Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review

Malik, J.; Zaidi, S. M. J.; Ishaq, U.; Ali, M.; Rana, A. S.; Iqbal, R.; Waqar, A. U.; Kashif, M.

Objective: This systematic review aimed at estimating the demographics, clinical characteristics, and prevalence of post-acute COVID-19 symptoms because of published literature that studied prolonged clinical manifestations after recovery from acute COVID-19 infection. Methods: After protocol setting, relevant articles were searched on various databases including PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Web of Sciences using MeSH keywords. The data regarding demographic, clinical characteristics and prevalence of each persisting symptom were carefully studied and tabulated. Data analysis was carried out using Statistical Package for Social Sciences (SPSS) version 26. Results: Out of the 153 articles reviewed, 21 articles qualified for the final analysis. The most common persistent clinical manifestations were fatigue (54.11%), dyspnea (24.38%), alopecia (23.21%), hyperhidrosis (23.6%), insomnia (25.98%), anxiety (17.29%), and arthralgia (16.35%). In addition to these symptoms, new-onset hypertension, diabetes, neuropsychiatric disorders, and bladder incontinence were also reported. Conclusion: Clinical features of post-acute COVID-19 infection can manifest even after 60 days of initial infection. Constitutional symptoms include fatigue, dyspnea, anosmia, and insomnia, most commonly reported in the literature. Multidisciplinary care along with regular follow-up must be provided to such patients. Curation and modification of guidelines are required to assess discharged hospitalized patients for better management of their post-acute COVID-19 syndrome.