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

TY - JOUR

T1 - Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

AU - Global Burden of Disease Long COVID Collaborators

AU - Wulf Hanson, Sarah

AU - Abbafati, Cristiana

AU - Aerts, Joachim G

AU - Al-Aly, Ziyad

AU - Ashbaugh, Charlie

AU - Ballouz, Tala

AU - Blyuss, Oleg

AU - Bobkova, Polina

AU - Bonsel, Gouke

AU - Borzakova, Svetlana

AU - Buonsenso, Danilo

AU - Butnaru, Denis

AU - Carter, Austin

AU - Chu, Helen

AU - De Rose, Cristina

AU - Diab, Mohamed Mustafa

AU - Ekbom, Emil

AU - El Tantawi, Maha

AU - Fomin, Victor

AU - Frithiof, Robert

AU - Gamirova, Aysylu

AU - Glybochko, Petr V

AU - Haagsma, Juanita A

AU - Haghjooy Javanmard, Shaghayegh

AU - Hamilton, Erin B

AU - Harris, Gabrielle

AU - Heijenbrok-Kal, Majanka H

AU - Helbok, Raimund

AU - Hellemons, Merel E

AU - Hillus, David

AU - Huijts, Susanne M

AU - Hultström, Michael

AU - Jassat, Waasila

AU - Kurth, Florian

AU - Larsson, Ing-Marie

AU - Lipcsey, Miklós

AU - Liu, Chelsea

AU - Loflin, Callan D

AU - Malinovschi, Andrei

AU - Mao, Wenhui

AU - Mazankova, Lyudmila

AU - McCulloch, Denise

AU - Menges, Dominik

AU - Mohammadifard, Noushin

AU - Munblit, Daniel

AU - Nekliudov, Nikita A

AU - Ogbuoji, Osondu

AU - Osmanov, Ismail M

AU - Peñalvo, José L

AU - Petersen, Maria Skaalum

AU - Puhan, Milo A

AU - Rahman, Mujibur

AU - Rass, Verena

AU - Reinig, Nickolas

AU - Ribbers, Gerard M

AU - Ricchiuto, Antonia

AU - Rubertsson, Sten

AU - Samitova, Elmira

AU - Sarrafzadegan, Nizal

AU - Shikhaleva, Anastasia

AU - Simpson, Kyle E

AU - Sinatti, Dario

AU - Soriano, Joan B

AU - Spiridonova, Ekaterina

AU - Steinbeis, Fridolin

AU - Svistunov, Andrey A

AU - Valentini, Piero

AU - van de Water, Brittney J

AU - van den Berg-Emons, Rita

AU - Wallin, Ewa

AU - Witzenrath, Martin

AU - Wu, Yifan

AU - Xu, Hanzhang

AU - Zoller, Thomas

AU - Adolph, Christopher

AU - Albright, James

AU - Amlag, Joanne O

AU - Aravkin, Aleksandr Y

AU - Bang-Jensen, Bree L

AU - Bisignano, Catherine

AU - Castellano, Rachel

AU - Castro, Emma

AU - Chakrabarti, Suman

AU - Collins, James K

AU - Dai, Xiaochen

AU - Daoud, Farah

AU - Dapper, Carolyn

AU - Deen, Amanda

AU - Duncan, Bruce B

AU - Erickson, Megan

AU - Ewald, Samuel B

AU - Ferrari, Alize J

AU - Flaxman, Abraham D

AU - Fullman, Nancy

AU - Gamkrelidze, Amiran

AU - Giles, John R

AU - Guo, Gaorui

AU - Hay, Simon I

AU - He, Jiawei

AU - Helak, Monika

AU - Hulland, Erin N

AU - Kereselidze, Maia

AU - Krohn, Kris J

AU - Lazzar-Atwood, Alice

AU - Lindstrom, Akiaja

AU - Lozano, Rafael

AU - Malta, Deborah Carvalho

AU - Månsson, Johan

AU - Mantilla Herrera, Ana M

AU - Mokdad, Ali H

AU - Monasta, Lorenzo

AU - Nomura, Shuhei

AU - Pasovic, Maja

AU - Pigott, David M

AU - Reiner, Robert C

AU - Reinke, Grace

AU - Ribeiro, Antonio Luiz P

AU - Santomauro, Damian Francesco

AU - Sholokhov, Aleksei

AU - Spurlock, Emma Elizabeth

AU - Walcott, Rebecca

AU - Walker, Ally

AU - Wiysonge, Charles Shey

AU - Zheng, Peng

AU - Bettger, Janet Prvu

AU - Murray, Christopher J L

AU - Vos, Theo

PY - 2022/10/25

Y1 - 2022/10/25

N2 - 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 (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.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.

AB - 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 (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.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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Child

KW - Child, Preschool

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Young Adult

KW - Bayes Theorem

KW - COVID-19/complications

KW - Fatigue/epidemiology

KW - Pain/epidemiology

KW - SARS-CoV-2

KW - Syndrome

KW - Cognition Disorders/epidemiology

KW - Respiratory Insufficiency/epidemiology

KW - Internationality

KW - Global Health/statistics & numerical data

KW - Mood Disorders/epidemiology

KW - Post-Acute COVID-19 Syndrome

U2 - 10.1001/jama.2022.18931

DO - 10.1001/jama.2022.18931

M3 - SCORING: Journal article

C2 - 36215063

VL - 328

SP - 1604

EP - 1615

JO - JAMA-J AM MED ASSOC

JF - JAMA-J AM MED ASSOC

SN - 0098-7484

IS - 16

ER -