Post-COVID-19-associated multiorgan complications or "long COVID" with literature review and management strategy discussion: A meta-analysis
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Updated: Aug 2, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Phool Iqbal1, Fateen Ata2, Hassan Chaudhry3
1Department of Internal Medicine New York Medical College/Metropolitan Hospital Center New York New York USA.
Insights
This study reveals significant long COVID complications affecting multiple organ systems, with neurological and pulmonary issues being most prevalent. Understanding these long-term effects is crucial for public health strategies.
Area of Science:
- Medical Research
- Infectious Diseases
- Public Health
Background:
- COVID-19 infection can lead to persistent health issues beyond the acute phase, termed long COVID.
- Understanding the spectrum and prevalence of these long-term complications is essential for patient management and healthcare planning.
- Pre-Omicron variant data provides a baseline for assessing long COVID's impact before significant viral evolution.
Purpose of the Study:
- To investigate the long-term complications of COVID-19 (long COVID) across various organ systems.
- To analyze complications occurring at least 3 months post-infection, specifically in the period before the Omicron variant.
- To conduct a comparative literature analysis and meta-analysis of existing studies.
Main Methods:
- Systematic literature search across PubMed, Scopus, and Cochrane Library.
- Inclusion of case reports, series, observational, case-control, and experimental studies reporting post-COVID-19 complications.
- Meta-analysis to determine the effect size (ES) and confidence intervals (CI) for various complications.
Main Results:
- Neurological (29%) and pulmonary (28%) complications were most common, followed by dermatological (25%) and psychiatric (24%).
- Gastrointestinal (22%) and musculoskeletal (18%) symptoms also showed significant prevalence.
- Cardiac (9%), endocrine (8%), and renal (3%) complications were less frequent, with miscellaneous outcomes at 39%.
Conclusions:
- The study quantifies the significant burden of long COVID complications across multiple organ systems.
- Findings highlight the need for continued research and clinical attention to long-term post-COVID-19 sequelae.
- This analysis provides valuable insights for improving community health strategies and patient care following COVID-19 infection.
Objective:
To investigate the post-COVID-19 long-term complications or long COVID of various organ systems in patients after 3 months of the infection, specifically before the Omicron variant, with comparative literature analysis.
Methods:
A systemic literature search and meta-analysis were conducted using multiple electronic databases (PubMed, Scopus, Cochrane library) with predefined search terms to identify eligible articles. Eligible studies reported long-term complications of COVID-19 infection before the Omicron variant infection. Case reports, case series, observational studies with cross-sectional or prospective research design, case-control studies, and experimental studies that reported post-COVID-19 complications were included. The complications reported after 3 months after the recovery from COVID-19 infection were included in the study.
Results:
The total number of studies available for analysis was 34. The effect size (ES) for neurological complications was 29% with 95% confidence interval (CI): 19%-39%. ES for psychiatric complications was 24% with 95% CI: 7%-41%. ES was 9% for cardiac outcomes, with a 95% CI of 1%-18%. ES was 22%, 95% CI: 5%-39% for the gastrointestinal outcome. ES for musculoskeletal symptoms was 18% with 95% CI: 9%-28%. ES for pulmonary complications was 28% with 95% CI: 18%-37%. ES for dermatological complications was 25%, with a 95% CI of 23%-26%. ES for endocrine outcomes was 8%, with a 95% CI of 8%-9%. ES size for renal outcomes was 3% with a 95% CI of 1%-7%. At the same time, other miscellaneous uncategorized outcomes had ES of 39% with 95% CI of 21%-57%. Apart from analyzing COVID-19 systemic complications outcomes, the ES for hospitalization and intensive care unit admissions were found to be 4%, 95% CI: 0%-7%, and 11% with 95% CI: 8%-14%.
Conclusion:
By acquiring the data and statistically analyzing the post-COVID-19 complications during the prevalence of most virulent strains, this study has generated a different way of understanding COVID-19 and its complications for better community health.
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