Please ensure Javascript is enabled for purposes of website accessibility
REVIEW PAPER
Complications after COVID-19 – review of scientific reports and meta-analysis
 
More details
Hide details
1
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
 
 
Submission date: 2023-09-10
 
 
Final revision date: 2023-12-22
 
 
Acceptance date: 2024-03-01
 
 
Publication date: 2024-06-29
 
 
Corresponding author
Arkadiusz Żurawski
Arkadiusz Żurawski Collegium Medicum Jan Kochanowski University Kielce, Poland
 
 
Medical Studies 2024;40(2):225-239
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The typical complications considered in the paper include cardiovascular, neurological, respiratory, and vascular thrombosis-related complications.

Aim of the research:
To analyse the complications induced by COVID-19.

Material and methods:
The authors performed a thorough systematic review in databases related to COVID complications, as well as scientific articles and publications. The analysis focused on original research on post-COVID-19 complications, which was an inclusion criterion. Among the papers selected for analysis were surveys that involved patients who had undergone COVID-19 infection and related complications. Many papers were cross-sectional studies. Most studies used the PAPI questionnaire, which is the most common research method when quantitative techniques are concerned. The studies were analysed using a meta-analysis involving a PRISMA method.

Results:
The studies indicated a correlation between the incidence of COVID-19 and the complications that arose from it.

Conclusions:
The results obtained suggest multifaceted monitoring of post-COVID-19 complications in the longer term.
REFERENCES (58)
1.
Roffi M, Guagliumi G, Ibanez B. The obstacle course of reperfusion for ST-segment-elevation myocardial infarction in the COVID-19 pandemic. Circulation. 2020 Jun; 141(24): 1951-1953,.
 
2.
Fernández Cruz A, Ruiz-Antorán B, Muńoz Gómez A, Sancho López A, Sánchez PM, Centeno Soto GA, Alon- so SB, Javaloyes Garachana L, Galán Gómez A, Alijo ÁV, Gómez Irusta J, Payares-Herrera C, Morrás Torre I, Sánchez Chica E, Delgado Téllez de Cepeda L, Callejas Díaz A, Ramos Martínez A, Múńez Rubio E, Avendańo-Solá Cristina; Puerta de Hierro COVID-19 Study Group. Impact of glucocorticoid treatment in SARS-COV-2 infection mortality: a retrospective controlled cohort study. medRxiv. 2020 May. https://doi.org/10.1101/2020.0....
 
3.
RECOVERY Collaborative Group, Horby P, Lim W, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi E, Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie JK, Haynes R, Landray MJ. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med. 2021 Feb; 384(8): 693-704.
 
4.
Ramiro S, Mostard RL, Magro-Checa C, van Dongen CMP, Dormans T, Buijs J, Gronenschild M, de Kruif MD, van Haren EHJ, van Kraaij T, Leers MPG, Peeters R, Wong DR, Landewé RBM. Historically controlled comparison of glucocorticoids with or without tocilizumab versus supportive care only in patients with COVID-19-associated cytokine storm syndrome: results of the CHIC study. Ann Rheum Dis. 2020 Sep; 79(9): 1143-1151.
 
5.
Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet Sep. 2003; 362(9386): 782-788.
 
6.
Dequin PF, Heming N, Meziani F, Plantefève G, Voiriot G, Badié J, François B, Aubron C, Ricard JD, Ehrmann S, Jouan Y, Guillon A, Leclerc M, Coffre C, Bourgoin H, Lengellé C, Caille-Fénérol C, Tavernier E, Zohar S, Girau- deau B, Annane D, Le Gouge A; CAPE COVID Trial Group and the CRICS-TriGGERSep Network. Effect of hydrocortisone on 21-day mortality or respiratory support among critically ill patients with COVID-19 – a randomized clinical trial. JAMA. 2020 Oct; 324(13): 1298-1306.
 
7.
Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and Forest plots using a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes. 2012 Jan; 5: 52.
 
8.
Cochrane Collaboration. (2017). Cochrane handbook for systematic reviews of interventions. Version 5.2.0. Chapter 20.3.2.5 – Approaches to integrating qualitative and quantitative evidence syntheses. Available at: https://training.cochrane.org/... Accessed on 18.12.18.
 
9.
European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 pandemic. Available at: https://www.escardio.org/Educa....
 
