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Global Prevalence of Long COVID, Its Subtypes, and Risk Factors: An Updated Systematic Review and Meta-analysis
Yiren Hou1, Tian Gu2, Zhouchi Ni1
1Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Open Forum Infectious Diseases
|September 29, 2025
Summary
Long COVID affects 36% globally, with higher rates in South America. Key risk factors include being unvaccinated, pre-Omicron variant infections, and female sex.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Long COVID, a persistent condition post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, presents a significant global health challenge.
- Understanding its prevalence, subtypes, and risk factors is crucial for effective management and prevention strategies.
Purpose of the Study:
- To evaluate the global prevalence of long COVID and its various subtypes and symptoms.
- To assess the influence of identified risk factors on the development of long COVID.
Main Methods:
- A mega-systematic review and meta-analysis of 429 studies published between July 2021 and May 2024.
- Data were pooled using a random-effects model with DerSimonian-Laird estimator.
- Risk of bias was assessed to ensure study quality.
Main Results:
- The global pooled prevalence of long COVID was 36% (95% CI, 33%-40%), with South America reporting the highest rates (51%).
- Prevalence persisted over time, with 35% at <1 year and 46% at 1-2 years post-infection.
- Most common subtypes included general fatigue (20%), respiratory (20%), psychological (18%), and neurological (16%).
- Key risk factors identified were being unvaccinated against COVID-19 (OR, 2.09), infections from pre-Omicron variants (OR, 1.74), and female sex (OR, 1.56).
Conclusions:
- Long COVID remains a prevalent global health issue following SARS-CoV-2 infection.
- Significant heterogeneity in prevalence estimates necessitates well-designed, globally representative follow-up studies with consistent measurement tools.
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