The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies

Lauren L. O’Mahoney, Ash Routen, Clare Gillies, Sian A. Jenkins, Abdullah Almaqhawi, Daniel Ayoubkhani, Amitava Banerjee, Chris Brightling, Melanie Calvert, Shabana Cassambai, Winifred Ekezie, Mark P. Funnell, Anneka Welford, Arron Peace, Rachael A. Evans, Shavez Jeffers, Andrew P. Kingsnorth, Manish Pareek, Samuel Seidu, Thomas J. Wilkinson, Andrew Willis, Roz Shafran, Terence Stephenson, Jonathan Sterne, Helen Ward, Tom Ward and Kamlesh Khunti ()
Additional contact information
Lauren L. O’Mahoney: University of Leicester
Ash Routen: University of Leicester
Clare Gillies: University of Leicester
Sian A. Jenkins: University of Leicester
Abdullah Almaqhawi: King Faisal University
Daniel Ayoubkhani: University of Leicester
Amitava Banerjee: University College London
Chris Brightling: University of Leicester
Melanie Calvert: University of Birmingham
Shabana Cassambai: University of Leicester
Winifred Ekezie: Aston University
Mark P. Funnell: University of Leicester
Anneka Welford: University of Leicester
Arron Peace: University of Leicester
Rachael A. Evans: University of Leicester
Shavez Jeffers: University of Leicester
Andrew P. Kingsnorth: Loughborough University
Manish Pareek: University of Leicester
Samuel Seidu: University of Leicester
Thomas J. Wilkinson: University of Leicester
Andrew Willis: University College Cork
Roz Shafran: University College London
Terence Stephenson: University College London
Jonathan Sterne: University of Bristol
Helen Ward: Imperial College London
Tom Ward: University of Leicester
Kamlesh Khunti: University of Leicester

Nature Communications, 2025, vol. 16, issue 1, 1-8

Abstract: Abstract The global evidence on the risk of symptoms of Long Covid in general populations infected with SARS-CoV-2 compared to uninfected comparator/control populations remains unknown. We conducted a systematic literature search using multiple electronic databases from January 1, 2022, to August 1, 2024. Included studies had ≥100 people with confirmed or self-reported COVID-19 at ≥28 days following infection onset, and an uninfected comparator/control group. Results were summarised descriptively and meta-analyses were conducted to derive pooled risk ratio estimates. 50 studies totaling 14,661,595 people were included. In all populations combined, there was an increased risk of a wide range of 39 out of 40 symptoms in those infected with SARS‑CoV‑2 compared to uninfected controls. The symptoms with the highest pooled relative risks were loss of smell (RR 4.31; 95% CI 2.66, 6.99), loss of taste (RR 3.71; 95% CI 2.22, 7.26), poor concentration (RR 2.68; 95% CI 1.66, 4.33), impaired memory (RR 2.53; 95% CI 1.82, 3.52), and hair loss/alopecia (RR 2.38; 95% CI 1.69, 3.33). This evidence synthesis, of 50 controlled studies with a cumulative participant count exceeding 14 million people, highlights a significant risk of diverse long-term symptoms in individuals infected with SARS-CoV-2, especially among those who were hospitalised.

Date: 2025
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DOI: 10.1038/s41467-025-59012-w

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