Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

Abstract

ImportanceSome individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).ObjectiveTo estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration.Design, Setting, and ParticipantsBayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022.ExposuresSymptomatic SARS-CoV-2 infection.Main Outcomes and MeasuresProportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age.ResultsA total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months.Conclusions and RelevanceThis study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

The Long-COVID Experience Changed People’s Vaccine Hesitancy but Not Their Vaccination Fear

“…Future studies should examine the effects of long-COVID-19 on attitudes in greater depth. The literature on COVID-19 and vaccine hesitancy research does not broadly address long-COVID-19 [ 33 , 34 , 35 , 36 , 37 ]. However, studies on people who have experienced COVID-19 or who have been exposed to the experiences of people close to them revealed that there is a significant relationship between vaccine hesitancy and these experiences [ 67 , 68 , 69 ].…”

“…Long-COVID-19 is a definition used to describe the disease in people who have recovered from the COVID-19 disease but still report lasting effects of the infection or have usual symptoms for much longer than expected [ 32 ]. Lately, there are a growing number of studies on long-COVID, whose symptoms can occur in many different ways [ 33 , 34 , 35 , 36 , 37 ].…”

Long COVID: The latest manifestations, mechanisms, and potential therapeutic interventions

“… 123 The persistent existence of SARS‐CoV‐2 antigens such as the receptor binding domain (RBD) of Spike, RdRp, and nucleocapsid antigen (not infectious virus) enables a continuously activated and robust immune response, which contributes to the development of long COVID. 109 , 200 Recently, researches found alterations in genes express in olfactory epithelium and involve in the metabolism of odor molecules, indicating a new mechanism of long COVID smell dysfunction.…”

Impact of vaccination on postacute sequelae of SARS CoV-2 infection in patients with rheumatic diseases

“…affects anywhere from less than 10% to between 20% and 40% of people after acute infection; up to 50%-70% of patients because of COVID-19 may continue to have symptoms months following hospital discharge. [10][11][12][13][14][15] Patients with SARDs may be vulnerable to PASC due to altered immunity, immunosuppressive therapy, and increased risk for severe acute COVID-19.…”