Prevalence and risk factors for long COVID in China: A systematic review and meta-analysis of observational studies

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2025-01-04 DOI:10.1016/j.jiph.2025.102652

Le-Yan Hu , An-Qi Cai , Bo Li , Ying-Qiu Sun , Zheng Li , Jian-Ping Liu , Hui-Juan Cao

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Abstract

Background

With the outbreak of COVID-19 in China, a large number of COVID-19 patients are at risk of long COVID after recovery. The purpose of our research is to systematically review the existing clinical studies to understand the current prevalence and related risk factors of long COVID in COVID-19 patients in China.

Methods

The protocol of this systematic review was registered on PROSPERO (CRD42024519375). We searched six electronic databases from 1st January 2020–1st March 2024. Literature screening, data extraction, and risk bias assessment were independently carried out by two reviewers. Quality of the included studies was evaluated by AHRQ and NOS. The meta-analysis was performed by R software 4.2.3 to derive the prevalence of long COVID and risk factors.

Results

Overall, 50 studies with 65880 participants were included. The results showed that the prevalence of long COVID (with at least one symptom) among the COVID-19 patients was approximately 50 % (95 %Confidence Interval (CI) 42–58 %) in China. Although we conducted meta-regression and subgroup analysis, the heterogeneity of the study was high. But the Omicron BA.2 variant had a statistically significant effect on the prevalence of long COVID (P = 0.0004). The three most common symptoms of long COVID were fatigue (0.33, 95 %CI 0.28–0.39), cognitive decline (0.30, 95 %CI 0.14–0.46) and shortness of breath (0.29, 95 %CI 0.15–0.43). Patients with severe acute phase of COVID-19 (Odds Ratio (OR) 1.57, 95 % CI 1.39–1.77), combined 2 comorbidities (OR 1.80, 95 % CI 1.40–2.32), combined 3 comorbidities (OR 2.13, 95 % CI 1.64–2.77), advanced age (OR 1.02, 95 % CI 1.01–1.04), female (OR 1.58, 95 % CI 1.44–1.73) were the risk factors for long COVID prevalence.

Conclusion

Current systematic review found that nearly half of COVID-19 patients may suffering from long COVID in China. Establishing a long COVID recovery-support platform and regular follow-up would help to long-term monitor and manage the patients, especially those high-risk population.

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中国长期COVID的患病率和危险因素：观察性研究的系统回顾和荟萃分析。

背景：随着新冠肺炎疫情在中国的爆发，大量新冠肺炎患者在康复后面临长期感染的风险。我们的研究目的是系统回顾现有的临床研究，了解中国COVID-19患者长冠状病毒的流行现状及其相关危险因素。方法：本系统评价的方案在PROSPERO注册（CRD42024519375）。检索了2020年1月1日至2024年3月1日的6个电子数据库。文献筛选、资料提取和风险偏倚评估由两位审稿人独立进行。采用AHRQ和NOS对纳入研究的质量进行评估。采用R软件4.2.3进行meta分析，得出长冠状病毒感染率和危险因素。结果：总共纳入了50项研究，65880名参与者。结果显示，中国COVID-19患者中长冠状病毒（至少有一种症状）的患病率约为50% %（95% %可信区间（CI） 42-58 %）。虽然我们进行了meta回归和亚组分析，但研究的异质性较高。但Omicron BA.2变异对长COVID的患病率有统计学意义（P = 0.0004）。长冠肺炎的三个最常见症状是疲劳（0.33,95 %CI 0.28-0.39）、认知能力下降（0.30,95 %CI 0.14-0.46）和呼吸短促（0.29,95 %CI 0.15-0.43）。COVID-19严重急性期患者（比值比（OR） 1.57, 95 % CI 1.39-1.77）、合并2种合并症（OR 1.80, 95 % CI 1.40-2.32）、合并3种合并症（OR 2.13, 95 % CI 1.64-2.77）、高龄（OR 1.02, 95 % CI 1.01-1.04）、女性（OR 1.58, 95 % CI 1.44-1.73）是COVID-19长期流行的危险因素。结论：目前的系统评价发现，中国近一半的COVID-19患者可能患有长期COVID。建立长效康复支持平台，定期随访，有利于对患者特别是高危人群进行长期监测和管理。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.