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

Theo Vos; Sarah Wulf Hanson; Cristiana Abbafati; Joachim G. Aerts; Ziyad Al-Aly; Charlie Ashbaugh; Tala Ballouz; Oleg Blyuss; Polina Bobkova; Gouke Bonsel; Svetlana Borzakova; Danilo Buonsenso; Denis Butnaru; Austin Carter; Helen Chu; Cristina De Rose; Mohamed Mustafa Diab; Emil Ekbom; Maha El Tantawi; Victor Fomin; Robert Frithiof; Aysylu Gamirova; Petr V. Glybochko; Juanita A. Haagsma; Shaghayegh Haghjooy Javanmard; Erin B. Hamilton; Gabrielle Harris; Majanka H. Heijenbrok-Kal; Raimund Helbok; Merel E. Hellemons; David Hillus; Susanne M. Huijts; Michael Hultström; Waasila Jassat; Florian Kurth; Ing Marie Larsson; Miklós Lipcsey; Chelsea Liu; Callan D. Loflin; Andrei Malinovschi; Wenhui Mao; Lyudmila Mazankova; Denise McCulloch; Dominik Menges; Noushin Mohammadifard; Daniel Munblit; Nikita A. Nekliudov; Osondu Ogbuoji; Ismail M. Osmanov; José L. Peñalvo; Maria Skaalum Petersen; Milo A. Puhan; Mujibur Rahman; Verena Rass; Nickolas Reinig; Gerard M. Ribbers; Antonia Ricchiuto; Sten Rubertsson; Elmira Samitova; Nizal Sarrafzadegan; Anastasia Shikhaleva; Kyle E. Simpson; Dario Sinatti; Joan B. Soriano; Ekaterina Spiridonova; Fridolin Steinbeis; Andrey A. Svistunov; Piero Valentini; Brittney J. Van De Water; Rita Van Den Berg-Emons; Ewa Wallin; Martin Witzenrath; Yifan Wu; Hanzhang Xu; Thomas Zoller; Christopher Adolph; James Albright; Joanne O. Amlag; Aleksandr Y. Aravkin; Bree L. Bang-Jensen; Catherine Bisignano; Rachel Castellano; Emma Castro; Suman Chakrabarti; James K. Collins; Xiaochen Dai; Farah Daoud; Carolyn Dapper; Amanda Deen; Bruce B. Duncan; Megan Erickson; Samuel B. Ewald; Alize J. Ferrari; Abraham D. Flaxman; Nancy Fullman; Amiran Gamkrelidze; John R. Giles; Gaorui Guo; Simon I. Hay; Jiawei He; Monika Helak; Erin N. Hulland; Maia Kereselidze; Kris J. Krohn; Alice Lazzar-Atwood; Akiaja Lindstrom; Rafael Lozano; Deborah Carvalho Malta; Johan Månsson; Ana M. Mantilla Herrera; Ali H. Mokdad; Lorenzo Monasta; Shuhei Nomura; Maja Pasovic; David M. Pigott; Robert C. Reiner; Grace Reinke; Antonio Luiz P. Ribeiro; Damian Francesco Santomauro; Aleksei Sholokhov; Emma Elizabeth Spurlock; Rebecca Walcott; Ally Walker; Charles Shey Wiysonge; Peng Zheng; Janet Prvu Bettger; Christopher J.L. Murray

