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Travel Med Infect Dis . COVID-19 Sequelae in adults aged less than 50 years: A Systematic Review

tetano

Editor, Senior Moderator
Travel Med Infect Dis


. 2021 Feb 22;101995.
doi: 10.1016/j.tmaid.2021.101995. Online ahead of print.
COVID-19 Sequelae in adults aged less than 50 years: A Systematic Review


Sandra Willi[SUP] 1 [/SUP], Renata L?thold[SUP] 2 [/SUP], Adam Hunt[SUP] 2 [/SUP], Nadescha Viviane H?nggi[SUP] 2 [/SUP], Donik? Sejdiu[SUP] 2 [/SUP], Camila Scaff[SUP] 2 [/SUP], Nicole Bender[SUP] 2 [/SUP], Kaspar Staub[SUP] 3 [/SUP], Patricia Schlagenhauf[SUP] 4 [/SUP]



Affiliations

Abstract

Background: There is emerging evidence of long-term sequelae in a considerable proportion of COVID-19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed. This review aims to evaluate the available evidence of all intermediate and long-term COVID-19 sequelae affecting formerly healthy adults.
Methods: A systematic literature search of Embase, WHO, Scopus, Pubmed, Litcovid, bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO (CRD42020208725). Search terms included "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "sequelae" and "consequence*". Publications on adult participants, with a confirmed SARS-CoV-2 infection were included. Elderly (>50 years old) and children (<18 years old) were excluded. Bias assessment was performed using a modified Newcastle-Ottawa Scale.
Results: A total of 31 papers were included. Study types included prospective and retrospective cohort studies, cross-sectional studies and case reports. Sequelae persistence since infection spanned 14 days to three months. Sequelae included persistent fatigue (39-73% of assessed persons), breathlessness (39-74%), decrease in quality of life (44-69%), impaired pulmonary function, abnormal CT findings including pulmonary fibrosis (39-83%), evidence of peri-/perimyo-/myocarditis (3-26%), changes in microstructural and functional brain integrity with persistent neurological symptoms (55%), increased incidence of psychiatric diagnoses (5.8% versus 2.5-3.4% in controls), incomplete recovery of olfactory and gustatory dysfunction (33-36% of evaluated persons).
Conclusions: A variety of organ systems are affected by COVID-19 in the intermediate and longer-term after recovery. Main sequelae include post-infectious fatigue, persistent reduced lung function and carditis. Careful follow-up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality.

Keywords: COVID-19; SARS-CoV-2; consequences; coronavirus; long-term; sequelae.
 
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