BMJ Global Health (Oct 2024)

Long Covid: a global health issue – a prospective, cohort study set in four continents

  • Synne Jenum,
  • Renaud Tamisier,
  • Clark D Russell,
  • Rachel Evans,
  • Piero Valentini,
  • Sylvain Diamantis,
  • Dominique Deplanque,
  • Jordi Rello,
  • Agnes Meybeck,
  • Maxime Hentzien,
  • Clotilde Allavena,
  • André Cabié,
  • Firouzé Bani-Sadr,
  • Patrick Rossignol,
  • Lionel Piroth,
  • Mathieu Blot,
  • Marie-Pierre Debray,
  • François Angoulvant,
  • Marc Leone,
  • Ewen M Harrison,
  • Maria Zambon,
  • Michael Edelstein,
  • Florentia Kaguelidou,
  • Marc Lambert,
  • Olivier Lairez,
  • Tom Solomon,
  • Carrol Gamble,
  • Laura Marsh,
  • Christiana Kartsonaki,
  • Natalie Wright,
  • Behzad Nadjm,
  • Srinivas Murthy,
  • Gail Carson,
  • Jake Dunning,
  • Laura Merson,
  • Peter Horby,
  • Timothy M Uyeki,
  • Piero Olliaro,
  • Guillermo Maestro de la Calle,
  • Stephen R Knight,
  • Thomas M Drake,
  • Marlene Murris,
  • Aurore Bousquet,
  • Kenneth A McLean,
  • Hugues Cordel,
  • Marc Fabre,
  • Laurence Bouillet,
  • Katrina Hann,
  • Xavier Duval,
  • James Lee,
  • Christian Rabaud,
  • Paul Klenerman,
  • Jean-Christophe Lucet,
  • Jean-François Timsit,
  • Jennifer Lee,
  • David J Lowe,
  • Nicolas Terzi,
  • Saad Nseir,
  • Gwenhaël Colin,
  • Steve Webb,
  • Kalynn Kennon,
  • Caroline Mudara,
  • Diana Hernández,
  • Yazdan Yazdanpanah,
  • Jean-François Payen,
  • Samreen Ijaz,
  • Joanne McPeake,
  • Meera Chand,
  • Catherine A Shaw,
  • Cameron J Fairfield,
  • Bruno Levy,
  • Eric D'ortenzio,
  • Pierre Delobel,
  • Tiphaine Goulenok,
  • Bronner P Gonçalves,
  • Arnaud Scherpereel,
  • Danilo Buonsenso,
  • Mark G Pritchard,
  • Susanne Dudman,
  • Adrien Auvet,
  • Caterina Caminiti,
  • Debby Bogaert,
  • Elisabeth Botelho-Nevers,
  • Amandine Gagneux-Brunon,
  • Merce Jourdain,
  • Sue Smith,
  • Jia Wei,
  • Antoine Khalil,
  • Clément Le Bihan,
  • Nathalie Pansu,
  • Vincent Le Moing,
  • Victor Fomin,
  • Christophe Fraser,
  • Daniel Munblit,
  • William Greenhalf,
  • François-Xavier Lescure,
  • Nicolas Carlier,
  • Saye Khoo,
  • Annemarie B Docherty,
  • Christopher A Green,
  • Riinu Pius,
  • Louise Sigfrid,
  • Sophie Halpin,
  • Clare Jackson,
  • Antonia Ho,
  • Malcolm G Semple,
  • Andrew Dagens,
  • Carlo Palmieri,
  • Lance Turtle,
  • Zeno Bisoffi,
  • Thomas Flament,
  • Julie Mankikian,
  • Romain Basmaci,
  • Peter Openshaw,
  • Rob Fowler,
  • Tom Fletcher,
  • Adrien Lemaignen,
  • Pierre Tattevin,
  • Christelle Delmas,
  • Hélène Espérou,
  • Claire Lévy-Marchal,
  • Olivier Picone,
  • Jeanne Sibiude,
  • Cecile Yelnik,
  • Michelle Girvan,
  • Piero L Olliaro,
  • Beatrice Alex,
  • Benjamin Bach,
  • Wendy S Barclay,
  • Graham S Cooke,
  • Ana da Silva Filipe,
  • Alexander J Mentzer,
  • Alison M Meynert,
  • Mahdad Noursadeghi,
  • Shona C Moore,
  • Massimo Palmarini,
  • William A Paxton,
  • Georgios Pollakis,
  • David L Robertson,
  • Vanessa Sancho-Shimizu,
  • Janet T Scott,
