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

Author

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

Subjects
Adult, Male, Internationality, long covid, Adolescent, Pain, Global Health, Cov-2, proportion of polpulation, Young Adult, Post-Acute COVID-19 Syndrome, Humans, Child, Fatigue, Original Investigation, Aged, SARS-CoV-2, Mood Disorders, COVID-19, Bayes Theorem, Syndrome, General Medicine, Middle Aged, Child, Preschool, Female, Cognition Disorders, Respiratory Insufficiency
Abstract

ImportanceSome individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).ObjectiveTo 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 ParticipantsBayesian 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.ExposuresSymptomatic SARS-CoV-2 infection.Main Outcomes and MeasuresProportion 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.ResultsA 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 RelevanceThis 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.

Published
2022

11. Prognostic value of the systemic inflammation modified Glasgow prognostic score in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy: Results from a large multicenter international collaboration

Author

Soria, Francesco, Giordano, Andrea, D'Andrea, David, Moschini, Marco, Rouprêt, Morgan, Margulis, Vitaly, Karakiewicz, Pierre I., Briganti, Alberto, Bensalah, Karim, Mathieu, Romain, Chlosta, Piotr, Babjuk, Marek, Glybochko, Petr V., Enikeev, Dmitry V., Remzi, Mesut, Gust, Kilian, Gontero, Paolo, and Shariat, Shahrokh F.

Published
2020
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12. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021

Author

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

Abstract

Importance: While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID. Objective: To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery. Design: We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study. Results: Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8-312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38-7.

Published
2022
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13. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021

Author

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

Published
2022
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16. Efficacy of Preoperative Chemotherapy for High Risk Upper Tract Urothelial Carcinoma

Author

Foerster, Beat, primary, Abufaraj, Mohammad, additional, Petros, Firas, additional, Azizi, Mounsif, additional, Gupta, Mohit, additional, Schweitzer, Donald, additional, Margulis, Vitaly, additional, Iwata, Takehiro, additional, Kimura, Shoji, additional, Shabsigh, Ahmad, additional, Briganti, Alberto, additional, Ku, Ja H., additional, Muilwijk, Tim, additional, Kassouf, Wassim, additional, Matin, Surena F., additional, Spiess, Philippe E., additional, Pierorazio, Phillip M., additional, Hendricksen, Kees, additional, Shariat, Shahrokh F., additional, Clinton, Timothy, additional, Broutian, Tatevik, additional, Bandini, Marco, additional, Monteiro, Leonardo L., additional, Liao, Ross, additional, Moschini, Marco, additional, Bivalacqua, Trinity J., additional, Krabbe, Laura-Maria, additional, Nasu, Yasutomo, additional, Egawa, Shin, additional, Joniau, Steven, additional, John, Hubert, additional, van der Heijden, Michiel S., additional, Glybochko, Petr V., additional, Fajkovic, Harun, additional, Singla, Nirmish, additional, and Necchi, Andrea, additional

Published
2020
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17. The prognostic impact of tumour NSD2 expression in advanced prostate cancer

Author

Stangl-Kremser, Judith, primary, Lemberger, Ursula, additional, Hassler, Melanie R., additional, Garstka, Nathalie, additional, Grubmüller, Bernhard, additional, Haitel, Andrea, additional, Enikeev, Dmitry V., additional, Glybochko, Petr V., additional, Kramer, Gero, additional, Susani, Martin, additional, and Shariat, Shahrokh F., additional

Published
2020
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18. Assessment of body composition in the advanced stage of castration-resistant prostate cancer: special focus on sarcopenia

Author

Stangl-Kremser, Judith, primary, Suarez‐Ibarrola, Rodrigo, additional, Andrea, David D’, additional, Korn, Stephan M., additional, Pones, Mario, additional, Kramer, Gero, additional, Marhold, Maximilian, additional, Krainer, Michael, additional, Enikeev, Dmitry V., additional, Glybochko, Petr V., additional, Tamandl, Dietmar, additional, Shariat, Shahrokh F., additional, and Baltzer, Pascal, additional

Published
2019
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20. Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis

Author

Janisch, Florian, primary, Shariat, Shahrokh F., additional, Baltzer, Pascal, additional, Fajkovic, Harun, additional, Kimura, Shoji, additional, Iwata, Takehiro, additional, Korn, Philipp, additional, Yang, Lin, additional, Glybochko, Petr V., additional, Rink, Michael, additional, and Abufaraj, Mohammad, additional

Published
2019
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22. 3D reconstruction of CT scans aid in preoperative planning for sarcomatoid renal cancer: A case report and mini-review

Author

Glybochko, Petr V., primary, Alyaev, Yuriy G., additional, Khokhlachev, Sergey B., additional, Fiev, Dmitriy N., additional, Shpot, Evgeniy V., additional, Petrovsky, Nikolay V., additional, Zhang, Deying, additional, Proskura, Alexandra V., additional, Yurova, Maria, additional, Matz, Ethan Lester, additional, Wang, Xisheng, additional, Atala, Anthony, additional, Zhang, Yuanyuan, additional, and Butnaru, Denis V., additional

Published
2019
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24. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021.

Author

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, El Tantawi M, Fomin V, Frithiof R, Gamirova A, Glybochko PV, Haagsma JA, Javanmard SH, 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, Magistro B, Malta DC, Månsson J, Herrera AMM, Mokdad AH, Monasta L, Nomura S, Pasovic M, Pigott DM, Reiner RC Jr, Reinke G, Ribeiro ALP, Santomauro DF, Sholokhov A, Spurlock EE, Walcott R, Walker A, Wiysonge CS, Zheng P, Bettger JP, Murray CJ, and Vos T

Abstract

Importance: While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID., Objective: To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery., Design: We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study., Results: Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8-312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38-7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9-92.4), 60.4% (18.9-89.1), and 35.4% (9.4-75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84-4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10-9.78]). At twelve months, 15.1% (10.3-21.1) continued to experience long COVID symptoms., Conclusions and Relevance: The occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane., Key Points: Question: What are the extent and nature of the most common long COVID symptoms by country in 2020 and 2021? Findings: Globally, 144.7 million people experienced one or more of three symptom clusters (fatigue; cognitive problems; and ongoing respiratory problems) of long COVID three months after infection, in 2020 and 2021. Most cases arose from milder infections. At 12 months after infection, 15.1% of these cases had not yet recovered. Meaning: The substantial number of people with long COVID are in need of rehabilitative care and support to transition back into the workplace or education when symptoms start to wane.

Published
2022
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