Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis

Abstract

Background A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome. Methods A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855 Findings A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design. Interpretation In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.

Gastrointestinal symptoms at the acute COVID-19 phase are risk factors for developing gastrointestinal post-COVID symptoms: a multicenter study

“…Identification of risk factors is needed for close monitoring and early intervention of patients at a higher risk of developing post-COVID symptoms. A recent meta-analysis found very limited data on predictors of post-COVID symptoms without studies assessing gastrointestinal post-COVID symptoms associated risk factors [ 10 ]. In our study, the presence of gastrointestinal symptoms at the acute phase of the infection was associated with the presence of gastrointestinal post-COVID symptoms eight months after infection.…”

Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care

“…There are few rigorous, prospective studies on the natural history of PASC, including prevalence and duration, with most studies following patients for fewer than 7 months ( Table 1 , Table 2 ). 4 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 However, existing reports indicate that the burden of impairments is relatively high. An analysis of the US Department of Veterans Affairs electronic health database used a high-dimensional approach to evaluate 6-month outcomes for patients surviving the initial 30 days after COVID-19.…”

Clinical Predictors of Mortality and Critical Illness in Patients with COVID-19 Pneumonia

“…Many studies suggest a template or scores for predicting the prognosis of COVID-19 patients [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. It is difficult to accurately predict clinical outcomes for patients across this spectrum of clinical presentations [ 12 , 13 , 14 , 15 , 16 , 17 ], thus making it difficult to manage these patients. An improved understanding of predictive factors for COVID-19 is critical for improving clinical decisions.…”