학술논문

Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021.
Document Type
Academic Journal
Author
Wulf Hanson S; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Abbafati C; Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy.; Aerts JG; Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Al-Aly Z; John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri.; Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, Missouri.; Ashbaugh C; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Ballouz T; Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland.; Blyuss O; Wolfson Institute of Population Health, Queen Mary University of London, London, England.; Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Bobkova P; Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Bonsel G; EuroQol Research Foundation, Rotterdam, the Netherlands.; Borzakova S; Pirogov Russian National Research Medical University, Moscow.; Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department, Moscow, Russia.; Buonsenso D; Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy.; Global Health Research Institute, Catholic University of Sacred Heart, Rome, Italy.; Butnaru D; I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Carter A; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Chu H; Department of Medicine, University of Washington, Seattle.; De Rose C; Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy.; Diab MM; Center for Policy Impact in Global Health, Duke University, Durham, North Carolina.; Department of Surgery, Duke University, Durham, North Carolina.; Ekbom E; Uppsala University Hospital, Uppsala, Sweden.; El Tantawi M; Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt.; Fomin V; Rector's Office, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Frithiof R; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Gamirova A; Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Glybochko PV; Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Haagsma JA; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.; Haghjooy Javanmard S; Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.; Hamilton EB; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Harris G; School of Nursing, Duke University, Durham, North Carolina.; Heijenbrok-Kal MH; Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, the Netherlands.; Helbok R; Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.; Hellemons ME; Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Hillus D; Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany.; Huijts SM; Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Hultström M; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.; Jassat W; Department of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa.; Kurth F; Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany.; Department of Clinical Research and Tropical Medicine, Bernhard-Nocht Institute of Tropical Medicine, Hamburg, Germany.; Larsson IM; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Lipcsey M; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Liu C; Department of Epidemiology, Harvard University, Boston, Massachusetts.; Loflin CD; School of Nursing, Duke University, Durham, North Carolina.; Malinovschi A; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.; Mao W; Center for Policy Impact in Global Health, Duke University, Durham, North Carolina.; Duke Global Health Institute, Duke University, Durham, North Carolina.; Mazankova L; Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow.; McCulloch D; Department of Medicine, University of Washington, Seattle.; Menges D; Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland.; Mohammadifard N; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.; Munblit D; Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; National Heart and Lung Institute, Imperial College London, London, England.; Nekliudov NA; Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Ogbuoji O; Duke Global Health Institute, Duke University, Durham, North Carolina.; Osmanov IM; Pirogov Russian National Research Medical University, Moscow.; ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia.; Peñalvo JL; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.; Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.; Petersen MS; Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands.; Centre of Health Science, University of Faroe Islands, Torshavn.; Puhan MA; Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland.; Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.; Rahman M; Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.; Rass V; Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.; Reinig N; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Ribbers GM; Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Ricchiuto A; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Rubertsson S; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden.; Samitova E; Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow.; ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia.; Sarrafzadegan N; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.; School of Population and Public Health, University of British Columbia, Vancouver, Canada.; Shikhaleva A; Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Simpson KE; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Sinatti D; Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy.; Soriano JB; Hospital Universitario de La Princesa, Madrid, Spain.; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (Center for Biomedical Research in Respiratory Diseases Network), Madrid, Spain.; Spiridonova E; Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Steinbeis F; Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany.; Svistunov AA; Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.; Valentini P; Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy.; van de Water BJ; Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts.; Nursing and Midwifery Department, Seed Global Health, Boston, Massachusetts.; van den Berg-Emons R; Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.; Wallin E; Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden.; Witzenrath M; Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany.; German Center for Lung Research, Berlin.; Wu Y; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Xu H; Department of Family Medicine and Community Health, Duke University, Durham, North Carolina.; Zoller T; Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany.; Adolph C; Department of Political Science, University of Washington, Seattle.; Center for Statistics and the Social Sciences, University of Washington, Seattle.; Albright J; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Amlag JO; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Aravkin AY; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Applied Mathematics, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Bang-Jensen BL; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Bisignano C; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Castellano R; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Castro E; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Chakrabarti S; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Global Health, University of Washington, Seattle.; Collins JK; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Dai X; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Daoud F; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Dapper C; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Deen A; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Duncan BB; Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.; Erickson M; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Ewald SB; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Ferrari AJ; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; School of Public Health, University of Queensland, Brisbane, Australia.; Flaxman AD; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Fullman N; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Gamkrelidze A; National Center for Disease Control and Public Health, Tbilisi, Georgia.; Giles JR; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Guo G; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Hay SI; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; He J; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Helak M; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Hulland EN; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Global Health, University of Washington, Seattle.; Kereselidze M; National Center for Disease Control and Public Health, Tbilisi, Georgia.; Krohn KJ; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Lazzar-Atwood A; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Lindstrom A; School of Public Health, University of Queensland, Brisbane, Australia.; School of Public Health, Queensland Centre for Mental Health Research, Wacol, Australia.; Lozano R; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Malta DC; Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil.; Månsson J; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Mantilla Herrera AM; School of Public Health, University of Queensland, Brisbane, Australia.; West Moreton Hospital Health Services, Queensland Centre for Mental Health Research, Wacol, Australia.; Mokdad AH; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Monasta L; Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.; Nomura S; Department of Health Policy and Management, Keio University, Tokyo, Japan.; Department of Global Health Policy, University of Tokyo, Tokyo, Japan.; Pasovic M; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Pigott DM; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Reiner RC Jr; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Reinke G; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Ribeiro ALP; Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.; Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil.; Santomauro DF; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; School of Public Health, University of Queensland, Brisbane, Australia.; Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia.; Sholokhov A; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Spurlock EE; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut.; Walcott R; Evans School of Public Policy and Governance, University of Washington, Seattle.; Walker A; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Wiysonge CS; Cochrane South Africa, South African Medical Research Council, Cape Town.; HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban.; Zheng P; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Bettger JP; Department of Orthopedic Surgery, Duke University, Durham, North Carolina.; Murray CJL; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.; Vos T; Institute for Health Metrics and Evaluation, University of Washington, Seattle.; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle.
Source
Publisher: American Medical Association Country of Publication: United States NLM ID: 7501160 Publication Model: Print Cited Medium: Internet ISSN: 1538-3598 (Electronic) Linking ISSN: 00987484 NLM ISO Abbreviation: JAMA Subsets: MEDLINE
Subject
Language
English
Abstract
Importance: Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).
Objective: To 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 Participants: Bayesian 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.
Exposures: Symptomatic SARS-CoV-2 infection.
Main Outcomes and Measures: Proportion 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.
Results: A 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 Relevance: This 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.