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Definition and measurement of post-COVID-19 conditions in real-world practice: a global systematic literature review
  1. Jingyan Yang1,2,
  2. Kristen Markus3,
  3. Kathleen Michelle Andersen1,
  4. Abby E Rudolph1,
  5. Leah J McGrath1,
  6. Jennifer L Nguyen1,
  7. Moe H Kyaw1,
  8. Isabelle Whittle3,
  9. Vasileios Blazos3,
  10. Louise Heron3,
  11. Julia Regazzini Spinardi4
  1. 1Pfizer Inc, New York, New York, USA
  2. 2Institute for Social and Economic Research and Policy, Columbia University, New York, New York, USA
  3. 3Adelphi Values PROVE, Bollington, UK
  4. 4Emerging Markets, Pfizer Brasil, São Paulo, Brazil
  1. Correspondence to Dr Jingyan Yang; jingyan.yang{at}pfizer.com

Abstract

Post-COVID-19 conditions (PCC) is an umbrella term that encompasses a range of signs, symptoms and conditions present weeks after the acute phase of a SARS-CoV-2 infection. This systematic literature review summarises the heterogeneous methodology used to measure PCC across real-world studies and highlights trends by region, age group, PCC follow-up period and data source.

Methods Medline, EMBASE and the Cochrane Library were searched and supplemented with conference and grey literature searches. Eligible studies included individuals with (1) PCC or (2) a positive SARS-CoV-2 test or COVID-19 diagnosis who were followed over time. Included studies were published in English between 1 January 2020 and 14 November 2022.

Findings Of 291 publications included, 175 (60%) followed individuals with confirmed COVID-19 over time for PCC and 116 (40%) used a prespecified PCC definition. There was substantial heterogeneity in study design, geography, age group, PCC conditions/symptoms assessed and their classification and duration of follow-up. Among studies using a prespecified PCC definition, author-defined criteria (51%) were more common than criteria recommended by major public health organisations (19%). Measurement periods for PCC outcomes from date of acute COVID-19 test were primarily 3 to <6 months (39.2%), followed by 6 to <12 months (27.5%) and <3 months (22.9%). When classified by organ/system, constitutional-related PCC were the most frequently assessed in adult (86%) and paediatric (87%) populations. Within constitutional symptoms, fatigue was most frequently assessed in adult (91.6%) and paediatric (95.0%) populations, followed by fever/chills (37.9% and 55%, respectively).

Conclusions PCC definitions are heterogenous across real-world studies, which limits reliable comparisons between studies. However, some similarities were observed in terms of the most frequently measured PCC-associated symptoms/conditions, which may aid clinical management of patients with PCC.

CRD42022376111.

  • COVID-19
  • systematic review
  • infectious diseases

Data availability statement

No data are available. All data supporting the findings of this study are available within the paper and its supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2023-077886

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    Data availability statement

    No data are available. All data supporting the findings of this study are available within the paper and its supplementary information.

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    Footnotes

    • Contributors JY, KMA, LJMcG, JLN, MHK, AER, JS, LH, KM, IW and VB were involved in study conception and design, material preparation, data collection and analysis. The first draft of the manuscript was written by VB, IW, KM and LH, and all authors provided comments on subsequent drafts.

      JY is responsible for the overall content as the guarantor. All authors read and approved the final manuscript.

    • Funding Adelphi Values PROVE received funding from the study sponsor for the conduct of the review.

    • Competing interests JY, KMA, LJMcG, JLN, MHK, AER and JRS are employees of Pfizer and may hold stock or stock options. LH, KM, IW and VB are employees of Adelphi Values PROVE.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.