Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

Abstract

Background: One-third of patients who recover from COVID-19 present with long COVID. Their symptoms are broad, affecting their physical functioning and, ultimately, their quality of life. Many of those individuals who develop long COVID, possibly from a mild COVID-19 infection, are in the 18-65 age group. This prolongation of malaise directly influences national workforce economies.

Objectives: To summarise the commonly reported physical symptoms of long COVID in order to inform potential adjustments in healthcare for the employable population.

Methods: The Embase, CINAHL, Medline, SCOPUS, and WHO COVID-19 databases were searched. The study selection process was based on the PRISMA guidelines. The extracted data were synthesised and presented narratively.

Results: 7403 studies were accessed, comprising 60 cohort studies and 10 case series/studies, representing 289,213 patients who met our criteria. The most frequently reported physical symptoms were fatigue (92%), shortness of breath (SOB) (81.8%), muscle pain (43.6%), and joint pain (34.5%).

Conclusions: The range of reported physical symptoms was broad and varied; the main ones being fatigue, breathlessness/SOB, and pain. Similarities observed between long COVID and other post-acute infection syndromes may help formulate protocols to manage and promote recovery for long COVID patients. Inconsistencies were evident, particularly with a lack of adherence to the standardised definitions of long COVID.

Keywords: adults; long COVID; mild COVID-19; physical symptoms.

Figure 3

Radar chart illustrating the prevalence of the specific long COVID symptoms in the cohort studies with study number indicated on the circle circumference [15,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87]. Supplementary Table S2 illustrates how this radar chart was formulated.

Figure 1

Classification of long COVID based on timing from symptom onset according to the NICE guidelines [11] and the WHO definition [9].

Figure 2

The PRISMA Flow Chart describing the search strategy. Page et al., 2020 [28].