Sequelae of COVID-19 among previously hospitalized patients up to 1 year after discharge: a systematic review and meta-analysis

Abstract

Objective Although complications and clinical symptoms of COVID-19 have been elucidated, the prevalence of long-term sequelae of COVID-19 is less clear in previously hospitalized COVID-19 patients. This review and meta-analysis present the occurrence of different symptoms up to 1 year of follow-up for previously hospitalized patients. Methods We performed a systematic review from PubMed and Web of Science using keywords such as “COVID-19”, “SARS-CoV-2”, “sequelae”, “long-term effect” and included studies with at least 3-month of follow-up. Meta-analyses using random-effects models were performed to estimate the pooled prevalence for different sequelae. Subgroup analyses were conducted by different follow-up time, regions, age and ICU admission. Results 72 articles were included in the meta-analyses after screening 11,620 articles, identifying a total of 167 sequelae related to COVID-19 from 88,769 patients. Commonly reported sequelae included fatigue (27.5%, 95% CI 22.4–33.3%, range 1.5–84.9%), somnipathy (20.1%, 95% CI 14.7–26.9%, range 1.2–64.8%), anxiety (18.0%, 95% CI 13.8–23.1%, range 0.6–47.8%), dyspnea (15.5%, 95% CI 11.3–20.9%, range 0.8–58.4%), PTSD (14.6%, 95% CI 11.3–18.7%, range 1.2–32.0%), hypomnesia (13.4%, 95% CI 8.4–20.7%, range 0.6–53.8%), arthralgia (12.9%, 95% CI 8.4–19.2%, range 0.0–47.8%), depression (12.7%, 95% CI 9.3–17.2%, range 0.6–37.5%), alopecia (11.2%, 95% CI 6.9–17.6%, range 0.0–47.0%) over 3–13.2 months of follow-up. The prevalence of most symptoms reduced after > 9 months of follow-up, but fatigue and somnipathy persisted in 26.2% and 15.1%, respectively, of the patients over a year. COVID-19 patients from Asia reported a lower prevalence than those from other regions. Conclusions This review identified a wide spectrum of COVID-19 sequelae in previously hospitalized COVID-19 patients, with some symptoms persisting up to 1 year. Management and rehabilitation strategies targeting these symptoms may improve quality of life of recovered patients. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-022-01862-3.

Singing Voice Symptomatology Following Presumed SARS-CoV-2 Infection

“…Pulmonary changes are expected with a SARS-CoV-2 virus by definition 19 , however a high percentage of non-pulmonary related sequelae were also relevant concerns for the surveyed singers. This is consistent with the literature and suggests non-dyspnea or dysphonic sequelae are as common (if not more so) than pulmonary sequelae 20 , 21 .…”

Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition

“…The final step involves screening for sensitivity to other stimuli, including sensitivity to sound (phonophobia), light (photophobia), or odors, and the presence of other comorbid symptoms, including poor sleep quality, fatigue, and cognitive problems [ 19 ]. As previously documented, all these symptoms are frequently present in individuals with long COVID [ 4 , 5 , 6 , 7 , 8 , 9 ] and those without post-COVID pain. The CSI can be useful for assessing comorbid symptoms [ 49 , 50 ].…”

“…Central sensitization, defined by the IASP as an increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input [ 46 ], is thought to be the main underlying mechanism of nociplastic pain [ 21 ]. Other central nervous system-derived symptoms related to neuro-immune alteration, such as fatigue, sleep problems, memory loss, concentration problems, or psychological disturbances, are also typical of nociplastic pain conditions [ 47 ] and are often present in individuals with long COVID [ 4 , 5 , 6 , 7 , 8 , 9 ].…”

“…More than 100 symptoms have been described, affecting multiple systems, e.g., cardiovascular, neurological, respiratory, and musculoskeletal [ 3 ]. In fact, several meta-analyses have observed that almost 50% of COVID-19 survivors exhibit a plethora of lingering symptoms lasting for weeks or months [ 4 , 5 , 6 ] and up to one year after infection [ 7 , 8 , 9 ]. A recent systematic review investigating multiple post-COVID symptoms identified that 20% of COVID-19 survivors reported post-COVID pain at different follow-up periods during the first year after infection [ 10 ].…”

Need for inpatient rehabilitation and skilled nursing services in COVID-19 patients post hospitalization: a retrospective cohort study

“…Another recent meta-analysis reported a wide spectrum of COVID-19 sequelae in previously hospitalized COVID-19 patients with symptoms like fatigue and sleeping disorders persisting up to a year (38). COVID-19 patients should have long-term access to multidisciplinary health care, including rehabilitation services post discharge (39).…”