Prevalence of post-COVID symptoms across variants of concern and follow-up periods: A systematic review and meta-analysis

Lugtu et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2026.108522, PROSPERO CRD42024566180, Mar 2026
Systematic review and meta-analysis of 35 studies (n = 159,000) showing that post-COVID condition remains prevalent across SARS-CoV-2 variants of concern, with an overall pooled prevalence of 28.5%. Pre-Omicron variants had significantly higher post-COVID prevalence (35.5%) compared to Omicron (22.8%).
Lugtu et al., 10 Mar 2026, USA, peer-reviewed, 12 authors, trial PROSPERO CRD42024566180. Contact: cesar.fernandez@urjc.es, knotart1@jmi.edu.
Abstract: Contents lists available at ScienceDirect International Journal of Infectious Diseases journal homepage: www.elsevier.com/locate/ijid Prevalence of post-COVID symptoms across variants of concern and follow-up periods: A systematic review and meta-analysis Eiron John Lugtu 1 , # , Delfin Ynigo Pilapil IV 1 , # , Mikhail Harvey Cabunoc 1 , Joshua Lawrence Bautista 1 , Francis Matthew Pleta 1 , Jeremy Ace Ng 2 , Farid Shahid 3 , Timothy Hudson David Culasino Carandang 4 , 5 , Giuseppe Lippi 6 , Brandon Michael Henry 7 , César Fernández-de-las-Peñas 8 , ∗ , Kin Israel Notarte 9 , ∗∗ 1 Faculty of Medicine & Surgery, University of Santo Tomas, Manila, Philippines 2 College of Medicine, University of the Philippines, Manila, Philippines 3 National Institute of Neurological Disorders, National Institutes of Health, Bethesda, Maryland, USA 4 Research Development Unit, Dr. Paulino J. Garcia Memorial Research and Medical Center, Nueva Ecija, Philippines - 5 Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines 6 Section of Clinical Biochemistry, University of Verona, Verona, Italy - 7 Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Ohio, USA - 8 Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain 9 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA a r t i c l e i n f o Article history: Received 7 February 2026 Revised 1 March 2026 Accepted 5 March 2026 Keywords: Post-COVID PASC SARS-CoV-2 variants Symptomatology a b s t r a c t Objectives: The interaction between SARS-CoV-2 variants of concern (VoC) and post-COVID symptom duration remains unexplored. This is the first study to evaluate post-COVID prevalence stratified by VoC and follow-up periods. Methods: Six databases were searched (12/2019-12/2024) for studies of adults with laboratory-confirmed SARS-CoV-2 and symptoms lasting ≥ 3 months. Data were stratified by VoC (Alpha through Omicron) and follow-up ( < 6 vs ≥ 6 months) to estimate pooled prevalence using random-effects models. Results: Pooled prevalence across 35 studies ( n = 159,0 0 0) was 28.5% (95% CI: 21.6-36.0), higher in preOmicron (35.5%) than Omicron (22.8%) eras ( P = 0.04). Symptoms persisted beyond 6 months in 29.9% of cases. Fatigue was the most prevalent symptom across all VoCs and follow-ups followed by brain fog, dyspnea, and sleep impairment. Pre-Omicron variants were linked to dyspnea and anosmia, while Omicron was associated with brain fog and paresthesia. Most symptoms showed no significant reduction beyond 6 months. Sleep problems were higher in early pre-Omicron cohorts but improved over time; conversely, palpitations and ocular manifestations increased in later pre-Omicron follow-ups. Conclusion: Post-COVID condition remains a burden despite vaccination. Distinct symptomatology patterns across VoC and timelines highlight the need for tailored management strategies to mitigate longterm global impacts. © 2026 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license [( http://creativecommons.org/licenses/by-nc-nd/4.0/ )](http://creativecommons.org/licenses/by-nc-nd/4.0/) ∗ Corresponding author: Dr. César Fernández-de-las-Peñas,..
