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What are the long-term symptoms and complications of COVID-19: a protocol for a living systematic review

Michelen, M., Sigfrid, L., Manoharan, L., Elkheir, N., Hastie, C., O'Hara, M., Suett, J. C., Cheng, V., Burls, A., Foote, C. and Stavropoulou, C. ORCID: 0000-0003-4307-1848 (2020). What are the long-term symptoms and complications of COVID-19: a protocol for a living systematic review. F1000Research, 9, doi: 10.12688/f1000research.27284.1


Although the majority of patients with COVID-19 will experience mild to moderate symptoms and will recover fully, there is now increasing evidence that a significant proportion will experience persistent symptoms for weeks or months after the acute phase of the illness. These symptoms include, among others, fatigue, problems in breathing, lack of smell and taste, headaches, and also depression and anxiety. It has also become clear that the virus has lasting effects not only on the respiratory system but also on other parts of the body, including the heart, liver, and the nervous system.

In this paper we present a protocol for a living systematic review that aims to synthesize the evidence on the prevalence and duration of symptoms and clinical features of post-acute COVID-19 and its long-term complications.

The living systematic review will be updated regularly, initially monthly with update cycles under continuous review as the pace of new evidence generated develops through the pandemic. We will include studies that follow up with COVID-19 patients who have experienced persistent mild, moderate or severe symptoms, with no restrictions regarding country, setting, or language.

We will use descriptive statistics to analyse the data and our findings will be presented as infographics to facilitate transcription to lay audiences. Ultimately, we aim to support the work of policy makers, practitioners, and patients when planning rehabilitation for those recovering from COVID-19.

The protocol has been registered with PROSPERO (, CRD42020211131, 25/09/2020).

Publication Type: Article
Publisher Keywords: Living systematic review, COVID-19, long covid, lasting effects
Subjects: Q Science > QR Microbiology
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Departments: School of Health Sciences > Healthcare Services Research & Management
Date Deposited: 16 Dec 2020 16:12
Text - Accepted Version
Available under License Creative Commons: Attribution International Public License 4.0.

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