Prevalence and trajectories of post-COVID-19 neuromuscular conditions: A systematic-review and meta-analysis

Neuromuscular diseases (NMDs) are a significant component of the post-acute sequelae of COVID-19. However, their long-term prevalence and trajectories remain poorly defined. This systematic review and meta-analysis aimed to determine the long-term prevalence in COVID-19 survivors of fourteen specific NMDs and related symptoms: cranial nerve diseases, Guillain-Barré syndrome, small fiber neuropathy, (poly)radiculopathies, (poly)neuropathies, plexopathies, motor neuron disease, myasthenia gravis, Lambert-Eaton syndrome, neuropathic pain, sarcopenia, myalgia, myalgia associated with other symptoms, and of other muscle diseases.

We searched MEDLINE, Embase, and the Cochrane Library (January 2020 through November 2024) for studies with at least 3 months of follow-up. Pooled prevalence estimates were calculated at multiple time points (acute phase to 24 months) using random effects models.

Among 180 unique studies representing 15,865,322 cases (54 % female, mean age 50.0 years), the pooled prevalence for individuals with at least one NMD or related symptoms decreased from 36 % in the acute phase to 8 % at 24 months. Myalgia prevalence steadily declined from 35 % to 8 % by two years. A trend towards lower prevalences across the time points was observed also for Guillain-Barré syndrome, and other muscle diseases, while other conditions showed a more erratic pattern. The prevalence of neuropathic pain remained high and persisted almost unchanged through the follow-up period (from 31 % in the acute phase to 25 % at 12 months).

NMDs and related symptoms are common following COVID-19, but their general prevalence decreases with time. However, trajectories varied depending on the type of NMD or symptom.