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Mater Adv", "key": "10.1016/j.ijid.2026.108522_bib0002", "volume": "7", "year": "2022" }, { "DOI": "10.1039/D2CP00469K", "article-title": "Computational investigation of the increased virulence and pathogenesis of SARS-CoV-2 lineage B.1.1.7", "author": "Murugan", "doi-asserted-by": "crossref", "first-page": "20371", "journal-title": "Phys Chem Chem Phys PCCP", "key": "10.1016/j.ijid.2026.108522_bib0003", "volume": "24", "year": "2022" }, { "DOI": "10.3389/fmed.2022.849217", "article-title": "The biological functions and clinical significance of SARS-CoV-2 variants of corcern", "author": "Akkız", "doi-asserted-by": "crossref", "journal-title": "Front Med", "key": "10.1016/j.ijid.2026.108522_bib0004", "volume": "9", "year": "2022" }, { "DOI": "10.3390/biology12091267", "article-title": "From alpha to omicron: how different variants of concern of the SARS-Coronavirus-2 impacted the world", "author": "Andre", "doi-asserted-by": "crossref", "first-page": "1267", "journal-title": "Biology", "key": "10.1016/j.ijid.2026.108522_bib0005", "volume": "12", "year": "2023" }, { "DOI": "10.3390/v15010167", "article-title": "A detailed overview of SARS-CoV-2 Omicron: its sub-variants, mutations and pathophysiology, clinical characteristics, immunological landscape, immune escape, and therapies", "author": "Chatterjee", "doi-asserted-by": "crossref", "first-page": "167", "journal-title": "Viruses", "key": "10.1016/j.ijid.2026.108522_bib0006", "volume": "15", "year": "2023" }, { "DOI": "10.3389/fimmu.2023.1117464", "article-title": "Long COVID: a review and proposed visualization of the complexity of long COVID", "author": "Perumal", "doi-asserted-by": "crossref", "journal-title": "Front Immunol", "key": "10.1016/j.ijid.2026.108522_bib0007", "volume": "14", "year": "2023" }, { "DOI": "10.1007/s15010-021-01696-5", "article-title": "Long COVID: current definition", "author": "Fernández-de-Las-Peñas", "doi-asserted-by": "crossref", "first-page": "285", "journal-title": "Infection", "key": "10.1016/j.ijid.2026.108522_bib0008", "volume": "50", "year": "2022" }, { "DOI": "10.1016/S1473-3099(21)00703-9", "article-title": "A clinical case definition of post-COVID-19 condition by a Delphi consensus", "author": "Soriano", "doi-asserted-by": "crossref", "first-page": "e102", "journal-title": "Lancet Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib0009", "volume": "22", "year": "2022" }, { "DOI": "10.3390/pathogens11020269", "article-title": "Long-term sequelae of COVID-19: a systematic review and meta-analysis of one-year follow-up studies on post-COVID symptoms", "author": "Han", "doi-asserted-by": "crossref", "first-page": "269", "journal-title": "Pathog Basel Switz", "key": "10.1016/j.ijid.2026.108522_bib0010", "volume": "11", "year": "2022" }, { "DOI": "10.1016/j.jinf.2023.12.004", "article-title": "Persistence of post-COVID symptoms in the general population two years after SARS-CoV-2 infection: a systematic review and meta-analysis", "author": "Fernandez-de-Las-Peñas", "doi-asserted-by": "crossref", "first-page": "77", "journal-title": "J Infect", "key": "10.1016/j.ijid.2026.108522_bib0011", "volume": "88", "year": "2024" }, { "article-title": "COVID-19 and its long-term sequelae: what do we know in 2023?", "author": "Lippi", "journal-title": "Pol