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
Review
. 2025 Jun;97(6):e70429.
doi: 10.1002/jmv.70429.

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of Symptoms 3 Years Post-SARS-CoV-2 Infection

Masoud Rahmati  1   2   3   4 , Raphael Udeh  5 , Jiseung Kang  6 , Xenia Dolja-Gore  7   8 , Mark McEvoy  7   8   9 , Abdolreza Kazemi  4 , Pinar Soysal  10 , Lee Smith  11   12 , Tony Kenna  13 , Guillaume Fond  1   4 , Bastien Boussat  14 , Duy Cao Nguyen  15 , Huyen Do  16   17 , Bach X Tran  18   19 , Nicola Veronese  20 , Dong Keon Yon  21   22 , Laurent Boyer  1   4
Affiliations
Review

Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of Symptoms 3 Years Post-SARS-CoV-2 Infection

Masoud Rahmati et al. J Med Virol. 2025 Jun.

Abstract

The symptoms of long COVID are well-documented. However, the long-term effects beyond 2 years remain poorly understood due to a lack of data. This systematic review and meta-analysis examined the prevalence of persistent symptoms in COVID-19 survivors 3 years following initial SARS-CoV-2 infection. PubMed, MEDLINE (Ovid), CENTRAL, Web of Science, Scopus, and Embase were searched from inception of the databases up to July 20, 2024, by two independent researchers for articles reporting on the prevalence of persistent symptoms 3 years' post-infection of people who survived COVID-19 infection. We employed a random-effect model for the pooled analysis, and the meta-analytical effect size was prevalence for the applicable end-points, I2 statistics, and quality assessment of included studies using the Newcastle-Ottawa Scale. Eleven articles were included after the literature search yielded 223 potentially relevant articles. We found that among patients with long COVID, fatigue, sleep disturbances, and dyspnea were the most common symptoms. Pooled analysis showed that the proportion of individuals experiencing at least one persistent symptom 3 years post-COVID-19 is 20% (95% confidence interval [CI]: 8-43). The prevalence of persistent symptoms was dyspnea (12%; 95% CI: 10-15), fatigue (11%; 95% CI: 6-20), insomnia (11%; 95% CI: 2-37), loss of smell (7%; 95% CI: 5-8), loss of taste (7%; 95% CI: 3-16), and anxiety (6%; 95% CI: 1-32). Prevalence of other findings include impaired diffusion capacity (42%; 95% CI: 34-50) and impaired forced expiratory volume in 1 s (10%; 95% CI: 8-12). Our findings confirm the persistence of unresolved symptoms 3 years post-COVID-19 infection, with implications for future research, healthcare policy, and patient care.

Keywords: COVID‐19; SARS‐CoV‐2 infection; long COVID; meta‐analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection.
Figure 2
Figure 2
Forest plot of (a) at least one unresolved symptom and (b) at least one unresolved respiratory symptom 3 years after SARS‐CoV‐2 infection.
Figure 3
Figure 3
Forest plot of prevalence of various symptoms 3 years after SARS‐CoV‐2 infection.
Figure 3
Figure 3
Forest plot of prevalence of various symptoms 3 years after SARS‐CoV‐2 infection.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

References

    1. Boscolo‐Rizzo P., Hummel T., Spinato G., et al., “Olfactory and Gustatory Function 3 Years After Mild COVID‐19—A Cohort Psychophysical Study,” JAMA Otolaryngology‐Head & Neck Surgery 150, no. 1 (2024): 79–81, 10.1001/jamaoto.2023.3603. - DOI - PMC - PubMed
    1. Bota A. V., Bogdan I., Razvan D. V., et al., “A Three‐Year Cross‐Sectional Analysis of Depression, Anxiety, and Quality of Life in Patients With Post‐COVID‐19 Syndrome,” International Journal of General Medicine 17 (2024): 751–762, 10.2147/IJGM.S453247. - DOI - PMC - PubMed
    1. Cai M., Xie Y., Topol E. J., and Al‐Aly Z., “Three‐Year Outcomes of Post‐Acute Sequelae of COVID‐19,” Nature Medicine 30, no. 6 (2024): 1564–1573, 10.1038/s41591-024-02987-8. - DOI - PMC - PubMed
    1. Dai Y., Wang Y., Yang X. Y., et al., “Health Outcomes of COVID‐19 Patients From Wuhan, China 3‐Year After Hospital Discharge: A Cohort Study,” BMJ Open 14, no. 8 (2024): e084770, 10.1136/bmjopen-2024-084770. - DOI - PMC - PubMed
    1. Eligulashvili A., Gordon M., Lee J. S., et al., “Long‐Term Outcomes of Hospitalized Patients With SARS‐CoV‐2/COVID‐19 With and Without Neurological Involvement: 3‐Year Follow‐Up Assessment,” PLoS Medicine 21, no. 4 (2024): e1004263, 10.1371/journal.pmed.1004263. - DOI - PMC - PubMed