doi:10.1001/jama.2022.18931

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

Theo Vos, Sarah Wulf Hanson, Cristiana Abbafati, Joachim G. Aerts, Ziyad Al-Aly, Charlie Ashbaugh, Tala Ballouz, Oleg Blyuss, Polina Bobkova, Gouke Bonsel, Svetlana Borzakova, Danilo Buonsenso, Denis Butnaru, Austin Carter, Helen Chu, Cristina De Rose, Mohamed Mustafa Diab, Emil Ekbom, Maha El Tantawi, Victor FominRobert Frithiof, Aysylu Gamirova, Petr V. Glybochko, Juanita A. Haagsma, Shaghayegh Haghjooy Javanmard, Erin B. Hamilton, Gabrielle Harris, Majanka H. Heijenbrok-Kal, Raimund Helbok, Merel E. Hellemons, David Hillus, Susanne M. Huijts, Michael Hultström, Waasila Jassat, Florian Kurth, Ing Marie Larsson, Miklós Lipcsey, Chelsea Liu, Callan D. Loflin, Andrei Malinovschi, Wenhui Mao, Lyudmila Mazankova, Denise McCulloch, Dominik Menges, Noushin Mohammadifard, Daniel Munblit, Nikita A. Nekliudov, Osondu Ogbuoji, Ismail M. Osmanov, José L. Peñalvo, Maria Skaalum Petersen, Milo A. Puhan, Mujibur Rahman, Verena Rass, Nickolas Reinig, Gerard M. Ribbers, Antonia Ricchiuto, Sten Rubertsson, Elmira Samitova, Nizal Sarrafzadegan, Anastasia Shikhaleva, Kyle E. Simpson, Dario Sinatti, Joan B. Soriano, Ekaterina Spiridonova, Fridolin Steinbeis, Andrey A. Svistunov, Piero Valentini, Brittney J. Van De Water, Rita Van Den Berg-Emons, Ewa Wallin, Martin Witzenrath, Yifan Wu, Hanzhang Xu, Thomas Zoller, Christopher Adolph, James Albright, Joanne O. Amlag, Aleksandr Y. Aravkin, Bree L. Bang-Jensen, Catherine Bisignano, Rachel Castellano, Emma Castro, Suman Chakrabarti, James K. Collins, Xiaochen Dai, Farah Daoud, Carolyn Dapper, Amanda Deen, Bruce B. Duncan, Megan Erickson, Samuel B. Ewald, Alize J. Ferrari, Abraham D. Flaxman, Nancy Fullman, Amiran Gamkrelidze, John R. Giles, Gaorui Guo, Simon I. Hay, Jiawei He, Monika Helak, Erin N. Hulland, Maia Kereselidze, Kris J. Krohn, Alice Lazzar-Atwood, Akiaja Lindstrom, Rafael Lozano, Deborah Carvalho Malta, Johan Månsson, Ana M. Mantilla Herrera, Ali H. Mokdad, Lorenzo Monasta, Shuhei Nomura, Maja Pasovic, David M. Pigott, Robert C. Reiner, Grace Reinke, Antonio Luiz P. Ribeiro, Damian Francesco Santomauro, Aleksei Sholokhov, Emma Elizabeth Spurlock, Rebecca Walcott, Ally Walker, Charles Shey Wiysonge, Peng Zheng, Janet Prvu Bettger, Christopher J.L. Murray

Research output: Contribution to journal › Article › peer-review

390 Scopus citations

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.

Original language	English
Pages (from-to)	1604-1615
Number of pages	12
Journal	JAMA
Volume	328
Issue number	16
DOIs	https://doi.org/10.1001/jama.2022.18931
State	Published - Oct 25 2022

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10.1001/jama.2022.18931

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Vos, T., Hanson, S. W., Abbafati, C., Aerts, J. G., Al-Aly, Z., Ashbaugh, C., Ballouz, T., Blyuss, O., Bobkova, P., Bonsel, G., Borzakova, S., Buonsenso, D., Butnaru, D., Carter, A., Chu, H., De Rose, C., Diab, M. M., Ekbom, E., Tantawi, M. E., ... Murray, C. J. L. (2022). Estimated Global Proportions of Individuals with Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021. JAMA, 328(16), 1604-1615. https://doi.org/10.1001/jama.2022.18931

@article{93ccb00a6bc24bb1b2f2f0d78366cc05,

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

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.",

author = "Theo Vos and Hanson, {Sarah Wulf} and Cristiana Abbafati and Aerts, {Joachim G.} and Ziyad Al-Aly and Charlie Ashbaugh and Tala Ballouz and Oleg Blyuss and Polina Bobkova and Gouke Bonsel and Svetlana Borzakova and Danilo Buonsenso and Denis Butnaru and Austin Carter and Helen Chu and {De Rose}, Cristina and Diab, {Mohamed Mustafa} and Emil Ekbom and Tantawi, {Maha El} and Victor Fomin and Robert Frithiof and Aysylu Gamirova and Glybochko, {Petr V.} and Haagsma, {Juanita A.} and {Haghjooy Javanmard}, Shaghayegh and Hamilton, {Erin B.} and Gabrielle Harris and Heijenbrok-Kal, {Majanka H.} and Raimund Helbok and Hellemons, {Merel E.} and David Hillus and Huijts, {Susanne M.} and Michael Hultstr{\"o}m and Waasila Jassat and Florian Kurth and Larsson, {Ing Marie} and Mikl{\'o}s Lipcsey and Chelsea Liu and Loflin, {Callan D.} and Andrei Malinovschi and Wenhui Mao and Lyudmila Mazankova and Denise McCulloch and Dominik Menges and Noushin Mohammadifard and Daniel Munblit and Nekliudov, {Nikita A.} and Osondu Ogbuoji and Osmanov, {Ismail M.} and Pe{\~n}alvo, {Jos{\'e} L.} and Petersen, {Maria Skaalum} and Puhan, {Milo A.} and Mujibur Rahman and Verena Rass and Nickolas Reinig and Ribbers, {Gerard M.} and Antonia Ricchiuto and Sten Rubertsson and Elmira Samitova and Nizal Sarrafzadegan and Anastasia Shikhaleva and Simpson, {Kyle E.} and Dario Sinatti and Soriano, {Joan B.} and Ekaterina Spiridonova and Fridolin Steinbeis and Svistunov, {Andrey A.} and Piero Valentini and {Van De Water}, {Brittney J.} and {Van Den Berg-Emons}, Rita and Ewa Wallin and Martin Witzenrath and Yifan Wu and Hanzhang Xu and Thomas Zoller and Christopher Adolph and James Albright and Amlag, {Joanne O.} and Aravkin, {Aleksandr Y.} and Bang-Jensen, {Bree L.} and Catherine Bisignano and Rachel Castellano and Emma Castro and Suman Chakrabarti and Collins, {James K.} and Xiaochen Dai and Farah Daoud and Carolyn Dapper and Amanda Deen and Duncan, {Bruce B.} and Megan Erickson and Ewald, {Samuel B.} and Ferrari, {Alize J.} and Flaxman, {Abraham D.} and Nancy Fullman and Amiran Gamkrelidze and Giles, {John R.} and Gaorui Guo and Hay, {Simon I.} and Jiawei He and Monika Helak and Hulland, {Erin N.} and Maia Kereselidze and Krohn, {Kris J.} and Alice Lazzar-Atwood and Akiaja Lindstrom and Rafael Lozano and Malta, {Deborah Carvalho} and Johan M{\aa}nsson and {Mantilla Herrera}, {Ana M.} and Mokdad, {Ali H.} and Lorenzo Monasta and Shuhei Nomura and Maja Pasovic and Pigott, {David M.} and Reiner, {Robert C.} and Grace Reinke and Ribeiro, {Antonio Luiz P.} and Santomauro, {Damian Francesco} and Aleksei Sholokhov and Spurlock, {Emma Elizabeth} and Rebecca Walcott and Ally Walker and Wiysonge, {Charles Shey} and Peng Zheng and Bettger, {Janet Prvu} and Murray, {Christopher J.L.}",