Arch Intern Med", "key": "10.1016/j.ijid.2026.108522_bib0012", "volume": "133", "year": "2023" }, { "article-title": "Long COVID prevalence and impact on quality of life 2 years after acute COVID-19", "author": "Kim", "journal-title": "Sci Rep", "key": "10.1016/j.ijid.2026.108522_bib0013", "volume": "13", "year": "2023" }, { "DOI": "10.1038/s41579-022-00846-2", "article-title": "Long COVID: major findings, mechanisms and recommendations", "author": "Davis", "doi-asserted-by": "crossref", "first-page": "133", "journal-title": "Nat Rev Microbiol", "key": "10.1016/j.ijid.2026.108522_bib0014", "volume": "21", "year": "2023" }, { "DOI": "10.3390/v14122629", "article-title": "Long-COVID symptoms in individuals infected with different SARS-CoV-2 variants of concern: a systematic review of the literature", "author": "Fernández-de-las-Peñas", "doi-asserted-by": "crossref", "first-page": "2629", "journal-title": "Viruses", "key": "10.1016/j.ijid.2026.108522_bib0015", "volume": "14", "year": "2022" }, { "DOI": "10.3390/ijerph192316010", "article-title": "Comparison of long COVID-19 caused by different SARS-CoV-2 strains: a systematic review and meta-analysis", "author": "Du", "doi-asserted-by": "crossref", "journal-title": "Int J Environ Res Public Health", "key": "10.1016/j.ijid.2026.108522_bib0016", "volume": "19", "year": "2022" }, { "DOI": "10.3390/ijms241612962", "article-title": "SARS-CoV-2 reinfections and long COVID in the post-omicron phase of the pandemic", "author": "Boufidou", "doi-asserted-by": "crossref", "journal-title": "Int J Mol Sci", "key": "10.1016/j.ijid.2026.108522_bib0017", "volume": "24", "year": "2023" }, { "DOI": "10.1038/s41419-024-06642-5", "article-title": "Research progress of post-acute sequelae after SARS-CoV-2 infection", "author": "Jiao", "doi-asserted-by": "crossref", "first-page": "257", "journal-title": "Cell Death Dis", "key": "10.1016/j.ijid.2026.108522_bib0018", "volume": "15", "year": "2024" }, { "DOI": "10.1177/01410768211032850", "article-title": "Symptoms, complications and management of long COVID: a review", "author": "Aiyegbusi", "doi-asserted-by": "crossref", "first-page": "428", "journal-title": "J R Soc Med", "key": "10.1016/j.ijid.2026.108522_bib0019", "volume": "114", "year": "2021" }, { "DOI": "10.1093/cid/ciac007", "article-title": "Are patients exhibiting post-coronavirus disease (COVID) symptoms at 12 months the same at 5 or 9 months? The fluctuating nature of post-COVID", "author": "Fernández-de-Las-Peñas", "doi-asserted-by": "crossref", "first-page": "e1208", "journal-title": "Clin Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib0020", "volume": "75", "year": "2022" }, { "DOI": "10.1097/XEB.0000000000000054", "article-title": "Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data", "author": "Munn", "doi-asserted-by": "crossref", "first-page": "147", "journal-title": "Int J Evid Based Healthc", "key": "10.1016/j.ijid.2026.108522_bib0021", "volume": "13", "year": "2015" }, { "DOI": "10.1016/0197-2456(86)90046-2", "article-title": "Meta-analysis in clinical trials", "author": "DerSimonian", "doi-asserted-by": "crossref", "first-page": "177", "journal-title": "Control Clin Trials", "key": "10.1016/j.ijid.2026.108522_bib0022", "volume": "7", "year": "1986" }, { "DOI": "10.1214/aoms/1177729756", "article-title": "Transformations related to the angular and the square root", "author": "Freeman", "doi-asserted-by": "crossref", "first-page": "607", "journal-title": "Ann Math