  • Shiranee Sriskandan,
  • David Stuart,
  • Charlotte Summers,
  • Emma C Thomson,
  • Ryan S Thwaites,
  • Lance C W Turtle,
  • Hayley Hardwick,
  • Wilna Oosthuyzen,
  • Fiona Griffiths,
  • Jo Dalton,
  • Egle Saviciute,
  • Stephanie Roberts,
  • Janet Harrison,
  • Marie Connor,
  • Gary Leeming,
  • Ross Hendry,
  • Victoria Shaw,
  • Jade Ghosn,
  • Lucille Blumberg,
  • Nicolas Benech,
  • Odile Launay,
  • Yoan Lavie-Badie,
  • Minh Le,
  • Elise Artaud-Macari,
  • Muge Cevik,
  • Nicola Latronico,
  • Mylène Maillet,
  • Didier Laureillard,
  • Ben Morton,
  • Claire Hastie,
  • Nicholas Sedillot,
  • Anne-Sophie Boureau,
  • Laurent Abel,
  • Guillaume Martin-Blondel,
  • Valérie Garrait,
  • Isabelle Delacroix,
  • Andrea Cortegiani,
  • Jean-Benoît Arlet,
  • Raphaël Borie,
  • Kévin Bouiller,
  • Vincent Langlois,
  • Mélanie Roriz,
  • Vincent Dubée,
  • John H Amuasi,
  • Madiha Hashmi,
  • Edwin Jesudason,
  • Jan Cato Holter,
  • Anders Benjamin Kildal,
  • Luis Felipe Reyes,
  • Anna Beltrame,
  • Sulaiman Lakoh,
  • Stéphanie Fry,
  • Lynsey Goodwin,
  • Laurent Plantier,
  • Anna Casey,
  • Denis Malvy,
  • Nina Jamieson,
  • François Dubos,
  • Jean-Sébastien Hulot,
  • Paola Rodari,
  • Frank Bloos,
  • Cécile Tromeur,
  • Paul Loubet,
  • Marina Esposito-Farèse,
  • France Mentré,
  • Valérie Gaborieau,
  • Cécile Goujard,
  • Vincent Thibault,
  • Adam Ali,
  • Sadie Kelly,
  • Fernando A Bozza,
  • Bertrand Dussol,
  • Marion Schneider,
  • Marielle Buisson,
  • Yves Levy,
  • Carine Roy,
  • Walter Picard,
  • Olivier Sanchez,
  • Nazir Lone,
  • Antoine Kimmoun,
  • Roberto Roncon-Albuquerque,
  • Nathan Peiffer-Smadja,
  • Julien Poissy,
  • Lila Bouadma,
  • Bruno Lina,
  • Maude Bouscambert,
  • Alexandre Gaymard,
  • Gilles Peytavin,
  • Jeremie Guedj,
  • Claire Andrejak,
  • Cedric Laouenan,
  • Anissa Chair,
  • Samira Laribi,
  • Marie-Capucine Tellier,
  • Sandrine Couffin-Cadiergues,
  • Ventzislava Petrov-Sanchez,
  • Alpha Diallo,
  • Sarah Tubiana,
  • Patrick Imbert,
  • Emmanuelle Mercier,
  • Waasila Jassat,
  • Arsene Kpangon,
  • Dominique Luton,
  • Simone Piva,
  • Sophie Mahy,
  • Pierre-Adrien Bolze,
  • Sarah Moore,
  • Raphael Favory,
  • Andrea Angheben,
  • Andrea Rossanese,
  • Matthew Hall,
  • Johann Auchabie,
  • Christophe Rapp,
  • Vincent Peigne,
  • Fredrik Müller,
  • Christl A Donnelly,
  • François Goehringer,
  • Elodie Curlier,
  • Catherine Chirouze,
  • Vegard Skogen,
  • Stéphane Jaureguiberry,
  • Laurent Bitker,
  • Hodane Yonis,
  • Laurent Mandelbrot,
  • Jérémie Pasquier,
  • Bato Hammarström,
  • Thushan de Silva,
  • Polina Bugaeva,
  • Julie Chas,
  • Dario Sinatti,
  • Arne Søraas,
  • Murray Wham,
  • Sara Clohisey,
  • Seán Keating,
  • Thibault Chiarabini,
  • Agnes Sommet,
  • Hugues Aumaître,
  • Charlotte Charpentier,
  • Sylvie LeGac,
  • Sarah E McDonald,
  • Jeanne Truong,
  • Anne-Hélène Boivin,
  • Mariachiara Ippolito,
  • Ellen Pauley,
  • Diane Descamps,
  • Sérgio Gaião,
  • Stéphane Lasry,
  • Amanda Rojek,
