Global prevalence of post-COVID-19 condition (Long COVID): a systematic review and meta-analysis of observational...

Long COVID is an umbrella term for persistent, relapsing, or newly developed health problems after SARS-CoV-2 infection, whereas post-COVID-19 condition (PCC) refers more specifically to the World Health Organization clinical case definition. Reported prevalence varies substantially because of differences in terminology, operational definitions, study populations, follow-up duration, hospitalization status, and symptom ascertainment. This systematic review and meta-analysis synthesized global observational evidence on Long COVID/PCC prevalence and examined major sources of variability.

A systematic review and meta-analysis was conducted according to PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 Global Literature Database were searched for studies published from 1 January 2020 to 23 February 2026. Observational studies were eligible if they included individuals with confirmed or probable SARS-CoV-2 infection, reported Long COVID/PCC or persistent post-COVID symptoms at least 4 weeks after acute infection, and provided numerator and denominator data. Terminology and operational case definitions were extracted separately. Prevalence estimates were pooled using a random-effects model with logit transformation and back-transformation. Heterogeneity was assessed using Cochran's Q, I², tau², and prediction intervals. Subgroup and sensitivity analyses were performed.

Twenty-two studies contributing 27 prevalence estimates and more than 200,000 participants were included. The primary estimate-level pooled prevalence was 30.8% (95% CI 26.8-35.0). Heterogeneity was extreme: Q = 8031.9, df = 26, p < 0.001; I² = 99.7%; tau² = 0.252 on the logit scale. The prediction interval was 14.0-54.8%. Pooled prevalence was higher among hospitalized cohorts (37.9%, 95% CI 29.5-47.1) than among non-hospitalized, community-based, or mixed cohorts (26.2%, 95% CI 22.0-30.9). WHO-defined PCC yielded lower prevalence (22.8%, 95% CI 14.3-34.4) than broader symptom-based definitions (39.7%, 95% CI 30.5-49.5). Cohort-level sensitivity analysis yielded a similar prevalence of 31.0% (95% CI 26.8-35.4).

Long COVID/PCC represents a substantial post-acute public health burden. However, because heterogeneity was extreme, the pooled prevalence should be interpreted as a descriptive summary of heterogeneous observational evidence rather than as a single precise global rate. Standardized definitions, harmonized surveillance, transparent reporting, rehabilitation pathways, and multidisciplinary care models are needed.