Stat", "key": "10.1016/j.ijid.2026.108522_bib0023", "volume": "21", "year": "1950" }, { "DOI": "10.1186/1471-2288-14-135", "article-title": "Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range", "author": "Wan", "doi-asserted-by": "crossref", "first-page": "135", "journal-title": "BMC Med Res Methodol", "key": "10.1016/j.ijid.2026.108522_bib0024", "volume": "14", "year": "2014" }, { "key": "10.1016/j.ijid.2026.108522_bib0025", "unstructured": "Cochrane handbook for systematic reviews of interventions (current version) Cochrane n.d. https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current [accessed 26 September 2025]." }, { "DOI": "10.35566/jbds/v3n2/wang", "article-title": "Conducting meta-analyses of proportions in R", "author": "Wang", "doi-asserted-by": "crossref", "first-page": "64", "journal-title": "J Behav Data Sci", "key": "10.1016/j.ijid.2026.108522_bib0026", "volume": "3", "year": "2023" }, { "DOI": "10.1016/j.cegh.2018.05.005", "article-title": "Interpretation of subgroup analyses in systematic reviews: a tutorial", "author": "Richardson", "doi-asserted-by": "crossref", "first-page": "192", "journal-title": "Clin Epidemiol Glob Health", "key": "10.1016/j.ijid.2026.108522_bib0027", "volume": "7", "year": "2019" }, { "DOI": "10.1186/s12879-023-08947-w", "article-title": "Analysis of influencing factors on long COVID in COVID-19 patients infected with omicron variant three months after discharge: a cross-sectional study", "author": "Shang", "doi-asserted-by": "crossref", "first-page": "36", "issue": "1", "journal-title": "BMC Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib48", "volume": "24", "year": "2024" }, { "DOI": "10.1186/s12879-024-09108-3", "article-title": "Post-recovery health domain scores among outpatients by SARS-CoV-2 testing status during the pre-Delta period", "author": "King", "doi-asserted-by": "crossref", "first-page": "300", "issue": "1", "journal-title": "BMC Infect Dis.", "key": "10.1016/j.ijid.2026.108522_bib49", "volume": "24", "year": "2024" }, { "DOI": "10.3390/pathogens13030267", "article-title": "The course of COVID-19 and long COVID: identifying risk factors among patients suffering from the disease before and during the omicron-dominant period", "author": "Babicki", "doi-asserted-by": "crossref", "first-page": "267", "journal-title": "Pathog Basel Switz", "key": "10.1016/j.ijid.2026.108522_bib0043", "volume": "13", "year": "2024" }, { "article-title": "Prevalence and determinants of post-acute sequelae after SARS-CoV-2 infection (Long COVID) among adults in Mexico during 2022: a retrospective analysis of nationally representative data", "author": "Bello-Chavolla", "journal-title": "Lancet Reg Health Am", "key": "10.1016/j.ijid.2026.108522_bib0040", "volume": "30", "year": "2024" }, { "DOI": "10.1016/S2213-2600(23)00387-9", "article-title": "3-year outcomes of discharged survivors of COVID-19 following the SARS-CoV-2 omicron (B.1.1.529) wave in 2022 in China: a longitudinal cohort study", "author": "Zhang", "doi-asserted-by": "crossref", "first-page": "55", "issue": "1", "journal-title": "Lancet Respir Med", "key": "10.1016/j.ijid.2026.108522_bib50", "volume": "12", "year": "2024" }, { "DOI": "10.1371/journal.pone.0296488", "article-title": "Post COVID-19 condition among adults in Malaysia following the Omicron wave: a prospective cohort study", "author": "Tok", "doi-asserted-by": "crossref", "journal-title": "PLoS One", "key": "10.1016/j.ijid.2026.108522_bib0028", "volume": "19", "year": "2024" }, { "DOI": "10.24171/j.phrp.2023.0251", "article-title": "Prevalence and patterns of post-COVID-19 symptoms in recovered