10.
Fried JA, Ramasubbu K, Bhatt R, Topkara VK, Clerkin KJ, Horn E, Rabbani LR, Brodie D, Jain SS, Kirtane AJ, Masoumi A, Takeda K, Kumaraiah D, Burkhoff D, Leon M, Schwartz A, Uriel N, Sayer G. The variety of cardiovascular presentations of COVID-19. Circulation. 2020 Jun; 141(23): 1930-1936.
 
11.
Gao C, Cai Y, Zhang K, Zhou L, Zhang Y, Zhang X, Li Q, Li W, Yang S, Zhao X, Zhao Y, Wang H, Liu Y, Yin Z, Zhang R, Wang R, Yang M, Hui C, Wijns W, Mc- Evoy JW, Soliman O, Onuma Y, Serruys PW, Tao L, Li F. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. Eur Heart J. 2020 Jun; 41(22): 2058-2066.
 
12.
Lopes RD, Macedo AVS, de Barros E Silva PGM, Junqueira Moll-Bernardes R, Feldman A, Saba Arruda GD, Silvestre de Souza A, Campos de Albuquerque D, Mazza L, Santos MF, Salvador NZ, Gibson CM, Granger CB, Alexander JH, de Souza OF; BRACE CORONA investigators. Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – The BRACE CORONA Trial. Am Heart J. 2020 Aug; 226: 49-59.
 
13.
Lacourcière Y, Poirier L, Lefebvre J, Archambault F, Clé- roux J, Boileau G. Antihypertensive effects of amlodipine and hydrochlorothiazide in elderly patients with ambulatory hypertension. Am J Hypertens. 1995 Dec; 8(12): 1154-1159.
 
14.
Jamerson K, Weber MA, Bakris GL, Dahlöf B, Pitt B, Shi V, Hester A, Gupte J, Gatlin M, Velazquez EJ; ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008 Dec; 359(23): 2417-2428.
 
15.
Singh AK, Majumdar S, Singh R, Misra A. Role of corticosteroid in the management of COVID-19: a systemic review and a Clinician’s perspective. Diabetes Metab Syndr 2020; Sep-Oct; 14(5); 971-978.
 
16.
Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, Clark C, Iba T. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020 May; 18(5): 1023-1026.
 
17.
Shang J, Du R, Lu Q, Wu J, Xu S, Ke Z, Cai Z, G, Huang Q, Zhan Y, Yang J, Liu Y, Hu Y, Zhang H, Huang H, Xie Z, Li X, Hu W, Gong J, Ke W, Shao Z, Liu Z, Xie Jungang. The treatment and outcomes of patients with COVID-19 in Hubei, China: a multi-centered, retrospective, observational study. SSRN 2020. https://doi.org/10.2139/ssrn.3....
 
18.
Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS , Cook JR, Nordvig AS, Shalev D, Sehrawat TS, Ahluwalia N, Bikdeli B, Dietz D, Der-Nigoghos- sian C, Liyanage-Don N, Rosner GF, Bernstein EJ, Mohan S, Beckley AA, Seres DS, Choueiri TK, Uriel N, Ausiello JC, Accili D, Freedberg DE, Baldwin M, Schwartz A, Brodie D, Garcia CK, Elkind MSV, Connors JM, Bilezikian JP, Lan- dry DW, Wan EY. Post-acute COVID-19 syndrome. Nat Med. 2021 Apr; 27(4): 601-615.
 
19.
Gasecka A, Pruc M, Kukula K, Gilis-Malinowska N, Filipiak KJ, Jaguszewski MJ, Szarpak L. Post-COVID-19 heart syndrome. Cardiol J. 2021; 28: 353-354.
 
20.
Ortona E, Buonsenso D, Carfi A, Malorni W; Long Covid Kids study group. Long COVID: an estrogen-associated autoimmune disease? Cell Death Discov. 2021 Apr; 7(1): 77.
 
21.
Gupta A, Mackay J, Whitehouse A, Godec T, Collier T, Pocock S, Poulter N, Sever P. Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy study: 16-year follow-up results of a randomised factorial trial. Lancet. 2018 Sep; 392(10153): 1127-1137.
 
