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; Global Burden of Disease Long COVID Collaborators; 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; Gerard M. Ribbers; Rita Van Den Berg-Emons

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, Global Burden of Disease Long COVID Collaborators, 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 TantawiVictor 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, Gerard M. Ribbers, Rita Van Den Berg-Emons

^*Corresponding author for this work

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

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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
Publication status	Published - 10 Oct 2022

Bibliographical note

Funding/Support: Erasmus University Medical
Center received funding from the ZonMW COVID-19
Programme, Laurens (the Netherlands), and
Rijndam Rehabilitation. The Institute for Health
Metrics and Evaluation at the University of
Washington received funding from the Bill &
Melinda Gates Foundation and Bloomberg
Philanthropies. Uppsala University received funding
from the Knut and Alice Wallenburg Foundation,
the Swedish Heart-Lung Foundation, the Swedish
Kidney Foundation, the Swedish Society of
Medicine, and the Swedish Research Council. The
Queensland Centre for Mental Health Research
received funding from the Queensland Department
of Health. The Iran National Science Foundation,
the National Institute of Health Researchers of Iran,
and the World Health Organization provided
funding for Drs Haghjooy Javanmard,
Mohammadifard, and Sarrafzadegan. Cooperation’s
p/f Krunborg and Borgartun, the Velux Foundation,
the Faroese Research Council, the Faroese
Parkinson’s Association, and the Faroese Health
Insurance Fund provided funding for Dr Petersen.
The National Institute on Aging and the National
Institute on Minority Health and Health Disparities
provided funding for Dr Xu. The Benificus
Foundation provided funding for Dr Adolph. The
National Science Foundation provided funding for
Drs Aravkin and Reiner. The Ministry of Health
(Rome, Italy) and the Institute for Maternal and
Child Health IRCCS Burlo Garofolo (Trieste, Italy)
provided funding for Dr Monasta. The Ministry of
Education, Culture, Sports, Science, and
Technology of Japan provided funding for
Dr Nomura. The South African Medical Research
Council provided funding for Dr Wiysonge.

Publisher Copyright:
© 2022 American Medical Association. All rights reserved.

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10.1001/jama.2022.18931

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Vos, T., Hanson, S. W., Global Burden of Disease Long COVID Collaborators, 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., ... Van Den Berg-Emons, R. (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{44a9c5fa7d064383896f54f2b0aaf6cf,

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 {Global Burden of Disease Long COVID Collaborators} 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 Ribbers, {Gerard M.} and {Van Den Berg-Emons}, Rita",

note = "Funding/Support: Erasmus University Medical Center received funding from the ZonMW COVID-19 Programme, Laurens (the Netherlands), and Rijndam Rehabilitation. The Institute for Health Metrics and Evaluation at the University of Washington received funding from the Bill & Melinda Gates Foundation and Bloomberg Philanthropies. Uppsala University received funding from the Knut and Alice Wallenburg Foundation, the Swedish Heart-Lung Foundation, the Swedish Kidney Foundation, the Swedish Society of Medicine, and the Swedish Research Council. The Queensland Centre for Mental Health Research received funding from the Queensland Department of Health. The Iran National Science Foundation, the National Institute of Health Researchers of Iran, and the World Health Organization provided funding for Drs Haghjooy Javanmard, Mohammadifard, and Sarrafzadegan. Cooperation{\textquoteright}s p/f Krunborg and Borgartun, the Velux Foundation, the Faroese Research Council, the Faroese Parkinson{\textquoteright}s Association, and the Faroese Health Insurance Fund provided funding for Dr Petersen. The National Institute on Aging and the National Institute on Minority Health and Health Disparities provided funding for Dr Xu. The Benificus Foundation provided funding for Dr Adolph. The National Science Foundation provided funding for Drs Aravkin and Reiner. The Ministry of Health (Rome, Italy) and the Institute for Maternal and Child Health IRCCS Burlo Garofolo (Trieste, Italy) provided funding for Dr Monasta. The Ministry of Education, Culture, Sports, Science, and Technology of Japan provided funding for Dr Nomura. The South African Medical Research Council provided funding for Dr Wiysonge. Publisher Copyright: {\textcopyright} 2022 American Medical Association. All rights reserved.",

year = "2022",

month = oct,

day = "10",

doi = "10.1001/jama.2022.18931",

language = "English",

volume = "328",

pages = "1604--1615",

journal = "JAMA",

issn = "0098-7484",

publisher = "American Medical Association",

number = "16",

}

Vos, T, Hanson, SW, Global Burden of Disease Long COVID Collaborators, 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, Ribbers, GM & Van Den Berg-Emons, R 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

Estimated Global Proportions of Individuals with Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021. / Vos, Theo; Hanson, Sarah Wulf; Global Burden of Disease Long COVID Collaborators et al.
In: JAMA, Vol. 328, No. 16, 10.10.2022, p. 1604-1615.

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

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 - Global Burden of Disease Long COVID Collaborators

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 - Ribbers, Gerard M.

AU - Van Den Berg-Emons, Rita

N1 - Funding/Support: Erasmus University Medical Center received funding from the ZonMW COVID-19 Programme, Laurens (the Netherlands), and Rijndam Rehabilitation. The Institute for Health Metrics and Evaluation at the University of Washington received funding from the Bill & Melinda Gates Foundation and Bloomberg Philanthropies. Uppsala University received funding from the Knut and Alice Wallenburg Foundation, the Swedish Heart-Lung Foundation, the Swedish Kidney Foundation, the Swedish Society of Medicine, and the Swedish Research Council. The Queensland Centre for Mental Health Research received funding from the Queensland Department of Health. The Iran National Science Foundation, the National Institute of Health Researchers of Iran, and the World Health Organization provided funding for Drs Haghjooy Javanmard, Mohammadifard, and Sarrafzadegan. Cooperation’s p/f Krunborg and Borgartun, the Velux Foundation, the Faroese Research Council, the Faroese Parkinson’s Association, and the Faroese Health Insurance Fund provided funding for Dr Petersen. The National Institute on Aging and the National Institute on Minority Health and Health Disparities provided funding for Dr Xu. The Benificus Foundation provided funding for Dr Adolph. The National Science Foundation provided funding for Drs Aravkin and Reiner. The Ministry of Health (Rome, Italy) and the Institute for Maternal and Child Health IRCCS Burlo Garofolo (Trieste, Italy) provided funding for Dr Monasta. The Ministry of Education, Culture, Sports, Science, and Technology of Japan provided funding for Dr Nomura. The South African Medical Research Council provided funding for Dr Wiysonge. Publisher Copyright: © 2022 American Medical Association. All rights reserved.

PY - 2022/10/10

Y1 - 2022/10/10

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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