  • Charlotte Salmon Gandonniere,
  • Sebastien Preau,
  • Benoit Thill,
  • Karine Faure,
  • Denis Garot,
  • Grégory Corvaisier,
  • Elsa Nyamankolly,
  • Merete Ellingjord-Dale,
  • Eva Geraud,
  • Barbara Wanjiru Citarella,
  • Kévin Alexandre,
  • Nathalie Allou,
  • Séverine Ansart,
  • Laurène Azemar,
  • Cecile Azoulay,
  • Delphine Bachelet,
  • Claudine Badr,
  • Valeria Balan,
  • Marie Bartoli,
  • Joaquín Baruch,
  • Jules Bauer,
  • Alexandra Bedossa,
  • Husna Begum,
  • Marine Beluze,
  • Delphine Bergeaud,
  • Giulia Bertoli,
  • Simon Bessis,
  • Sybille Bevilcaqua,
  • Karine Bezulier,
  • Krishna Bhavsar,
  • Laetitia Bodenes,
  • Isabela Bolaños,
  • Olivier Bouchaud,
  • Sabelline Bouchez,
  • Camile Bouisse,
  • Marielle Boyer-Besseyre,
  • Axelle Braconnier,
  • Ingrid G Bustos,
  • Denis Butnaru,
  • Eder Caceres,
  • Cyril Cadoz,
  • Valentine Campana,
  • Pauline Caraux-Paz,
  • Thierry Carmoi,
  • Marie-Christine Carret,
  • Maire-Laure Casanova,
  • Guylaine Castor-Alexandre,
  • François-Xavier Catherine,
  • Minerva Cervantes-Gonzalez,
  • Catherine Chakveatze,
  • Jean-Marc Chapplain,
  • Antoine Cheret,
  • Bernard Cholley,
  • Marie-Charlotte Chopin,
  • Roxane Courtois,
  • Stéphanie Cousse,
  • Alexa Debard,
  • Nathalie DeCastro,
  • Romain Decours,
  • Eve Defous,
  • Karen Delavigne,
  • Elisa Demonchy,
  • Emmanuelle Denis,
  • Mathilde Desvallées,
  • Kévin Didier,
  • Jean-Luc Diehl,
  • Vincent Dinot,
  • Fara Diop,
  • Alphonsine Diouf,
  • Félix Djossou,
  • Céline Dorival,
  • Nathalie Dournon,
  • Murray Dryden,
  • Alexandre Ducancelle,
  • Paul Dunand,
  • Brigitte Elharrar,
  • Philippine Eloy,
  • Isabelle Enderle,
  • Ilka Engelmann,
  • Vincent Enouf,
  • Olivier Epaulard,
  • Manuel Etienne,
  • Isabelle Fabre,
  • François-Xavier Ferrand,
  • Eglantine Ferrand Devouge,
  • Nicolas Ferriere,
  • Céline Ficko,
  • Erwan Fourn,
  • Rostane Gaci,
  • Jean-Charles Gagnard,
  • Esteban Garcia-Gallo,
  • Tristan Gigante,
  • Guillermo Giordano,
  • Valérie Gissot,
  • Petr Glybochko,
  • Marie Gominet,
  • Isabelle Gorenne,
  • Laure Goubert,
  • Pascal Granier,
  • Segolène Greffe,
  • Martin Guego,
  • Romain Guery,
  • Anne Guillaumot,
  • Laurent Guilleminault,
  • Thomas Guimard,
  • Ali Hachemi,
  • Nadir Hadri,
  • Rebecca Hamidfar,
  • Lars Heggelund,
  • Rupert Higgins,
  • Hikombo Hitoto,
  • Alexandre Hoctin,
  • Isabelle Hoffmann,
  • Ikram Houas,
  • Margaux Isnard,
  • Danielle Jaafar,
  • Salma Jaafoura,
  • Julien Jabot,
  • Florence Jego,
  • Cédric Joseph,
  • Ouifiya Kafif,
  • Sabina Kali,
  • Younes Kerroumi,
  • Marie Lachatre,
  • Marie Lacoste,
  • Marie Lagrange,
  • Fabrice Laine,
  • Antonio Lalueza,
  • Marie Langelot-Richard,
  • Delphine Lariviere,
  • Andy Law,
  • Laurent Lefebvre,
  • Bénédicte Lefebvre,
  • Benjamin Lefèvre,
  • Jean-Daniel Lelievre,
  • Véronique Lemee,
  • Anthony Lemeur,
  • Quentin Lepiller,
  • Olivier Lesens,
  • Mathieu Lesouhaitier,
  • Geoffrey Liegeon,
  • Guillaume Lingas,
  • Sylvie Lion-Daolio,