patients of Delhi, India: a population-based study", "author": "Bhatnagar", "doi-asserted-by": "crossref", "first-page": "229", "journal-title": "Osong Public Health Res Perspect", "key": "10.1016/j.ijid.2026.108522_bib0033", "volume": "15", "year": "2024" }, { "DOI": "10.1002/jmv.28862", "article-title": "Prevalence and risk factors of long COVID 6-12 months after infection with the Omicron variant among nonhospitalized patients in Hong Kong", "author": "Luo", "doi-asserted-by": "crossref", "first-page": "e28862", "issue": "6", "journal-title": "J Med Virol", "key": "10.1016/j.ijid.2026.108522_bib51", "volume": "95", "year": "2023" }, { "DOI": "10.1093/cid/ciad045", "article-title": "Severe Fatigue and Persistent Symptoms at 3 Months Following Severe Acute Respiratory Syndrome Coronavirus 2 Infections During the Pre-Delta, Delta, and Omicron Time Periods: A Multicenter Prospective Cohort Study", "author": "Gottlieb", "doi-asserted-by": "crossref", "first-page": "1930", "issue": "11", "journal-title": "Clin Infect Dis Off Publ Infect Dis Soc Am", "key": "10.1016/j.ijid.2026.108522_bib52", "volume": "76", "year": "2023" }, { "DOI": "10.1093/cid/ciac947", "article-title": "CoviCare Study Team. Prevalence of Post-Coronavirus Disease Condition 12 Weeks After Omicron Infection Compared With Negative Controls and Association With Vaccination Status", "author": "Nehme", "doi-asserted-by": "crossref", "first-page": "1567", "issue": "9", "journal-title": "Clin Infect Dis Off Publ Infect Dis Soc Am", "key": "10.1016/j.ijid.2026.108522_bib53", "volume": "76", "year": "2023" }, { "author": "Bhandari", "first-page": "11", "issue": "2", "journal-title": "Post-COVID Syndrome: The Stranger Ghost of Culprit COVID-19. J Assoc Physicians India", "key": "10.1016/j.ijid.2026.108522_bib54", "volume": "71", "year": "2023" }, { "DOI": "10.1080/22221751.2023.2220578", "article-title": "A one-year follow-up study of systematic impact of long COVID symptoms among patients post SARS-CoV-2 omicron variants infection in Shanghai, China", "author": "Cai", "doi-asserted-by": "crossref", "first-page": "2220578", "issue": "2", "journal-title": "Emerg Microbes Infect", "key": "10.1016/j.ijid.2026.108522_bib55", "volume": "12", "year": "2023" }, { "DOI": "10.1371/journal.pone.0278825", "article-title": "Characteristics and predictors of Long COVID among diagnosed cases of COVID-19", "author": "Arjun", "doi-asserted-by": "crossref", "first-page": "e0278825", "issue": "12", "journal-title": "PloS One", "key": "10.1016/j.ijid.2026.108522_bib56", "volume": "17", "year": "2022" }, { "article-title": "Prevalence and predictors of persistent post-COVID-19 symptoms", "author": "Estrada-Codecido", "first-page": "208", "issue": "3", "journal-title": "J Assoc Med Microbiol Infect Dis Can J Off Assoc Pour Microbiol Medicale Infect Can", "key": "10.1016/j.ijid.2026.108522_bib57", "volume": "7", "year": "2022" }, { "DOI": "10.1093/ofid/ofab156", "article-title": "Persistent Symptoms and Association With Inflammatory Cytokine Signatures in Recovered Coronavirus Disease 2019 Patients", "author": "Ong", "doi-asserted-by": "crossref", "first-page": "ofab156", "issue": "6", "journal-title": "Open Forum Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib58", "volume": "8", "year": "2021" }, { "DOI": "10.1016/S0140-6736(22)01214-4", "article-title": "Lifelines Corona Research Initiative. