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Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis.
Zheng, Bang; Daines, Luke; Han, Qing; Hurst, John R; Pfeffer, Paul; Shankar-Hari, Manu; Elneima, Omer; Walker, Samantha; Brown, Jeremy S; Siddiqui, Salman; Quint, Jennifer K; Brightling, Christopher E; Evans, Rachael A; Wain, Louise V; Heaney, Liam G; Sheikh, Aziz.
  • Zheng B; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Daines L; Usher Institute, University of Edinburgh, Edinburgh, UK.
  • Han Q; Dept of Social Policy and Intervention, University of Oxford, Oxford, UK.
  • Hurst JR; UCL Respiratory, University College London, London, UK.
  • Pfeffer P; Barts Health NHS Trust, London, UK.
  • Shankar-Hari M; Queen Mary University of London, London, UK.
  • Elneima O; Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
  • Walker S; Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Brown JS; Asthma UK and British Lung Foundation, London, UK.
  • Siddiqui S; UCL Respiratory, University College London, London, UK.
  • Quint JK; Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Brightling CE; Dept of Respiratory Sciences, University of Leicester, Leicester, UK.
  • Evans RA; National Heart and Lung Institute, Imperial College London, London, UK.
  • Wain LV; Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Heaney LG; Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK.
  • Sheikh A; Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK.
Eur Respir Rev ; 31(166)2022 Dec 31.
Article in English | MEDLINE | ID: covidwho-2098297
ABSTRACT
Persistent breathlessness >28 days after acute COVID-19 infection has been identified as a highly debilitating post-COVID symptom. However, the prevalence, risk factors, mechanisms and treatments for post-COVID breathlessness remain poorly understood. We systematically searched PubMed and Embase for relevant studies published from 1 January 2020 to 1 November 2021 (PROSPERO registration number CRD42021285733) and included 119 eligible papers. Random-effects meta-analysis of 42 872 patients with COVID-19 reported in 102 papers found an overall prevalence of post-COVID breathlessness of 26% (95% CI 23-29) when measuring the presence/absence of the symptom, and 41% (95% CI 34-48) when using Medical Research Council (MRC)/modified MRC dyspnoea scale. The pooled prevalence decreased significantly from 1-6 months to 7-12 months post-infection. Post-COVID breathlessness was more common in those with severe/critical acute infection, those who were hospitalised and females, and was less likely to be reported by patients in Asia than those in Europe or North America. Multiple pathophysiological mechanisms have been proposed (including deconditioning, restrictive/obstructive airflow limitation, systemic inflammation, impaired mental health), but the body of evidence remains inconclusive. Seven cohort studies and one randomised controlled trial suggested rehabilitation exercises may reduce post-COVID breathlessness. There is an urgent need for mechanistic research and development of interventions for the prevention and treatment of post-COVID breathlessness.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans Language: English Year: 2022 Document Type: Article Affiliation country: 16000617.0071-2022

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Female / Humans Language: English Year: 2022 Document Type: Article Affiliation country: 16000617.0071-2022