Long COVID, a comprehensive systematic scoping review

Infection. 2021 Dec;49(6):1163-1186. doi: 10.1007/s15010-021-01666-x. Epub 2021 Jul 28.


Purpose: To find out what is known from literature about Long COVID until January 30, 2021.

Methods: We undertook a four-step search with no language restriction. A preliminary search was made to identify the keywords. A search strategy of all electronic databases resulted in 66 eligible studies. A forward and backward search of the references and citations resulted in additional 54 publications. Non-English language articles were translated using Google Translate. We conducted our scoping review based on the PRISMA-ScR Checklist.

Results: Of 120 papers, we found only one randomized clinical trial. Of the 67 original studies, 22 were cohort, and 28 were cross-sectional studies. Of the total 120 publications, 49.1% focused on signs and symptoms, 23.3% on management, and 10.8% on pathophysiology. Ten publications focused on imaging studies. The results are also presented extensively in a narrative synthesis in separated sections (nomenclature, diagnosis, pathophysiology, risk factors, signs/symptoms, management).

Conclusions: The controversies in its definition have impaired proper recognition and management. The predominant symptoms were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness.

Keywords: COVID-19; Corona virus; Long COVID-19; Long haulers COVID; Novel Corona Virus 2019; PASC post-acute sequela SARS-COV-2; Post COVID-19 Syndrome; Post-acute COVID-19; Post-acute SARS-CoV-2; SARS-Cov-2.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • COVID-19* / complications
  • Fatigue
  • Humans
  • Post-Acute COVID-19 Syndrome
  • Randomized Controlled Trials as Topic
  • SARS-CoV-2