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study", "author": "Ballering", "doi-asserted-by": "crossref", "first-page": "452", "issue": "10350", "journal-title": "Lancet Lond Engl", "key": "10.1016/j.ijid.2026.108522_bib59", "volume": "400", "year": "2022" }, { "DOI": "10.1186/s12879-023-08787-8", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib60", "unstructured": "Thi Khanh HN, Cornelissen L, Castanares-Zapatero D, De Pauw R, Van Cauteren D, Demarest S, et al. Association between SARS-CoV-2 variants and post COVID-19 condition: findings from a longitudinal cohort study in the Belgian adult population. BMC Infect Dis [Internet]. 2023 Nov 8 [cited 2025 Sep 23];23(1):774. Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08787-8" }, { "DOI": "10.3201/eid3007.231723", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib61", "unstructured": "Iba A, Hosozawa M, Hori M, Muto Y, Muraki I, Masuda R, et al. Prevalence of and Risk Factors for Post–COVID-19 Condition during Omicron BA.5–Dominant Wave, Japan. Emerg Infect Dis [Internet]. 2024 Jul [cited 2025 Sep 23];30(7). Available from: https://wwwnc.cdc.gov/eid/article/30/7/23-1723_article" }, { "DOI": "10.1093/ofid/ofae039", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib62", "unstructured": "Maier HE, Kowalski-Dobson T, Eckard A, Gherasim C, Manthei D, Meyers A, et al. Reduction in Long COVID Symptoms and Symptom Severity in Vaccinated Compared to Unvaccinated Adults. Open Forum Infect Dis [Internet]. 2024 Feb 1 [cited 2025 Sep 23];11(2):ofae039. Available from: https://academic.oup.com/ofid/article/doi/10.1093/ofid/ofae039/7585852" }, { "DOI": "10.7759/cureus.44888", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib63", "unstructured": "Karyakarte RP, Das R, Rajmane MV, Dudhate S, Agarasen J, Pillai P, et al. The Burden and Characteristics of Post-COVID-19 Conditions Among Laboratory-Confirmed Delta and Omicron COVID-19 Cases: A Preliminary Study From Maharashtra, India. Cureus [Internet]. 2023 Sep 8 [cited 2025 Sep 23]; Available from: https://www.cureus.com/articles/183536-the-burden-and-characteristics-of-post-covid-19-conditions-among-laboratory-confirmed-delta-and-omicron-covid-19-cases-a-preliminary-study-from-maharashtra-india" }, { "DOI": "10.3389/fimmu.2022.1038227", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib64", "unstructured": "Bellan M, Apostolo D, Albè A, Crevola M, Errica N, Ratano G, et al. Determinants of long COVID among adults hospitalized for SARS-CoV-2 infection: A prospective cohort study. Front Immunol [Internet]. 2022 Dec 19 [cited 2025 Sep 23];13:1038227. Available from: https://www.frontiersin.org/articles/10.3389/fimmu.2022.1038227/full" }, { "DOI": "10.1016/j.ijregi.2024.100366", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib65", "unstructured": "Møller M, Abelsen T, Sørensen AIV, Andersson M, Friis-Hansen L, Dilling-Hansen C, et al. Exploring the dynamics of COVID-19 in a Greenlandic cohort: Mild acute illness and moderate risk of long COVID. IJID Reg [Internet]. 2024 Jun [cited 2025 Sep 23];11:100366. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2772707624000377" }, { "author": "Hopff", "first-page": "2253", "issue": "6", "journal-title": "Comparison of post-COVID-19 symptoms in patients infected with the SARS-CoV-2 variants delta and omicron-results of the Cross-Sectoral Platform of the German National Pandemic Cohort Network (NAPKON-SUEP). Infection", "key": "10.1016/j.ijid.2026.108522_bib66", "volume": "52", "year": "2024" }, { "DOI": "10.3390/jcm11092411", "article-title": "Fatigue Is a Major Symptom at COVID-19 Hospitalization Follow-Up", "author": "Sperling", "doi-asserted-by": "crossref", "first-page": "2411", "issue": "9", "journal-title": "J