Evidence map›Paper›PMID 34580069›Full record

SynthesisBMJ global health2021

Characterising long COVID: a living systematic review.

Melina Michelen, Lakshmi Manoharan, Natalie Elkheir, Vincent Cheng, Andrew Dagens, Claire Hastie, Margaret O'Hara, Jake Suett, Dania Dahmash, Polina Bugaeva and 10 more

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05668039 (Enhanced External Counterpulsation), which is not on this map. Cited by 559 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
559citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05668039 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Enhanced External Counterpulsation (EECP/ECPT) to Treat Long-COVID-19 Fatigue - a Randomized Controlled Trial

TypeinterventionalSponsorSheba Medical CenterRan2023 to 2024Enrolled32ConditionsPost-Acute COVID-19 SyndromeArmsEnhanced external counterpulsation
3 · Its place in the literature

Who cites it

559 citing papers in PubMed, 17 syntheses or guidelines pooled it.

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  14. Psychosocial Aspects of the Lived Experience of Long COVID: A Systematic Review and Thematic Synthesis of Qualitative Studies.Health expectations : an international journal of public participation in health care and health policy · 2024
    Pooled it
  15. Psychosocial Aspects of the Lived Experience of Long COVID: A Systematic Review and Thematic Synthesis of Qualitative Studies.Health expectations : an international journal of public participation in health care and health policy · 2024
    Pooled it
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  17. Pathophysiological Mechanisms in Long COVID: A Mixed Method Systematic Review.International journal of environmental research and public health · 2024
    Pooled it
  18. Trial
  19. Long COVID Optimal Health Programme to Enhance Mental and Physical Health: A Feasibility Randomised Controlled Trial.Health expectations : an international journal of public participation in health care and health policy · 2025
    Trial
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499 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Melina MichelenSchool of Health Sciences, City University of London, London, UK.ORCID 0000-0003-3659-7788
Lakshmi Manoharan *ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Natalie Elkheir *Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0002-1786-8530
Vincent Cheng *Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-6162-4146
Andrew Dagens *ISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Claire HastieLong Covid Support, Birmingham, UK.ORCID 0000-0003-2075-2130
Margaret O'HaraLong Covid Support, Birmingham, UK.
Jake SuettAnaesthetic Department, Queen Elizabeth Hospital, Kings Lynn, UK.ORCID 0000-0001-8568-9107
Dania DahmashISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Polina BugaevaJulius-Maximilians-Universität Würzburg, Würzburg, Bayern, Germany.
Ishmeala RigbyISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Daniel MunblitDepartment of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Eli HarrissBodleian Health Care Libraries, University of Oxford, Oxford, UK.
Amanda BurlsSchool of Health Sciences, City University of London, London, UK.
Carole FooteFreelance, Soquel, California, USA.
Janet ScottMRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, UK.
Gail CarsonISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.ORCID 0000-0001-8439-9933
Piero OlliaroISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Louise SigfridISARIC Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
Charitini StavropoulouSchool of Health Sciences, City University of London, London, UK C.Stavropoulou@city.ac.uk.ORCID 0000-0003-4307-1848

Funding

Medical Research Council MC_PC_19026Medical Research Council MC_UU_12014/8
6 · The paper itself

Abstract

backgroundWhile it is now apparent clinical sequelae (long COVID) may persist after acute COVID-19, their nature, frequency and aetiology are poorly characterised. This study aims to regularly synthesise evidence on long COVID characteristics, to help inform clinical management, rehabilitation strategies and interventional studies to improve long-term outcomes.

methodsA living systematic review. Medline, CINAHL (EBSCO), Global Health (Ovid), WHO Global Research on COVID-19 database, LitCovid and Google Scholar were searched till 17 March 2021. Studies including at least 100 people with confirmed or clinically suspected COVID-19 at 12 weeks or more post onset were included. Risk of bias was assessed using the tool produced by Hoy

resultsA total of 39 studies were included: 32 cohort, 6 cross-sectional and 1 case-control. Most showed high or moderate risk of bias. None were set in low-income countries and few included children. Studies reported on 10 951 people (48% female) in 12 countries. Most included previously hospitalised people (78%, 8520/10 951). The longest mean follow-up time was 221.7 (SD: 10.9) days post COVID-19 onset. Over 60 physical and psychological signs and symptoms with wide prevalence were reported, most commonly weakness (41%; 95% CI 25% to 59%), general malaise (33%; 95% CI 15% to 57%), fatigue (31%; 95% CI 24% to 39%), concentration impairment (26%; 95% CI 21% to 32%) and breathlessness (25%; 95% CI 18% to 34%). 37% (95% CI 18% to 60%) of patients reported reduced quality of life; 26% (10/39) of studies presented evidence of reduced pulmonary function.

conclusionLong COVID is a complex condition with prolonged heterogeneous symptoms. The nature of studies precludes a precise case definition or risk evaluation. There is an urgent need for prospective, robust, standardised, controlled studies into aetiology, risk factors and biomarkers to characterise long COVID in different at-risk populations and settings. PROSPERO REGISTRATION NUMBER: CRD42020211131.

Indexed as

COVID-19Quality of LifeChildCross-Sectional StudiesFemaleHumansMalePost-Acute COVID-19 SyndromeProspective StudiesSARS-CoV-2COVID-19public healthsystematic review

Identifiers

PMID34580069
PMCPMC8478580

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.