Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021
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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. / Global Burden of Disease Long COVID Collaborators.
In: JAMA-J AM MED ASSOC, Vol. 328, No. 16, 25.10.2022, p. 1604-1615.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -