Long COVID remains a globally prevalent and persistent condition, with a pooled prevalence of 36% worldwide, highlighting the urgent need for follow-up studies and policy responses to address its long-term impact.
A systematic review and meta-analysis published in Open Forum Infectious Diseases reported a pooled prevalence of long COVID as 36% worldwide.
The World Health Organization has defined long COVID as the continuation or development of COVID-19-related symptoms 3 months or longer after initial infection with SARS-CoV-2.
To consolidate data on the prevalence of long COVID, investigators from the University of Michigan and Yale School of Public Health in the United States searched publication databases for relevant studies through July 2024.
A total of 429 studies, representing over 2 million individuals with confirmed COVID-19, were included in the final analysis. The studies were conducted in Europe (n=195), Asia (n=126), North America (n=61), South America (n=31), Africa (n=9), Oceania (n=3), and multiple regions (n=4).
The pooled global prevalence of long COVID among individuals who had confirmed COVID-19 was 36% (95% CI, 33-40; P <.001; I2=100%). The investigators posited that the heterogenous definition of long COVID, study design, population characteristics, and the evolution of SARS-CoV-2 likely contributed to the high heterogeneity.
Stratified by year, the estimated pooled global prevalence of long COVID was 38% (range, 10%-62%) using data published in 2021, 37% (range, 1%-92%) using data published in 2022, 37% (range, 6%-87%) using data published in 2023, and 34% (range, 3%-80%) using data published in 2024.
Stratified by COVID-19 severity, the rate of long COVID was 44% (95% CI, 38-51) among hospitalized patients and 29% (95% CI, 14-50) among nonhospitalized patients.
The estimated pooled prevalence of long COVID was highest in Africa (prevalence rate [PR], 53%; 95% CI, 38-67), followed by South America (PR, 51%; 95% CI, 35-66), Europe (PR, 39%; 95% CI, 31-48), Asia (PR, 35%; 95% CI, 25-46), and North America (PR, 30%; 95% CI, 24-38). Specifically, the estimated pooled prevalence was 29% (95% CI, 21-37) in the United States. The investigators noted that fewer than 5 studies from Africa were included in the analysis and results, therefore, should be interpreted with caution.
The rate of long COVID was higher among women and girls (PR, 45%; 95% CI, 33-58) than men and boys (PR, 37%; 95% CI, 27-48) and among adults (PR, 35%; 95% CI, 31-40) than adolescents and children (PR, 23%; 95% CI, 14-34).
Using 8 long COVID subtypes, the most common were respiratory (PR, 20%; 95% CI, 14-28), general fatigue (PR, 20%; 95% CI, 18-23), psychologic (PR, 18%; 95% CI, 11-28), neurologic (PR, 16%; 95% CI, 8-30), and dermatologic (PR, 12%; 95% CI, 8-17) subtypes.
Considering 41 specific symptoms, the most common were memory problems (PR, 11%; 95% CI, 7-19), followed by muscle weakness (PR, 11%; 95% CI, 5-23), breathlessness (PR, 8%; 95% CI, 3-22), dyspnea (PR, 7%; 95% CI, 6-10), joint pain (PR, 7%; 95% CI, 4-11), and cough (PR, 6%; 95% CI, 4-8).
Risk for long COVID was associated with unvaccinated status (odds ratio [OR], 2.09; 95% CI, 1.55-2.81), Alpha or Delta variants compared with Omicron variant (OR, 1.74; 95% CI, 1.40-2.17), female sex (OR, 1.56; 95% CI, 1.32-1.84), comorbidities (OR, 1.52; 95% CI, 1.27-1.82), preexisting cardiovascular disease (OR, 1.50; 95% CI, 1.24-1.81), intensive care unit admission (OR, 1.43; 95% CI, 1.02-2.02), and preexisting hypertension (OR, 1.37; 95% CI, 1.08-1.74).
Study limitations include high heterogeneity observed in the comparisons, potential selection and diagnostic biases, and the absence of key outcomes such as quality of life and mortality.
The investigators concluded, “[T]he persistence of long COVID symptoms across varying follow-up durations highlights the long-term burden of these conditions and the need to better understand long COVID physiology, identify diagnostic biomarkers, develop effective treatments, and address its impacts on healthcare systems and workforce participation.”
By Jessica Nye, PhD
References:
Hou Y, Gu T, Ni Z, Shi X, Ranney ML, Mukherjee B. Global prevalence of long COVID, its subtypes, and risk factors: an updated systematic review and meta-analysis. Open Forum Infect Dis. Published online August 30, 2025. doi:10.1093/ofid/ofaf533
Source : Infectious Disease Advisor
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