22.
Fadel R, Morrison AR, Vahia A, Smith ZR, Chaudhry Z, Bhargava P, Miller J, Kenney RM, Alangaden G, Ramesh MS; Henry Ford COVID-19 Management Task Force. Early short course corticosteroids in hospitalized patients with COVID-19. Clin Infect Dis. 2020 Nov; 71(16): 2114-2120.
 
23.
Bartoletti M, Marconi L, Scudeller L, Pancaldi L, Tede- schi S, Giannella M, Rinaldi M, Bussini L, Valentini I, Ferravante AF, Potalivo A, Marchionni E, Fornaro G, Pasca- le R, Pasquini Z, Puoti M, Merli M, Barchiesi F, Volpato F, Rubin A, Saracino A, Tonetti T, Gaibani P, Ranie- ri VM, Viale P, Cristini F; PREDICO Study Group. Efficacy of corticosteroid treatment for hospitalized patients with severe COVID-19: a multicentre study. Clin Microbiol Infect. 2021 Jan; 27(1): 105-111.
 
24.
van Vark LC, Bertrand M, Akkerhuis KM, Brugts JJ, Fox K, Mourad JJ, Boersma E. Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of renin-angiotensin-aldosterone system inhibitors involving 158,998 patients. Eur Heart J. 2012 Aug; 33(16): 2088-2097.
 
25.
Rentsch C, Beckamn J, Tomlinson L, Gellad WF, Alcorn C, Kidwai-Khan F, Skanderson M, Brittain E, King Jr JT, Ho YL, Eden S, Kundu S, Lann MF, Greevy Jr RA, Ho PM, Heidenreich PA, Jacobson DA, Douglas IJ, Tate JP, Evans SJW, Atkins D, Justice AC, Freiberg MS . Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study. BMJ. 2021 Feb; 372: n311.
 
26.
European Society of Hypertension/European Society for Cardiology: ESC guidance for the diagnosis and management of CV disease during the COVID-19 pandemic; Available at: https://www.escardio.org/Educa... (last update: 10 June 2020).
 
27.
Wu J, Huang J, Zhu G, Liu Y, Xiao H, Zhou Q, Si X, Yi H, Wang C, Yang D, Chen S, Liu X, Liu Z, Wang Q, Lv Q, Huang Y, Yu Y, Guan X, Li Y, Nirantharakumar K, Cheng KK, Peng S, Xiao H. Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: a retrospective cohort study. medRxiv. 2020. https://doi.org/10.1101/2020.0....
 
28.
Tomazini BM, Maia IS, Cavalcanti AB, Berwanger O, Ro- sa RG, Veiga VC, Avezum A, Lopes RD, Bueno FR, Silva MVAO, Baldassare FP, Costa ELV, Moura RAB, Honora- to MO, Costa AN, Damiani LP, Lisboa T, Kawano-Dourado L, Zampieri FG, Olivato GB, Righy C, Amendola CP, Roepke RML, Freitas DHM, Forte DN, Freitas FGR, Fernandes CCF, Melro LMG, Junior GFS, Morais DC, Zung S, Machado FR, Azevedo LCP, COALITION COVID-19 Brazil III Investigators. Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19. JAMA. 2020 Oct; 324(13): 1-11.
 
29.
Liu Z, Li X, Fan G, Zhou F, Wang Y, Lixue H, Yu J, Yang L, Shang L, Xie K, Xu J, Huang Z, Gu X, Li H, Zhang Y, Wang Y, Huang Z, Cao B. Low-to-moderate dose corticosteroids treatment in hospitalized adults with COVID-19. Clin Microbiol Infect. 2021 Jan; 27(1): 112-117.
 
30.
Gao C, Cai Y, Zhang K i wsp. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. Eur Heart J 2020; 41: 2058-2066.
 
31.
Berger JR. COVID-19 and the nervous system. J Neurovirol. 2020 Apr; 26(2): 143-148.
 
32.
Gangopadhyay KK, Mukherjee JJ, Sinha B, Ghosal S. The role of corticosteroids in the management of critically ill patients with coronavirus disease 2019 (COVID-19): a meta-analysis medRxiv. 2020 April. doi: https://doi.org/10.1101/2020.0....
 
33.
Keller MJ, Kitsis EA, Arora S, Chen JT, Agarwal S, Ross MJ, Tomer Y, Southern W. Effect of systemic glucocorticoids on mortality or mechanical ventilation in patients with COVID-19. J Hospital Med. 2020 Aug; 15(8): 489-493.
 