Clin Med", "key": "10.1016/j.ijid.2026.108522_bib67", "volume": "11", "year": "2022" }, { "DOI": "10.3389/fpubh.2024.1276391", "article-title": "Clinical and serological predictors of post COVID-19 condition-findings from a Canadian prospective cohort study", "author": "Collins", "doi-asserted-by": "crossref", "first-page": "1276391", "journal-title": "Front Public Health", "key": "10.1016/j.ijid.2026.108522_bib68", "volume": "12", "year": "2024" }, { "DOI": "10.5694/mja2.52256", "article-title": "Long COVID in a highly vaccinated but largely unexposed Australian population following the 2022 SARS-CoV-2 Omicron wave: a cross-sectional survey", "author": "Woldegiorgis", "doi-asserted-by": "crossref", "first-page": "323", "issue": "6", "journal-title": "Med J Aust", "key": "10.1016/j.ijid.2026.108522_bib69", "volume": "220", "year": "2024" }, { "DOI": "10.1093/ofid/ofad471", "article-title": "Prevalence of Long-term Symptoms Varies When Using Different Post-COVID-19 Definitions in Positively and Negatively Tested Adults: The PRIME Post-COVID Study", "author": "Pagen", "doi-asserted-by": "crossref", "first-page": "ofad471", "issue": "10", "journal-title": "Open Forum Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib70", "volume": "10", "year": "2023" }, { "DOI": "10.1371/journal.pone.0281429", "article-title": "Post COVID-19 condition after Wildtype, Delta, and Omicron SARS-CoV-2 infection and prior vaccination: Pooled analysis of two population-based cohorts", "author": "Ballouz", "doi-asserted-by": "crossref", "first-page": "e0281429", "issue": "2", "journal-title": "PloS One", "key": "10.1016/j.ijid.2026.108522_bib71", "volume": "18", "year": "2023" }, { "DOI": "10.1038/s41467-024-51893-7", "article-title": "Early biological markers of post-acute sequelae of SARS-CoV-2 infection", "author": "Lu", "doi-asserted-by": "crossref", "first-page": "7466", "issue": "1", "journal-title": "Nat Commun", "key": "10.1016/j.ijid.2026.108522_bib72", "volume": "15", "year": "2024" }, { "article-title": "A cohort study of post-COVID-19 condition across the Beta, Delta, and Omicron waves in South Africa: 6-month follow-up of hospitalized and nonhospitalized participants", "author": "Jassat", "first-page": "102", "journal-title": "Int J Infect Dis IJID Off Publ Int Soc Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib73", "volume": "128", "year": "2023" }, { "DOI": "10.1093/infdis/jiac474", "article-title": "Prevalence and Severity of Symptoms 3 Months After Infection With SARS-CoV-2 Compared to Test-Negative and Population Controls in the Netherlands", "author": "van der Maaden", "doi-asserted-by": "crossref", "first-page": "1059", "issue": "9", "journal-title": "J Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib74", "volume": "227", "year": "2023" }, { "DOI": "10.1093/cid/ciad143", "doi-asserted-by": "crossref", "key": "10.1016/j.ijid.2026.108522_bib75", "unstructured": "Kahlert CR, Strahm C, Güsewell S, Cusini A, Brucher A, Goppel S, et al. Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study. Clin Infect Dis [Internet]. 