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Review
. 2023 Sep 13:10:20499361231198335.
doi: 10.1177/20499361231198335. eCollection 2023 Jan-Dec.

Long-COVID-19 clinical and health outcomes: an umbrella review

Hu Li  1 , Jin Xia  2 , Dimitri Bennett  2   3 , Fatima Roque  4 , Rujuta A Bam  5 , Ana Bárbara Tadeu Tavares  4 , Mugdha Gokhale  6   7 , Fidelia Ida  8 , Jinnie Jiwon Rhee  9 , Montse Soriano Gabarro  10 , Yiqing Song  11
Affiliations
Review

Long-COVID-19 clinical and health outcomes: an umbrella review

Hu Li et al. Ther Adv Infect Dis. .

Abstract

Background: A growing interest in long-term sequelae of COVID-19 has prompted several systematic literature reviews (SLRs) to evaluate long-COVID-19 effects. However, many of these reviews lack in-depth information on the timing, duration, and severity of these conditions.

Objectives: Our aim was to synthesize both qualitative and quantitative evidence on prevalence and outcomes of long-term effect of COVID-19 through an umbrella review.

Design: Umbrella review of relevant SLRs on long-COVID-19 in terms of prolonged symptoms and clinical conditions, and comprehensively synthesized the latest existing evidence.

Data sources and methods: We systematically identified and appraised prior systematic reviews/meta-analyses using MEDLINE, Embase, and Cochrane database of systematic review from 2020 to 2021 following the preferred reporting items for systematic reviews and meta-analyses guidance. We summarized and categorized all relevant clinical symptoms and outcomes in adults with COVID-19 using the Medical Dictionary for Regulatory Activities System Organ Class (MedDRA SOC).

Results: We identified 967 systematic reviews/meta-analyses; 36 were retained for final data extraction. The most prevalent SOC were social circumstances (40%), blood and lymphatic system disorders (39%), and metabolism and nutrition disorder (38%). The most frequently reported SOC outcomes within each MedDRA category were poor quality of life (59%), wheezing and dyspnea (19-49%), fatigue (30-64%), chest pain (16%), decreased or loss of appetite (14-17%), abdominal discomfort or digestive disorder (12-18%), arthralgia with or without myalgia (16-24%), paresthesia (27%) and hair loss (14-25%), and hearing loss or tinnitus (15%).

Conclusion: This study confirmed a high prevalence of several long COVID-19 outcomes according to the MedDRA categories and indicated that the majority of evidence was rated as moderate to low.

Registration: The review was registered at PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022303557).

Keywords: MedDRA system organ classes; clinical outcomes; long COVID-19; prevalence; umbrella review.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: DB and JX are employees of Takeda. FI is an employee of CSL Behring LLC. MSG is an employee of Bayer AG. MG is a full-time employee of Merck. HL and RAB are employees of Gilead Sciences Inc. ABTT was funded by the Grant CENTRO-04-3559-FSE-000162 within the European Social Fund (ESF). All other authors report no conflict of interest.

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses flow diagram. *Other publication types include case report, case studies, editorial, comment, historical article, and conference abstract.
Figure 2.
Figure 2.
(a) Prevalence of outcomes by MedDRA SOC by time at assessment: Overall. (b) Prevalence of MedDRA SOC by time at assessment and severity of COVID-19 among hospitalized patients. (c) Prevalence of MedDRA SOC by time at assessment and severity of COVID-19 among non-hospitalized patients. MedDRA SOC, medical dictionary for regulatory activities system organ class.
Figure 3.
Figure 3.
(a) Meta-analysis results of prevalence estimates of conditions within MedDRA SOC: cardiac disorders. (b) Meta-analysis results of prevalence estimates of conditions within MedDRA SOC: psychiatric disorders. (c) Meta-analysis results of prevalence estimates of conditions within MedDRA SOC: fatigue. MedDRA SOC, medical dictionary for regulatory activities system organ class; PTSD, Post-traumatic stress disorder. *Fernandez-de-Las-Penas_1: hospitalized patients; Fernandez-de-Las_Penas_2: non-hospitalized patients.
Figure 4.
Figure 4.
Quality assessment using the AMSTAR 2 tool.
See this image and copyright information in PMC

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