  • Marine Livrozet,
  • Bouchra Loufti,
  • Guillame Louis,
  • Liem Luong,
  • Moïse Machado,
  • Gabriel Macheda,
  • Rafael Mahieu,
  • Thomas Maitre,
  • Victoria Manda,
  • Aldric Manuel,
  • Samuel Markowicz,
  • Martin Martinot,
  • Mathieu Mattei,
  • Laurence Maulin,
  • Thierry Mazzoni,
  • Cécile Mear-Passard,
  • Antoine Merckx,
  • Mayka Mergeay-Fabre,
  • Vanina Meysonnier,
  • Mehdi Mezidi,
  • Isabelle Michelet,
  • Lucia Moro,
  • Julien Moyet,
  • Jimmy Mullaert,
  • Nadège Neant,
  • Nikita Nekliudov,
  • Anthony Nghi,
  • Duc Nguyen,
  • Nadia Ouamara,
  • Rachida Ouissa,
  • Eric Oziol,
  • Justine Pages Maïder Pagadoy,
  • Aurélie Papadopoulos,
  • Bruno Pastene,
  • Christelle Paul,
  • Florent Peelman,
  • Daniel Perez,
  • Thomas Perpoint,
  • Vincent Pestre,
  • Ryadh Pokeerbux,
  • Diane Ponscarme,
  • Marie Rafiq,
  • Blandine Rammaert,
  • Stanislas Rebaudet,
  • Sarah Redl,
  • Anne-Sophie Resseguier,
  • Matthieu Revest,
  • Laurent Richier,
  • Patrick Rispal,
  • Karine Risso,
  • Olivier Robineau,
  • Manuel Rosa-Calatrava,
  • Benoît Roze,
  • Hélène Salvator,
  • Pierre-François Sandrine,
  • Benjamine Sarton,
  • Eric Senneville,
  • Albert Sotto,
  • Sarah Stabler,
  • Andrey Svistunov,
  • Coralie Tardivon,
  • François Téoulé,
  • Olivier Terrier,
  • Simon-Djamel Thiberville,
  • Peter S Timashev,
  • Noémie Tissot,
  • Tiffany Trouillon,
  • Christelle Tual,
  • Noémie Vanel,
  • Charline Vauchy,
  • Aurélie Veislinger,
  • Fanny Vuotto,
  • Aurélie Wiedemann,
  • Marion Zabbe,
  • David Zucman,
  • Silvio Hamacher,
  • Ekaterina Pazukhina,
  • Allegra Chatterjee,
  • Kyle Gomez,
  • Matteo Puntoni,
  • Oksana Kruglova,
  • Yock Ping Chow,
  • Yash Doshi,
  • Sara Isabel Duque Vallejo,
  • Elsa D Ibáñez-Prada,
  • Yuli V Fuentes,
  • Margaret E O'Hara,
  • Tigist Menkir,
  • Amal Abrous,
  • Younes Ait Tamlihat,
  • Aliya Mohammed Alameen,
  • Marta Alessi,
  • Kazali Enagnon Alidjnou,
  • Jean Baptiste Assie,
  • Eyvind W Axelsen,
  • John Kenneth Baillie,
  • José Luis Bernal Sobrino,
  • Sonja Hjellegjerde Brunvoll,
  • Roar Bævre-Jensen,
  • Jose Andres Calvache,
  • Léo Chenard,
  • Yock Ping Chow,
  • Barbara Wanjiru Citarella,
  • Juan Luis Cruz Bermúdez,
  • Jaime Cruz Rojo,
  • Charlene Da Silveira,
  • John Arne Dahl,
  • Etienne De Montmollin,
  • Cristina De Rose,
  • Fernanda Dias Da Silva,
  • Thomas Drake,
  • Amiel A Dror,
  • Anne Margarita Dyrhol-Riise,
  • Linn Margrete Eggesbø,
  • Mohammed El Sanharawi,
  • William Finlayson,
  • Aline-Marie Florence,
  • Linda Gail Skeie,
  • Noelia García Barrio,
  • Anatoliy Gavrylov,
  • Louis Gerbaud Morlaes,
  • Yanay Gorelik,
  • Jan Cato Holter,
  • Mette Stausland Istre,
  • Silje Bakken Jørgensen,
  • Karl Trygve Kalleberg,
  • Beathe Kiland Granerud,
  • Anders Benjamin Kildal,
  • Eyrun Floerecke Kjetland Kjetland,
  • Gry Kloumann Bekken,
  • Galyna Kutsyna,
  • Nadhem Lafhej,
  • Cyril Le Bris,
  • Georges Le Falher,
  • Lucie Le Fevre,
  • Quentin Le Hingrat,
  • Marion Le Maréchal,
