem Inflammatory Response
Fig. 5
Fig. 5
Number of articles according to dates of submission and publication
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. Honigsbaum M, Krishnan L. Taking pandemic sequelae seriously: from the Russian influenza to COVID-19 long-haulers. Lancet. 2020;396:1389–1391. doi: 10.1016/S0140-6736(20)32134-6. - DOI - PMC - PubMed
    1. Ahmed H, et al. Long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronavirus outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis. J Rehabil Med. 2020;52:1–11. - PubMed
    1. Wu X, Dong D, Ma D. Thin-section computed tomography manifestations during convalescence and long-term follow-up of patients with severe acute respiratory syndrome (SARS) Med Sci Monit Int Med J Exp Clin Res. 2016;22:2793. - PMC - PubMed
    1. Yu C, et al. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. 2006;82:140–144. doi: 10.1136/pgmj.2005.037515. - DOI - PMC - PubMed
    1. Wu Q, et al. Altered lipid metabolism in recovered SARS patients twelve years after infection. Sci Rep. 2017;7:1–12. - PMC - PubMed

Publication types