A systematic review and meta‐analysis of long‐term sequelae of COVID‐19 2‐year after SARS‐CoV‐2 infection: A call to action for neurological, physical, and psychological sciences

Abstract

Long‐term sequelae conditions of COVID‐19 at least 2‐year following SARS‐CoV‐2 infection are unclear and little is known about their prevalence, longitudinal trajectory, and potential risk factors. Therefore, we conducted a comprehensive meta‐analysis of survivors' health‐related consequences and sequelae at 2‐year following SARS‐CoV‐2 infection. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched up to February 10, 2023. A systematic review and meta‐analysis were performed to calculate the pooled effect size, expressed as event rate (ER) with corresponding 95% confidence interval (CI) of each outcome. Twelve studies involving 1 289 044 participants from 11 countries were included. A total of 41.7% of COVID‐19 survivors experienced at least one unresolved symptom and 14.1% were unable to return to work at 2‐year after SARS‐CoV‐2 infection. The most frequent symptoms and investigated findings at 2‐year after SARS‐CoV‐2 infection were fatigue (27.4%; 95% CI 17%–40.9%), sleep difficulties (25.1%; 95% CI 22.4%–27.9%), impaired diffusion capacity for carbon monoxide (24.6%; 95% CI 10.8%–46.9%), hair loss (10.2%; 95% CI 7.3%–14.2%), and dyspnea (10.1%; 95% CI 4.3%–21.9%). Individuals with severe infection suffered more from anxiety (OR = 1.69, 95% CI 1.17–2.44) and had more impairments in forced vital capacity (OR = 9.70, 95% CI 1.94–48.41), total lung capacity (OR = 3.51, 95% CI 1.77–6.99), and residual volume (OR = 3.35, 95% CI 1.85–6.07) after recovery. Existing evidence suggest that participants with a higher risk of long‐term sequelae were older, mostly female, had pre‐existing medical comorbidities, with more severe status, underwent corticosteroid therapy, and higher inflammation at acute infection. Our findings suggest that 2‐year after recovery from SARS‐CoV‐2 infection, 41.7% of survivors still suffer from either neurological, physical, and psychological sequela. These findings indicate that there is an urgent need to preclude persistent or emerging long‐term sequelae and provide intervention strategies to reduce the risk of long COVID.