Persistence of Post-COVID Symptoms in the General Population Two Years After SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

Abstract

Objective This meta-analysis investigated the prevalence of post-COVID symptoms two-years after SARS-CoV-2 infection.

Methods Electronic literature searches on PubMed, MEDLINE, CINAHL, EMBASE, Web of Science databases, and on medRxiv/bioRxiv preprint servers were conducted up to October 1, 2023. Studies reporting data on post-COVID symptoms at two-years after infection were included. Methodological quality was assessed using the Newcastle-Ottawa Scale. Random-effects models were used for meta-analytical pooled prevalence of each symptom.

Results From 742 studies identified, twelve met inclusion criteria. The sample included 7912 COVID-19 survivors (50.7% female; age: 59.5, SD: 16.3). Post-COVID symptoms were assessed at a follow-up of 722.9 (SD: 51.5) days after. The overall methodological quality of studies was moderate (mean: 6/10, SD: 1.2 points). The most prevalent post-COVID symptoms two-years after SARS-CoV-2 infection were fatigue (28.0%, 95%CI 12.0–47.0), cognitive impairments (27.6%, 95%CI 12.6–45.8), and pain (8.4%, 95%CI 4.9–12.8). Psychological disturbances such as anxiety (13.4%, 95%CI 6.3–22.5) and depressive (18.0%, 95%CI 4.8–36.7) levels as well as sleep problems (20.9%, 95%CI 5.25–43.25) were also prevalent. Pooled data showed high heterogeneity (I2 ≥ 75%).

Conclusion This meta-analysis shows the presence of post-COVID symptoms in 30% of patients two-years after COVID-19. Fatigue, cognitive disorders, and pain were the most prevalent post-COVID symptoms. Psychological disturbances as well as sleep problems were still present two-years after COVID-19.