(21) Long-Term Clinical and Health Outcomes Following COVID-19 Disease: An Umbrella Review

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1066

Presenting Author(s)

Hu Li, PhD
– Gilead Sciences, Foster City, California, United States

Co-Author(s)

Jin Xia
– Takeda Pharmaceuticals, United States
Dimitri Bennett
– Takeda Pharmaceuticals, United States
Fatima Roque
– Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), Guarda., Portugal
Rujuta Phadke
– Associate Director, Gilead, Foster City, CA, United States
Ana Bárbara Tavares
– Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI/IPG), Guarda., Fornos de Algodres, Guarda, Portugal
Mugdha Gokhale
– Merck & Co., Inc., West Point , Pennsylvania, United States
Fidelia Ida
– MCPHS University, King of Prussia, United States
Jinnie J. Rhee
– Stanford University School of Medicine, United States
Montse Soriano Gabarro, MD, MSc, FISPE, Bayer Distinguished Science Fellow
– Head Partnerships and Integrated Evidence Generation Office, Bayer AG, Berlin, Berlin, Germany

Background: The body of evidence about long-term clinical sequelae associated with COVID-19 disease continues to evolve but there is a lack of in-depth review of the timing, duration and severity of these conditions.

Objectives: To conduct an umbrella review of the existing systematic reviews and meta- analyses on long COVID-19.

Methods: Long-term COVID-19 was defined as any health conditions or symptoms associated with COVID-19 that last at least 60 days after the first diagnosis of COVID-19, initial symptom onset, or hospital admission, or at least 30 days after recovery from acute COVID-19 or hospital discharge. We searched MEDLINE, Embase and CDSR, published in English from January 2020 to December 2021, in accordance with the PRISMA guidance. We summarized the characteristics of all publications and categorized the clinical symptoms and outcomes into eight organ system domains. Descriptive statistics were collected, including frequency, prevalence or incidence rate, if available. Methodological quality of individual studies was critically appraised using AMSTAR II; the strength of the evidence was assessed using GRADE approach. The study protocol was registered with the PROSPERO register [CRD42022303557].

Results: We identified a total of 967 systematic reviews and meta-analyses, of which 453 were included for title and abstract screening. A total of 98 publications were retrieved for full-text review, among which 39 publications (22 systematic reviews and 17 meta-analyses) were retained for final data extraction. Top reasons for exclusion included not meeting the long COVID-19 definition or not being a systematic review and meta-analysis. Most publications did not report time at assessment, severity or duration of persistent conditions. The most-reported organ system domains were neurologic, respiratory, and others (conditions do not belong to any specific organ domains). The most frequently reported clinical outcomes were cough, headache, fatigue. The highest reported prevalence was sleeping disturbance (85%) followed by fatigue (73.1%), but not all publications reported such estimations. Data analyses including individual study quality and the evidence credibility assessments are currently ongoing.

Conclusions: Despite many published systematic reviews and meta-analyses of long COVID-19, only a few publications have reported full aspects of long COVID-19 in terms of timing, duration, and severity. Most publications identified and described long-term COVID-19 effects based on symptoms or condition while few studies adjusted for patients’ underlying conditions or assessed the attribution of these conditions to long-term COVID-19.