Frequency, signs and symptoms, and criteria adopted for long COVID: a systematic review, 2021, Cabrera Martimbianco et al

I'm not sure whether this deserves its own thread or not.

https://onlinelibrary.wiley.com/doi/abs/10.1111/ijcp.14357

SYSTEMATIC REVIEW
Free Access
Frequency, signs and symptoms, and criteria adopted for long COVID: a systematic review
Ana Luiza Cabrera Martimbianco

Rafael Leite Pacheco

Ângela Maria Bagattini

Rachel Riera
First published: 11 May 2021

https://doi.org/10.1111/ijcp.14357





ABSTRACT
Aims
to identify, systematically evaluate and summarise the best available evidence on the frequency of long COVID (post‐acute COVID‐19 syndrome), its clinical manifestations and the criteria used for diagnosis.

Methods
Systematic review conducted with a comprehensive search including formal databases, COVID‐19 or SARS‐CoV‐2 data sources, grey literature, and manual search. We considered for inclusion clinical trials, observational longitudinal comparative and non‐comparative studies, cross‐sectional, before‐and‐after and case series. We assessed the methodological quality by using specific tools based on the study designs. We presented the results as a narrative synthesis regarding frequency and duration of long COVID, signs and symptoms, criteria used for diagnosis, and potential risk factors.

Results
We included 25 observational studies with moderate to high methodological quality, considering 5,440 participants. The frequency of long COVID ranged from 4.7 to 80%, and the most prevalent signs/symptoms were chest pain (up to 89%), fatigue (up to 65%), dyspnea (up to 61%), and cough and sputum production (up to 59%). Temporal criteria used to define long COVID varied from 3 to 24 weeks after acute phase or hospital discharge. Potentially associated risk factors were old age, female sex, severe clinical status, a high number of comorbidities, hospital admission, and oxygen supplementation at the acute phase. However, limitations related to study designs added uncertainty to this finding. None of the studies assessed the duration of signs/symptoms.

Conclusion
The frequency of long COVID reached up to 80% over the studies included and occurred between 3 to 24 weeks after acute phase or hospital discharge. Chest pain, fatigue, dyspnea and cough were the most reported clinical manifestations attributed to the condition. Based on this systematic review findings, there is an urgent need to understand this emerging, complex and challenging medical condition. Proposals for diagnostic criteria and standard terminology are welcome.

 

There have already been multiple systematic reviews even though the necessary work hasn't even been done yet and that's just the most EBM thing ever. It's like people expect to jump in doing systematic reviews from day 1, as if the evidence just happens magically. Then systematic reviews of systematic reviews, no need to wait for the actual work to be done, let's do reviews of reviews of reviews.

No one is currently doing the necessary work for there to be a reliable study, let alone a review of multiple studies. Everything's stalled, everyone is waiting for a breakthrough that would magically give us an up-or-down answer on how to count it, except no one is actually doing the kind of work that can. Everything is just estimates, early work that was done to justify doing an actual systemic counting. There are multiple steps missing here, most of which consist mainly of doing the actual work.

This disease-only approach is ridiculous, you don't always just stumble on the first clue, sometimes you have to work hard at it. Except everyone is waiting on the first clue to begin working so nothing happens, everything is just frozen in place waiting for the answer to be handed down to them because no one wants to risk anything, would rather do safe but meaningless work than risk clearing out a dead-end, which is far more useful than most of the busywork happening right now.

I've never seen a more dysfunctional anything. This is amateur hour, it's excessive how much no one knows what they're doing relative to how much they are actually doing.