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Meta-Analysis
. 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
Meta-Analysis

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.

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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

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