34.
Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021 May; 8(5): 416-427.
 
35.
Chen J, Wu H, Yu Y, Tang N. Pulmonary alveolar regeneration in adult COVID-19 patients. Cell Res. 2020 Aug; 30(8): 708-710.
 
36.
Flerlage T, Boyd DF, Meliopoulos V, Thomas PG, Cherry SS. Influenza virus and SARS-CoV-2: pathogenesis and host responses in the respiratory tract. Nat Rev Microbiol. 2021; 19: 425-441.
 
37.
Rodríguez-Bano J, Pachon J, Carratala J, Ryan P, Jarrín I, Yllescas M, Arribas JR, Berenguer J; SAM-COVID Study Group. Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAMCOVID-19). Clin Microbiol Infect Dis. 2021; Feb; 27(2): 244-252.
 
38.
Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M; Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH). Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001 Nov; 86(5): 1327-1330.
 
39.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y,Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar; 395(10229): 1054-1062.
 
40.
Lu S, Zhou Q, Huang L, Shi Q, Zhao S, Wang Z, Li W, Tang Y, Ma Y, Luo X, Fukuoka T, Ahn HS, Lee MS, Luo Z, Liu E, Chen Y, Zhou C, Peng D; COVID-19 Evidence and Recommendations Working Group. Effectiveness and safety of glucocorticoids to treat COVID-19: a rapid review and meta-analysis. Ann Transl Med. 2020 May; 8(10): 627.
 
41.
Ye Z, Wang Y, Colunga-Lozano LE, Prasad M, Tangamornsuksan W, Rochwerg B, Yao L, Motaghi S, Couban RJ, Ghadimi M, Bala MM, Gomaa H, Fang F, Xiao Y, Guyatt GH. Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis. CMAJ. 2020 Jul; 192(27): E756-E767.
 
42.
Corral-Gudino L, Bahamonde A, Arnaiz-Revillas F, Gómez-Barquero J, Abadía-Otero J, García-Ibarbia C, Mora V, Cerezo-Hernández A, Hernández JL, López-Muńíz G, Hernández-Blanco F, Cifrián JM, Olmos JM, Carrascosa M, Nieto L, Farińas MC, Riancho JA; GLUCOCOVID investigators. Methylprednisolone in adults hospitalized with COVID-19 pneumonia: An open-label randomized trial (GLUCOCOVID). Wien Klin Wochenschr. 2021 Apr; 133(7-8): 303-311.
 
43.
Trybek A, Lichota P, Wilczyński J, Zieliński R. Neck phlegmon in COVID-19 patients. Stud Med. 2021 Dec; 37(4): 349-353.
 
44.
Lichota P, Wilczyński J, Zieliński R. Otolaryngological procedures during the COVID-19 pandemic. Stud Med. 2021 Jun; 37(2): 140-144.
 
45.
Wang Y, Jiang W, He Q, Wang C, Wang B, Zhou P, Dong N, Tong Q. A retrospective cohort study of methylprednisolone therapy in severe patients with COVID-19 pneumonia. Signal Transduct Target Ther. 2020 Apr; 5(1): 57.
 
46.
Bani-Sadr F, Hentzien M, Pascard M, N’Guyen Y, Servettaz A, Andreoletti L, Kanagaratnam L, Jolly D. Corticosteroid therapy for patients with COVID-19 pneumonia: a before-after study. Int J Antimicrob Agents. 2020 Aug; 56(2): 106077.
 
47.
Hu Y, Wang T, Hu Z, Wang X, Zhang Z, Li L, Peng P. Clinical efficacy of glucocorticoid on the treatment of patients with COVID-19 pneumonia: a single-center experience. Biomed Pharmacother. 2020 Oct; 130: 110529.
 
48.
Li Q, Li W, Jin Y, Xu W, Huang C, Li L, Huang Y, Fu Q, Chen L. Efficacy evaluation of early, low-dose, short-term corticosteroids in adults hospitalized with non-severe COVID-19 pneumonia: a retrospective cohort study. Infect Dis Ther. 2020 Dec; 9(4): 823-836.
 
49.
Ma Y, Zeng H, Zhan Z, Lu H, Zeng Z, He C, Liu X, Chen C, Qin Q, He J, Zhou Z, Huang P, Jiang M, Deng D, Liao X, Xiang Z, Huang X, Chen Y, Chen P. Corticosteroid use in the treatment of COVID-19: a multicenter retrospective study in Hunan, China. Front Pharmacol. 2020 Aug; 11: 1198.
 
