Sequelae of COVID-19 among previously hospitalized patients up to 1 year after discharge: a systematic review and meta-analysis

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Abstract
Objective Although complications and clinical symptoms of COVID-19 have been elucidated, the prevalence of long-term sequelae of COVID-19 is less clear in previously hospitalized COVID-19 patients. This review and meta-analysis present the occurrence of different symptoms up to 1 year of follow-up for previously hospitalized patients. Methods We performed a systematic review from PubMed and Web of Science using keywords such as “COVID-19”, “SARS-CoV-2”, “sequelae”, “long-term effect” and included studies with at least 3-month of follow-up. Meta-analyses using random-effects models were performed to estimate the pooled prevalence for different sequelae. Subgroup analyses were conducted by different follow-up time, regions, age and ICU admission. Results 72 articles were included in the meta-analyses after screening 11,620 articles, identifying a total of 167 sequelae related to COVID-19 from 88,769 patients. Commonly reported sequelae included fatigue (27.5%, 95% CI 22.4–33.3%, range 1.5–84.9%), somnipathy (20.1%, 95% CI 14.7–26.9%, range 1.2–64.8%), anxiety (18.0%, 95% CI 13.8–23.1%, range 0.6–47.8%), dyspnea (15.5%, 95% CI 11.3–20.9%, range 0.8–58.4%), PTSD (14.6%, 95% CI 11.3–18.7%, range 1.2–32.0%), hypomnesia (13.4%, 95% CI 8.4–20.7%, range 0.6–53.8%), arthralgia (12.9%, 95% CI 8.4–19.2%, range 0.0–47.8%), depression (12.7%, 95% CI 9.3–17.2%, range 0.6–37.5%), alopecia (11.2%, 95% CI 6.9–17.6%, range 0.0–47.0%) over 3–13.2 months of follow-up. The prevalence of most symptoms reduced after > 9 months of follow-up, but fatigue and somnipathy persisted in 26.2% and 15.1%, respectively, of the patients over a year. COVID-19 patients from Asia reported a lower prevalence than those from other regions. Conclusions This review identified a wide spectrum of COVID-19 sequelae in previously hospitalized COVID-19 patients, with some symptoms persisting up to 1 year. Management and rehabilitation strategies targeting these symptoms may improve quality of life of recovered patients.

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