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. 2024 Jan 17;14(1):e077886.
doi: 10.1136/bmjopen-2023-077886.

Definition and measurement of post-COVID-19 conditions in real-world practice: a global systematic literature review

Jingyan Yang  1   2 , Kristen Markus  3 , Kathleen Michelle Andersen  4 , Abby E Rudolph  4 , Leah J McGrath  4 , Jennifer L Nguyen  4 , Moe H Kyaw  4 , Isabelle Whittle  3 , Vasileios Blazos  3 , Louise Heron  3 , Julia Regazzini Spinardi  5
Affiliations

Definition and measurement of post-COVID-19 conditions in real-world practice: a global systematic literature review

Jingyan Yang et al. BMJ Open. .

Abstract

Post-COVID-19 conditions (PCC) is an umbrella term that encompasses a range of signs, symptoms and conditions present weeks after the acute phase of a SARS-CoV-2 infection. This systematic literature review summarises the heterogeneous methodology used to measure PCC across real-world studies and highlights trends by region, age group, PCC follow-up period and data source.

Methods: Medline, EMBASE and the Cochrane Library were searched and supplemented with conference and grey literature searches. Eligible studies included individuals with (1) PCC or (2) a positive SARS-CoV-2 test or COVID-19 diagnosis who were followed over time. Included studies were published in English between 1 January 2020 and 14 November 2022.

Findings: Of 291 publications included, 175 (60%) followed individuals with confirmed COVID-19 over time for PCC and 116 (40%) used a prespecified PCC definition. There was substantial heterogeneity in study design, geography, age group, PCC conditions/symptoms assessed and their classification and duration of follow-up. Among studies using a prespecified PCC definition, author-defined criteria (51%) were more common than criteria recommended by major public health organisations (19%). Measurement periods for PCC outcomes from date of acute COVID-19 test were primarily 3 to <6 months (39.2%), followed by 6 to <12 months (27.5%) and <3 months (22.9%). When classified by organ/system, constitutional-related PCC were the most frequently assessed in adult (86%) and paediatric (87%) populations. Within constitutional symptoms, fatigue was most frequently assessed in adult (91.6%) and paediatric (95.0%) populations, followed by fever/chills (37.9% and 55%, respectively).

Conclusions: PCC definitions are heterogenous across real-world studies, which limits reliable comparisons between studies. However, some similarities were observed in terms of the most frequently measured PCC-associated symptoms/conditions, which may aid clinical management of patients with PCC.CRD42022376111.

Keywords: COVID-19; infectious diseases; systematic review.

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Conflict of interest statement

Competing interests: JY, KMA, LJMcG, JLN, MHK, AER and JRS are employees of Pfizer and may hold stock or stock options. LH, KM, IW and VB are employees of Adelphi Values PROVE.

Figures

Figure 1
Figure 1
PRISMA flow chart of publications included in the SLR. *SLR/NMA were excluded but bibliographies were reviewed to ensure all relevant publications were included. †Duplicate and non-English publications were excluded as ‘other’. NMA, network meta-analysis; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RWE, real-world evidence; SLR, systematic literature review.
Figure 2
Figure 2
Distribution of the most frequently assessed symptom/condition domains stratified by (A) age group, (B) data source, (C) study design and (D) follow-up length.
Figure 3
Figure 3
Distribution of the most frequently assessed symptoms/conditions by symptom/condition domain in adult and pediatric population.
See this image and copyright information in PMC

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