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



Vos T1, 63 ; Hanson SW1 ; Abbafati C2 ; Aerts JG3 ; Alaly Z4, 5 ; Ashbaugh C1 ; Ballouz T6 ; Blyuss O7, 8 ; Bobkova P9 ; Bonsel G10 ; Borzakova S11, 12 ; Buonsenso D13, 14 ; Butnaru D15 ; Carter A1 Show All Authors
Authors
  1. Vos T1, 63
  2. Hanson SW1
  3. Abbafati C2
  4. Aerts JG3
  5. Alaly Z4, 5
  6. Ashbaugh C1
  7. Ballouz T6
  8. Blyuss O7, 8
  9. Bobkova P9
  10. Bonsel G10
  11. Borzakova S11, 12
  12. Buonsenso D13, 14
  13. Butnaru D15
  14. Carter A1
  15. Chu H16
  16. De Rose C13
  17. Diab MM17, 18
  18. Ekbom E19
  19. Tantawi ME20
  20. Fomin V21
  21. Frithiof R22
  22. Gamirova A23
  23. Glybochko PV24
  24. Haagsma JA25
  25. Haghjooy Javanmard S26
  26. Hamilton EB1
  27. Harris G27
  28. Heijenbrokkal MH28, 29
  29. Helbok R30
  30. Hellemons ME3
  31. Hillus D31
  32. Huijts SM32
  33. Hultstrom M22, 33
  34. Jassat W34
  35. Kurth F35, 36
  36. Larsson IM22
  37. Lipcsey M22
  38. Liu C37
  39. Loflin CD27
  40. Malinovschi A38
  41. Mao W17, 39
  42. Mazankova L40
  43. Mcculloch D16
  44. Menges D6
  45. Mohammadifard N42
  46. Munblit D8, 43
  47. Nekliudov NA23
  48. Ogbuoji O39
  49. Osmanov IM11, 44
  50. Penalvo JL45, 46
  51. Petersen MS47, 48
  52. Puhan MA6, 49
  53. Rahman M50
  54. Rass V30
  55. Reinig N1
  56. Ribbers GM28
  57. Ricchiuto A51
  58. Rubertsson S22, 52
  59. Samitova E40, 44
  60. Sarrafzadegan N42, 53
  61. Shikhaleva A9
  62. Simpson KE1
  63. Sinatti D13
  64. Soriano JB54, 55
  65. Spiridonova E23
  66. Steinbeis F31
  67. Svistunov AA24
  68. Valentini P13
  69. Van De Water BJ56, 57
  70. Van Den Bergemons R28
  71. Wallin E22
  72. Witzenrath M35, 58
  73. Wu Y1
  74. Xu H59
  75. Zoller T31
  76. Adolph C60, 61
  77. Albright J1
  78. Amlag JO1
  79. Aravkin AY1, 62, 63
  80. Bangjensen BL1
  81. Bisignano C1
  82. Castellano R1
  83. Castro E1
  84. Chakrabarti S1, 64
  85. Collins JK1
  86. Dai X1, 63
  87. Daoud F1
  88. Dapper C1
  89. Deen A1
  90. Duncan BB65
  91. Erickson M1
  92. Ewald SB1
  93. Ferrari AJ1, 66
  94. Flaxman AD1, 63
  95. Fullman N1
  96. Gamkrelidze A67
  97. Giles JR1
  98. Guo G1
  99. Hay SI1, 63
  100. He J1
  101. Helak M1
  102. Hulland EN1, 64
  103. Kereselidze M67
  104. Krohn KJ1
  105. Lazzaratwood A1
  106. Lindstrom A66, 68
  107. Lozano R1, 63
  108. Malta DC69
  109. Mansson J1
  110. Mantilla Herrera AM66, 70
  111. Mokdad AH1, 63
  112. Monasta L71
  113. Nomura S72, 73
  114. Pasovic M1
  115. Pigott DM1, 63
  116. Reinke G1
  117. Ribeiro ALP74, 75
  118. Santomauro DF1, 66, 76
  119. Sholokhov A1
  120. Spurlock EE1, 77
  121. Walcott R78
  122. Walker A1
  123. Wiysonge CS79, 80
  124. Zheng P1, 63
  125. Bettger JP41
  126. Murray CJL1, 63
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, United States
  2. 2. Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy
  3. 3. Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
  4. 4. John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, MO, United States
  5. 5. Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, MO, United States
  6. 6. Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland
  7. 7. Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
  8. 8. Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  9. 9. Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  10. 10. EuroQol Research Foundation, Rotterdam, Netherlands
  11. 11. Pirogov Russian National Research Medical University, Moscow, Russian Federation
  12. 12. Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department, Moscow, Russian Federation
  13. 13. Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
  14. 14. Global Health Research Institute, Catholic University of Sacred Heart, Rome, Italy
  15. 15. I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  16. 16. Department of Medicine, University of Washington, Seattle, United States
  17. 17. Center for Policy Impact in Global Health, Duke University, Durham, NC, United States
  18. 18. Department of Surgery, Duke University, Durham, NC, United States
  19. 19. Uppsala University Hospital, Uppsala, Sweden
  20. 20. Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
  21. 21. Rector's Office, I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  22. 22. Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
  23. 23. Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  24. 24. Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
  25. 25. Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
  26. 26. Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  27. 27. School of Nursing, Duke University, Durham, NC, United States
  28. 28. Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
  29. 29. Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, Netherlands
  30. 30. Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
