Frequency and Variety of Persistent Symptoms Among Patients With COVID-19 A Systematic Review

Key Points
Question What are the frequency and variety of persistent symptoms after COVID-19 infection?


In this systematic review of 45 studies including 9751 participants with COVID-19, the median proportion of individuals who experienced at least 1 persistent symptom was 73%; symptoms occurring most frequently included shortness of breath or dyspnea, fatigue or exhaustion, and sleep disorders or insomnia. However, the studies were highly heterogeneous and needed longer follow-up and more standardised designs.


Health care professionals and patients have reported symptoms long after recovery from the acute phase of COVID-19 infection. COVID-19 has consequences for many organ systems. Recently published commentaries have reported the prevalence of long-term outcomes across a range of studies. 

Most studies of COVID-19 risks have focused on mortality, which is highest among older populations, and have omitted or minimized the disease burden associated with persistent or long-term morbidity among individuals of all ages. Reliable estimates of such morbidity are important for individual care, prognosis, and development of public health policy.

  1. Shortness of Breath or Dyspnea
  2. Fatigue or Exhaustion
  3. Cough, Atypical Chest Pain, and Fever
  4. Anosmia and Ageusia or Dysgeusia
  5. Depression and/or Anxiety
  6. Cognitive Functioning
  7. Composite Quality of Life

This systematic review found that persistent COVID-19 symptoms were common, with 72.5% of patients reporting at least 1 symptom at 60 days or more after diagnosis, symptom onset, or hospitalization or at 30 days or more after recovery from acute illness or hospital discharge.

This finding was consistent even among studies that followed up patients for almost 6 months, suggesting that symptoms may persist long after recovery among some patients.

Most patients reported thus far were previously hospitalized. This finding suggests that inclusion of the prolonged burden of morbidity is warranted for future research on the overall health implications of the pandemic.


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