year = "2022",

month = oct,

day = "25",

doi = "10.1001/jama.2022.18931",

language = "English",

volume = "328",

pages = "1604--1615",

journal = "JAMA",

issn = "0098-7484",

number = "16",

}

Vos, T, Hanson, SW, Abbafati, C, Aerts, JG, Al-Aly, Z, Ashbaugh, C, Ballouz, T, Blyuss, O, Bobkova, P, Bonsel, G, Borzakova, S, Buonsenso, D, Butnaru, D, Carter, A, Chu, H, De Rose, C, Diab, MM, Ekbom, E, Tantawi, ME, Fomin, V, Frithiof, R, Gamirova, A, Glybochko, PV, Haagsma, JA, Haghjooy Javanmard, S, Hamilton, EB, Harris, G, Heijenbrok-Kal, MH, Helbok, R, Hellemons, ME, Hillus, D, Huijts, SM, Hultström, M, Jassat, W, Kurth, F, Larsson, IM, Lipcsey, M, Liu, C, Loflin, CD, Malinovschi, A, Mao, W, Mazankova, L, McCulloch, D, Menges, D, Mohammadifard, N, Munblit, D, Nekliudov, NA, Ogbuoji, O, Osmanov, IM, Peñalvo, JL, Petersen, MS, Puhan, MA, Rahman, M, Rass, V, Reinig, N, Ribbers, GM, Ricchiuto, A, Rubertsson, S, Samitova, E, Sarrafzadegan, N, Shikhaleva, A, Simpson, KE, Sinatti, D, Soriano, JB, Spiridonova, E, Steinbeis, F, Svistunov, AA, Valentini, P, Van De Water, BJ, Van Den Berg-Emons, R, Wallin, E, Witzenrath, M, Wu, Y, Xu, H, Zoller, T, Adolph, C, Albright, J, Amlag, JO, Aravkin, AY, Bang-Jensen, BL, Bisignano, C, Castellano, R, Castro, E, Chakrabarti, S, Collins, JK, Dai, X, Daoud, F, Dapper, C, Deen, A, Duncan, BB, Erickson, M, Ewald, SB, Ferrari, AJ, Flaxman, AD, Fullman, N, Gamkrelidze, A, Giles, JR, Guo, G, Hay, SI, He, J, Helak, M, Hulland, EN, Kereselidze, M, Krohn, KJ, Lazzar-Atwood, A, Lindstrom, A, Lozano, R, Malta, DC, Månsson, J, Mantilla Herrera, AM, Mokdad, AH, Monasta, L, Nomura, S, Pasovic, M, Pigott, DM, Reiner, RC, Reinke, G, Ribeiro, ALP, Santomauro, DF, Sholokhov, A, Spurlock, EE, Walcott, R, Walker, A, Wiysonge, CS, Zheng, P, Bettger, JP & Murray, CJL 2022, 'Estimated Global Proportions of Individuals with Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021', JAMA, vol. 328, no. 16, pp. 1604-1615. https://doi.org/10.1001/jama.2022.18931

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 - Vos, Theo

AU - Hanson, Sarah Wulf

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 - Tantawi, Maha El

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.

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 (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.

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 (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.

UR - http://www.scopus.com/inward/record.url?scp=85140623380&partnerID=8YFLogxK

U2 - 10.1001/jama.2022.18931

DO - 10.1001/jama.2022.18931

M3 - Article

C2 - 36215063

AN - SCOPUS:85140623380

SN - 0098-7484

VL - 328

SP - 1604

EP - 1615

JO - JAMA

JF - JAMA

IS - 16

ER -

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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