Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis.

BACKGROUND: Post-acute coronavirus 2019 (COVID-19) syndrome is now recognized as a complex systemic disease that is associated with substantial morbidity. OBJECTIVES: To estimate the prevalence of persistent symptoms and signs at least 12 weeks after acute COVID-19 at different follow-up periods. DATA SOURCES: Searches were conducted up to October 2021 in Ovid Embase, Ovid Medline, and PubMed. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: Articles in English that reported the prevalence of persistent symptoms among individuals with confirmed severe acute respiratory syndrome coronavirus 2 infection and included at least 50 patients with a follow-up of at least 12 weeks after acute illness. METHODS: Random-effect meta-analysis was performed to produce a pooled prevalence for each symptom at four different follow-up time intervals. Between-study heterogeneity was evaluated using the I2 statistic and was explored via meta-regression, considering several a priori study-level variables. Risk of bias was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa Scale for prevalence studies and comparative studies, respectively. RESULTS: After screening 3209 studies, a total of 63 studies were eligible, with a total COVID-19 population of 257 348. The most commonly reported symptoms were fatigue, dyspnea, sleep disorder, and difficulty concentrating (32%, 25%, 24%, and 22%, respectively, at 3- to <6-month follow-up); effort intolerance, fatigue, sleep disorder, and dyspnea (45%, 36%, 29%, and 25%, respectively, at 6- to <9-month follow-up); fatigue (37%) and dyspnea (21%) at 9 to <12 months; and fatigue, dyspnea, sleep disorder, and myalgia (41%, 31%, 30%, and 22%, respectively, at >12-month follow-up). There was substantial between-study heterogeneity for all reported symptom prevalences. Meta-regressions identified statistically significant effect modifiers: world region, male sex, diabetes mellitus, disease severity, and overall study quality score. Five of six studies including a comparator group consisting of COVID-19-negative cases observed significant adjusted associations between COVID-19 and several long-term symptoms. CONCLUSIONS: This systematic review found that a large proportion of patients experience post-acute COVID-19 syndrome 3 to 12 months after recovery from the acute phase of COVID-19. However, available studies of post-acute COVID-19 syndrome are highly heterogeneous. Future studies need to have appropriate comparator groups, standardized symptom definitions and measurements, and longer follow-up.

Knowledge, perception, and attitudes of Universal Health Coverage policies among Alfaisal University students in Saudi Arabia.

BACKGROUND: Saudi Arabia aims to achieve Universal Health Coverage (UHC) by a combination of free public healthcare and mandatory cooperative health insurance. To ensure the effectiveness of UHC policies, every individual should have a strong knowledge of their health-care rights and the system that guarantees it. OBJECTIVES: The aim of this study is to measure the knowledge of Alfaisal students and record their perceptions and attitudes about Saudi Arabia's basic health-care coverage structure and UHC policies. MATERIALS AND METHODS: A cross-sectional survey was developed with 22 items measuring knowledge and 7 items evaluating perception and attitudes and distributed through E-mail with a consecutive sampling method at Alfaisal University to achieve the required calculated sample size for March-April of 2020. The accumulated data were organized, tabulated, and statistically analyzed using SPSS software. Comparison between two groups and more was made using the Chi-square test. RESULTS: Students' self-reported knowledge on the three main knowledge questions ranged from 30.6% to 57.7%, with medical students admitting to similar or worse knowledge compared to their colleagues from other colleges. About 57.3% of our respondents believe the Saudi system provides effective and sufficient healthcare to all, but only 42.7% believe that the system provides financial protection to all. CONCLUSION: The study showed a low level of knowledge about Saudi Arabia's UHC policies among Alfaisal students, especially among medical students, with a generally positive perception and attitudes toward them, although with some serious misconceptions that should be addressed.