  31. 31. Department of Infectious Diseases and Respiratory Medicine, Charite Medical University Berlin, Berlin, Germany
  32. 32. Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
  33. 33. Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
  34. 34. Department of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa
  35. 35. Department of Infectious Diseases and Respiratory Medicine, Charite University Medical Center Berlin, Berlin, Germany
  36. 36. Department of Clinical Research and Tropical Medicine, Bernhard-Nocht Institute of Tropical Medicine, Hamburg, Germany
  37. 37. Department of Epidemiology, Harvard University, Boston, MA, United States
  38. 38. Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  39. 39. Duke Global Health Institute, Duke University, Durham, NC, United States
  40. 40. Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
  41. 41. Department of Orthopedic Surgery, Duke University, Durham, NC, United States
  42. 42. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  43. 43. National Heart and Lung Institute, Imperial College London, London, United Kingdom
  44. 44. ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russian Federation
  45. 45. Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
  46. 46. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
  47. 47. Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
  48. 48. Centre of Health Science, University of Faroe Islands, Torshavn, Faroe Islands
  49. 49. Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
  50. 50. Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  51. 51. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  52. 52. Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
  53. 53. School of Population and Public Health, University of British Columbia, Vancouver, Canada
  54. 54. Hospital Universitario de la Princesa, Madrid, Spain
  55. 55. Centro de Investigacion Biomedica en Red Enfermedades Respiratorias, Madrid, Spain
  56. 56. Department of Global Health and Social Medicine, Harvard University, Boston, MA, United States
  57. 57. Nursing and Midwifery Department, Seed Global Health, Boston, MA, United States
  58. 58. German Center for Lung Research, Berlin, United States
  59. 59. Department of Family Medicine and Community Health, Duke University, Durham, NC, United States
  60. 60. Department of Political Science, University of Washington, Seattle, United States
  61. 61. Center for Statistics and the Social Sciences, University of Washington, Seattle, United States
  62. 62. Department of Applied Mathematics, University of Washington, Seattle, United States
  63. 63. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, United States
  64. 64. Department of Global Health, University of Washington, Seattle, United States
  65. 65. Postgraduate Program in Epidemiology, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
  66. 66. School of Public Health, University of Queensland, Brisbane, Australia
  67. 67. National Center for Disease Control and Public Health, Tbilisi, Georgia
  68. 68. School of Public Health, Queensland Centre for Mental Health Research, Wacol, Australia
  69. 69. Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
  70. 70. West Moreton Hospital Health Services, Queensland Centre for Mental Health Research, Wacol, Australia
  71. 71. Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
  72. 72. Department of Health Policy and Management, Keio University, Tokyo, Japan
  73. 73. Department of Global Health Policy, University of Tokyo, Tokyo, Japan
  74. 74. Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
  75. 75. Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil
  76. 76. Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia
  77. 77. Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, United States
  78. 78. Evans School of Public Policy and Governance, University of Washington, Seattle, United States
  79. 79. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
  80. 80. HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa

Source: JAMA Published:2022


Abstract

Importance: Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID). Objective: To 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 Participants: Bayesian 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 (10501 hospitalized individuals and 42891 nonhospitalized individuals), the 10 collaborating cohort studies (10526 and 1906), and the 2 US electronic medical record databases (250928 and 846046). Data collection spanned March 2020 to January 2022. Exposures: Symptomatic SARS-CoV-2 infection. Main Outcomes and Measures: Proportion 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. Results: A 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 Relevance: This 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. © 2022 American Medical Association. All rights reserved.
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