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The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies

Author

Listed:
  • Lauren L. O’Mahoney

    (University of Leicester)

  • Ash Routen

    (University of Leicester)

  • Clare Gillies

    (University of Leicester
    University of Leicester)

  • Sian A. Jenkins

    (University of Leicester)

  • Abdullah Almaqhawi

    (King Faisal University)

  • Daniel Ayoubkhani

    (University of Leicester
    Government Buildings)

  • Amitava Banerjee

    (University College London
    University College London)

  • Chris Brightling

    (University of Leicester)

  • Melanie Calvert

    (University of Birmingham
    University Hospital Birmingham and University of Birmingham
    University of Birmingham)

  • Shabana Cassambai

    (University of Leicester)

  • Winifred Ekezie

    (Aston University)

  • Mark P. Funnell

    (University of Leicester)

  • Anneka Welford

    (University of Leicester)

  • Arron Peace

    (University of Leicester)

  • Rachael A. Evans

    (University of Leicester
    University Hospitals of Leicester NHS Trust)

  • Shavez Jeffers

    (University of Leicester)

  • Andrew P. Kingsnorth

    (Loughborough University)

  • Manish Pareek

    (University of Leicester
    University of Leicester)

  • Samuel Seidu

    (University of Leicester)

  • Thomas J. Wilkinson

    (University of Leicester)

  • Andrew Willis

    (University College Cork)

  • Roz Shafran

    (University College London)

  • Terence Stephenson

    (University College London)

  • Jonathan Sterne

    (University of Bristol)

  • Helen Ward

    (Imperial College London)

  • Tom Ward

    (University of Leicester)

  • Kamlesh Khunti

    (University of Leicester)

Abstract

The global evidence on the risk of symptoms of Long Covid in general populations infected with SARS-CoV-2 compared to uninfected comparator/control populations remains unknown. We conducted a systematic literature search using multiple electronic databases from January 1, 2022, to August 1, 2024. Included studies had ≥100 people with confirmed or self-reported COVID-19 at ≥28 days following infection onset, and an uninfected comparator/control group. Results were summarised descriptively and meta-analyses were conducted to derive pooled risk ratio estimates. 50 studies totaling 14,661,595 people were included. In all populations combined, there was an increased risk of a wide range of 39 out of 40 symptoms in those infected with SARS‑CoV‑2 compared to uninfected controls. The symptoms with the highest pooled relative risks were loss of smell (RR 4.31; 95% CI 2.66, 6.99), loss of taste (RR 3.71; 95% CI 2.22, 7.26), poor concentration (RR 2.68; 95% CI 1.66, 4.33), impaired memory (RR 2.53; 95% CI 1.82, 3.52), and hair loss/alopecia (RR 2.38; 95% CI 1.69, 3.33). This evidence synthesis, of 50 controlled studies with a cumulative participant count exceeding 14 million people, highlights a significant risk of diverse long-term symptoms in individuals infected with SARS-CoV-2, especially among those who were hospitalised.

Suggested Citation

  • Lauren L. O’Mahoney & Ash Routen & Clare Gillies & Sian A. Jenkins & Abdullah Almaqhawi & Daniel Ayoubkhani & Amitava Banerjee & Chris Brightling & Melanie Calvert & Shabana Cassambai & Winifred Ekezi, 2025. "The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies," Nature Communications, Nature, vol. 16(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-59012-w
    DOI: 10.1038/s41467-025-59012-w
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