2023 Jul 15 [cited 2025 Sep 26];77(2):194–202. Available from: https://doi.org/10.1093/cid/ciad143" }, { "DOI": "10.1016/j.ijid.2023.11.038", "article-title": "Patients with long COVID continue to experience significant symptoms at 12 months and factors associated with improvement: a prospective cohort study in France (PERSICOR)", "author": "Salmon", "doi-asserted-by": "crossref", "first-page": "9", "journal-title": "Int J Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib0042", "volume": "140", "year": "2024" }, { "DOI": "10.1016/j.jiac.2022.08.007", "article-title": "Post COVID-19 condition of the Omicron variant of SARS-CoV-2", "author": "Morioka", "doi-asserted-by": "crossref", "first-page": "1546", "issue": "11", "journal-title": "J Infect Chemother Off J Jpn Soc Chemother", "key": "10.1016/j.ijid.2026.108522_bib76", "volume": "28", "year": "2022" }, { "DOI": "10.1001/jamanetworkopen.2022.38804", "article-title": "Prevalence and Correlates of Long COVID Symptoms Among US Adults", "author": "Perlis", "doi-asserted-by": "crossref", "first-page": "e2238804", "issue": "10", "journal-title": "JAMA Netw Open", "key": "10.1016/j.ijid.2026.108522_bib77", "volume": "5", "year": "2022" }, { "DOI": "10.1093/ofid/ofaf533", "article-title": "Global prevalence of long COVID, its subtypes, and risk factors: an updated systematic review and meta-analysis", "author": "Hou", "doi-asserted-by": "crossref", "first-page": "ofaf533", "journal-title": "Open Forum Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib0029", "volume": "12", "year": "2025" }, { "DOI": "10.1038/s41467-025-59012-w", "article-title": "The risk of long COVID symptoms: a systematic review and meta-analysis of controlled studies", "author": "O’Mahoney", "doi-asserted-by": "crossref", "first-page": "4249", "journal-title": "Nat Commun", "key": "10.1016/j.ijid.2026.108522_bib0030", "volume": "16", "year": "2025" }, { "DOI": "10.1186/s12916-025-03974-7", "article-title": "Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia", "author": "Kogevinas", "doi-asserted-by": "crossref", "first-page": "140", "journal-title": "BMC Med", "key": "10.1016/j.ijid.2026.108522_bib0031", "volume": "23", "year": "2025" }, { "DOI": "10.3892/mi.2025.216", "article-title": "Prevalence of and risk factors for long COVID following infection with the COVID‑19 omicron variant&nbsp", "author": "Moritani", "doi-asserted-by": "crossref", "first-page": "1", "journal-title": "Med Int", "key": "10.1016/j.ijid.2026.108522_bib0032", "volume": "5", "year": "2025" }, { "DOI": "10.3390/covid4070067", "article-title": "Prevalence and predictors of long COVID-19 and the average time to diagnosis in the general population: a systematic review, meta-analysis and meta-regression", "author": "Muthuka", "doi-asserted-by": "crossref", "first-page": "968", "journal-title": "COVID", "key": "10.1016/j.ijid.2026.108522_bib0034", "volume": "4", "year": "2024" }, { "DOI": "10.1183/16000617.0254-2022", "article-title": "SARS-CoV-2 post-acute sequelae in previously hospitalised patients: systematic literature review and meta-analysis", "author": "Kelly", "doi-asserted-by": "crossref", "journal-title": "Eur Respir Rev", "key": "10.1016/j.ijid.2026.108522_bib0035", "volume": "32", "year": "2023" }, { "DOI": "10.1186/s12879-025-11023-0", "article-title": "Trajectories of persisting COVID-19 symptoms up to 24 months after acute infection: findings from the Predi-Covid cohort study", "author": "Fischer", "doi-asserted-by": "crossref", "first-page": "603", "journal-title": "BMC Infect Dis", "key": "10.1016/j.ijid.2026.108522_bib0036", "volume": "25", "year": "2025" }, { "DOI": "10.1056/NEJMp2008017", "article-title": "Mental health and the Covid-19 pandemic", "author": "Pfefferbaum", "doi-asserted-by": "crossref", "first-page": "510", "journal-title": "N Engl J Med", "key": "10.1016/j.ijid.2026.108522_bib0037", "volume": "383", "year": "2020" }, { "article-title": "Ocular manifestations of COVID-19: a systematic review 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