50.
Ruiz-Irastorza G, Pijoan JI, Bereciartua E, Dunder S, Dominguez J, Garcia-Escudero P, Rodrigo A, Gomez-Carbal- lo C, Varona J, Guio L, Ibarrola M, Ugarte A, Martinez-Berriotxoa A; the Cruces COVID Study Group. Second week methyl-prednisolone pulses improve prognosis in patients with severe coronavirus disease 2019 pneumonia: an observational comparative study using routine care data. PLoS One. 2020; 15(9): e0239401.
 
51.
Yang R, Xiong Y, Ke H, Chen T, Gao S. The role of methylprednisolone on preventing disease progression for hospitalized patients with severe COVID-19. Eur J Clin Invest. 2020 Nov; 50: e13412.
 
52.
Wei C, Liu Y, Liu Y, Zhang K, Su D, Zhong M, Meng X. Clinical characteristics and manifestations in older patients with COVID-19. BMC Geriatr. 2020 Oct; 20(1): 395.
 
53.
Rubio-Rivas M, Ronda M, Padulles A, Mitjavila F, Riera-Mestre A, García-Forero C, Iriarte A, Mora JM, Padul- les N, Gonzalez M, Solanich X, Gasa M, Suarez-Cuartin G, Sabater J, Perez-Fernandez XL, Santacana E, Leiva E, Ariza- Sole A, Dallaglio PD, Quero M, Soriano A, Pasqualetto A, Koo M, Esteve V, Antoli A, Moreno-Gonzalez R, Yun S, Cerda P, Llaberia M, Formiga F, Fanlo M, Montero A, Chivite D, Capdevila O, Bolao F, Pinto X, Llop J, Sabate A, Guardiola J, Cruzado JM, Comin-Colet J, Santos S, Jodar R, Corbella X. Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness. Int J Infect Dis. 2020 Dec; 101: 290-297.
 
54.
Narain S. Comparative survival analysis of immunomodulatory therapy for COVID-19 ‘cytokine storm’: a retrospective observational cohort study (6/9/2020). SSRN: https://ssrn.com/abstract=3627... or http://dx.doi.org/10.2139/ssrn....
 
55.
Wu J, Jianqiang H, Guochao Z, Yihao L, Han X, Qian Z, Xiang Si, Yi H, Wang C, Yang D, Chen S, Liu X, Liu Z, Wang Q, Lv Q, Huang Y, Yu Y, Guan X, Li Y, Nirantharakumar K, Cheng KK, Peng S, Xiao H. Systemic corticosteroids show no benefit in severe and critical COVID-19 patients in Wuhan, China: a retrospective cohort study. J Clin Endocrinol Metabol. 2020 Dec; 105(12): dgaa627.
 
56.
Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19. A meta-analysis. The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. JAMA. 2020; 324(13): 1330-1341.
 
57.
Chen X, Zhu B, Hong W, Zeng J, He X, Chen J, Zheng H, Qiu S, Deng Y, Chan JC, Wang J, Zhang Y. Associations of clinical characteristics and treatment regimens with the duration of viral RNA shedding in patients with COVID-19. Int J Infect Dis. 2020 Sep; 98: 252-260.
 
58.
Salton F, Confalonieri P, Meduri GU, Santus P, Harari S, Scala R, Lanini S, Vertui V, Oggionni T, Caminati A, Patruno V, Tamburrini M, Scartabellati A, Parati M, Villani M, Radovanovic D, Tomassetti S, Ravaglia C, Poletti V, Vianello A, Gaccione AT, Guidelli L, Raccanelli R, Lucerno- ni P, Lacedonia D, Foschino Barbaro MP, Centanni S, Mondoni M, Davì M, Fantin A, Cao X, Torelli L, Zucchet- to A, Montico M, Casarin A, Romagnoli M, Gasparini S, Bonifazi M, D’Agaro P, Marcello A, Licastro D, Ruaro B, Volpe MC, Umberger R, Confalonieri M. Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia. medRxiv. 2020 Jan; 2020.06.17.20134031.
 
eISSN:2300-6722
ISSN:1899-1874
Journals System - logo
Scroll to top