Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review

  1. Talal Almas
  2. Jahanzeb Malik
  3. Abdulla K. Alsubai
  4. Syed Muhammad Jawad Zaidi
  5. Raafe Iqbal
  6. Kashif Khan
  7. Muhammad Ali
  8. Uzma Ishaq
  9. Majid Alsufyani
  10. Sebastian Hadeed
  11. Reema Alsufyani
  12. Reema Ahmed
  13. Tushar Thakur
  14. Helen Huang
  15. Meetty Antony
  16. Ishan Antony
  17. Anhad Bhullar
  18. Farida Kotait
  19. Lubabah Al-Ani

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Abstract

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  1. Version published to 10.1016/j.amsu.2022.103995
  2. Version published to 10.1101/2021.05.09.21256911v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.05.09.21256911: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Data was collected after protocol approval from the ethical review board of Foundation University Medical College (
    Sex as a biological variablenot detected.
    RandomizationWe included randomized clinical trials, observational, cross-sectional, and cohort studies which were in the English language, and peer-reviewed published articles that reported signs and symptoms after at least two weeks from the recovery of acute COVID-19.
    BlindingAll the screening and inclusion of the articles were conducted by two independent reviewers (ASR, SMJZ) blinded to each other’s decisions.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy and data extraction (selection and coding): The main databases used for study selection were PubMed and Medline through LitCOVID [8], the Cumulative Index to Nursing and Allied Health Literature (CINAHL)
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)
    ), Embase, and Web of Science.
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    After the initial search and removal of duplicates, all the search was imported on EndNote version 20 (Clarivate Analytics™).
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Once the initial screening was finished, all the included studies were referenced in Mendeley.
    Mendeley
    suggested: (Mendeley Data, RRID:SCR_002750)
    Strategy for data synthesis: For statistical analysis, Statistical Package for the Social Sciences (SPSS) version 26 (IBM Corp. Armonk, NY, USA) was used, and based on the distribution of quantitative variables, they were expressed as mean ± standard deviation (SD) or median and interquartile range (IQR).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This systematic review had several limitations. One is the small number of studies with underpowered sample size, creating a potential bias and variation in defined outcomes leading to the heterogeneity of the results. Many studies used a self-reporting method which can produce an interobserver bias and almost all studies enrolled COVID-19 patients in mild, moderate, and severe disease category with variable follow-up times references. This can produce heterogeneous results. There was a predefined assessment of symptoms in every study assessed, which can lead to unreported outcomes. One other limitation is that there is no definition of the effect of one severity of COVID-19 and its associated symptoms. A critical illness survivor can have prolonged symptoms while a patient with mild disease can recover early from the same problem. Hence, there is a need for prospective studies to determine if the post-acute COVID-19 effects are a continuation of SARS-COV-2 or complications of premorbid conditions.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.05.09.21256911v1 on medRxiv