Psychological and Cognitive Sequelae of COVID-19: Systematic Review and Meta-Analysis

COVID-19 pandemic has exacerbated global mental health problems with the development of persistent symptoms.

To conduct a prevalence meta-analysis of persistent psychological and cognitive sequelae of COVID-19 based on cohort studies.

This study followed PRISMA. Cohort studies that followed individuals for at least 12 weeks post-COVID-19 were included and pediatric studies were excluded. The databases Embase, Lilacs/BVS, PubMed, SciELO and Scopus were searched in November 2023. Meta-analyses were performed with subgroup analyses conducted. Results were presented with forest plot graphs and tables. Risk of bias and methodological quality were assessed using Eggers's Test and the Newcastle-Ottawa Scale.

2,456 studies were identified and screened. Forty-seven articles were included in the systematic review, and 46 in the meta-analysis (192,158 participants). The most prevalent psychological outcome was anxiety (0.17; 95% CI 0.11-0.27, 19 studies), followed by cognitive impairments (0.15; 95% CI 0.11-0.20, 35 studies), sleep disturbances (0.14; 95% CI 0.09-0.19, 33 studies) and depression (0.11; 95% CI 0.06-0.19, 16 studies).

The mental health consequences of COVID-19 highlight the need for long-term monitoring and represent a significant public health challenge. The limitation is the heterogeneity among the studies.

These findings represent a public health issue emphasizing the need for public policies and support strategies to mitigate consequences.

Although high prevalence rates were identified, the prediction intervals were wide and heterogeneity remained high-common characteristics of studies conducted during the pandemic.

Registered in the international Prospective Register of Ongoing Systematic Reviews (PROSPERO) under number CRD42023460632, on September 5, 2023.