  • Soizic Le Mestre,
  • Gwenaël Le Moal,
  • Hervé Le Nagard,
  • Sophie Letrou,
  • Wei Shen Lim,
  • Andreas Lind,
  • Carlos Lumbreras Bermejo,
  • Miles Lunn,
  • Olga Martynenko,
  • Roberta Meta,
  • Lina Morales Cely,
  • Clara Mouton Perrot,
  • Alamin Mustafa,
  • Karl Erik Müller,
  • Ebrahim Ndure,
  • Anders Benteson Nygaard,
  • Claudia Milena Orozco-Chamorro,
  • Paul Otiku,
  • Miguel Pedrera Jiménez,
  • Frank Olav Pettersen,
  • Chiara Piubelli,
  • Víctor Quirós González,
  • Else Quist-Paulsen,
  • Dag Henrik Reikvam,
  • Luis Felipe Reyes,
  • Antonia Ricchiuto,
  • Aleksander Rygh Holten,
  • Nadia Saidani,
  • Pablo Serrano Balazote,
  • Nassima Si Mohammed,
  • Lene Bergendal Solberg,
  • Edouard Soum,
  • Elisabetta Spinuzza,
  • Trude Steinsvik,
  • Birgitte Stiksrud,
  • Mathew Thorpe,
  • Vadim Tieroshyn,
  • Kristian Tonby,
  • Anders Tveita,
  • Sylvie Van Der Werf,
  • Paul Henri Wicky,
  • Ibrahim Richard Bangura,
  • Leonardo Bastos,
  • Daniel Cassaglia,
  • Barbara Citarella,
  • Sarah Duque,
  • Anne Margarita Dyrhol Riise,
  • Annelies Gillesen,
  • Bronner P Goncalvez,
  • Margareta O’Hara,
  • Lars Hegelund,
  • Aquiles Henriquez Trujillo,
  • Elsa D Ibañez,
  • Jane Ireson,
  • Oksana Krugalova,
  • Sam Lissaeur,
  • Sinnadurai Manohan,
  • Prasan K Panda,
  • Daniel R Plotkin,
  • Liliana Resende,
  • Sergio Ruiz Saltana,
  • Steffi Ryckaert,
  • Girish Sindhwani Pulm,
  • Caroline Vika

DOI
https://doi.org/10.1136/bmjgh-2024-015245
Journal volume & issue
Vol. 9, no. 10

Abstract

Read online

Introduction A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).Methods A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to <6 and 6 to <12 months post-hospital discharge. A standardised case report form developed by International Severe Acute Respiratory and emerging Infection Consortium’s Global COVID-19 Follow-up working group evaluated the frequency of fever, persistent symptoms, breathlessness (MRC dyspnoea scale), fatigue and impact on daily activities.Results Of 11 860 participants (median age: 52 (IQR: 41–62) years; 52.1% females), 56.5% were from HICs and 43.5% were from LMICs. The proportion identified with Long Covid was significantly higher in HICs vs LMICs at both assessment time points (69.0% vs 45.3%, p<0.001; 69.7% vs 42.4%, p<0.001). Participants in HICs were more likely to report not feeling fully recovered (54.3% vs 18.0%, p<0.001; 56.8% vs 40.1%, p<0.001), fatigue (42.9% vs 27.9%, p<0.001; 41.6% vs 27.9%, p<0.001), new/persistent fever (19.6% vs 2.1%, p<0.001; 20.3% vs 2.0%, p<0.001) and have a higher prevalence of anxiety/depression and impact on usual activities compared with participants in LMICs at 2 to <6 and 6 to <12 months post-COVID-19 hospital discharge, respectively.Conclusion Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. Further research into the aetiology of Long Covid and the burden in LMICs is critical to implement effective, accessible treatment and support strategies to improve COVID-19 outcomes for all.