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Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  Among individuals who had symptomatic SARS-CoV-2 infection in 2020 and 2021, what proportion experienced common self-reported Long COVID symptom clusters 3 months after initial infection?

Findings  This observational analysis involved bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. The modeled estimated proportion with at least 1 of the 3 self-reported Long COVID symptom clusters 3 months after symptomatic SARS-CoV-2 infection was 6.2%, including 3.7% for ongoing respiratory problems, 3.2% for persistent fatigue with bodily pain or mood swings, and 2.2% for cognitive problems after adjusting for health status before COVID-19.

Meaning  This study presents modeled estimates of the proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

Abstract

Importance  Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).

Objective  To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration.

Design, Setting, and Participants  Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022.

Exposures  Symptomatic SARS-CoV-2 infection.

Main Outcomes and Measures  Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age.

Results  A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months.

Conclusions and Relevance  This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

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Article Information

Corresponding Author: Theo Vos, PhD, Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA 98195 (tvos@uw.edu).

Accepted for Publication: September 25, 2022.

Published Online: October 10, 2022. doi:10.1001/jama.2022.18931

Authors/Global Burden of Disease Long COVID Collaborators: Sarah Wulf Hanson, PhD; Cristiana Abbafati, PhD; Joachim G. Aerts, MD; Ziyad Al-Aly, MD; Charlie Ashbaugh, MA; Tala Ballouz, MD; Oleg Blyuss, PhD; Polina Bobkova, MD; Gouke Bonsel, PhD; Svetlana Borzakova, MD; Danilo Buonsenso, MD; Denis Butnaru, PhD; Austin Carter, MPH; Helen Chu, MD; Cristina De Rose, MD; Mohamed Mustafa Diab, MD; Emil Ekbom, MD; Maha El Tantawi, PhD; Victor Fomin, PhD; Robert Frithiof, PhD; Aysylu Gamirova, BSc; Petr V. Glybochko, PhD; Juanita A. Haagsma, PhD; Shaghayegh Haghjooy Javanmard, PhD; Erin B. Hamilton, MPH; Gabrielle Harris, PhD; Majanka H. Heijenbrok-Kal, PhD; Raimund Helbok, MD; Merel E. Hellemons, PhD; David Hillus, MD; Susanne M. Huijts, PhD; Michael Hultström, PhD; Waasila Jassat, MMed; Florian Kurth, MD; Ing-Marie Larsson, PhD; Miklós Lipcsey, PhD; Chelsea Liu, MSc; Callan D. Loflin, BA; Andrei Malinovschi, PhD; Wenhui Mao, PhD; Lyudmila Mazankova, MD; Denise McCulloch, MD; Dominik Menges, MD; Noushin Mohammadifard, PhD; Daniel Munblit, PhD; Nikita A. Nekliudov, MD; Osondu Ogbuoji, ScD; Ismail M. Osmanov, MD; José L. Peñalvo, PhD; Maria Skaalum Petersen, PhD; Milo A. Puhan, PhD; Mujibur Rahman, MD; Verena Rass, PhD; Nickolas Reinig, BS; Gerard M. Ribbers, PhD; Antonia Ricchiuto, MD; Sten Rubertsson, PhD; Elmira Samitova, MD; Nizal Sarrafzadegan, MD; Anastasia Shikhaleva, BSc; Kyle E. Simpson, BS; Dario Sinatti, MD; Joan B. Soriano, MD; Ekaterina Spiridonova, BSc; Fridolin Steinbeis, MD; Andrey A. Svistunov, PhD; Piero Valentini, MD; Brittney J. van de Water, PhD; Rita van den Berg-Emons, PhD; Ewa Wallin, PhD; Martin Witzenrath, MD; Yifan Wu, MPH; Hanzhang Xu, PhD; Thomas Zoller, PhD; Christopher Adolph, PhD; James Albright, BS; Joanne O. Amlag, MPH; Aleksandr Y. Aravkin, PhD; Bree L. Bang-Jensen, MA; Catherine Bisignano, MPH; Rachel Castellano, MA; Emma Castro, MS; Suman Chakrabarti, MA; James K. Collins, BS; Xiaochen Dai, PhD; Farah Daoud, BS; Carolyn Dapper, MA; Amanda Deen, MPH; Bruce B. Duncan, MD; Megan Erickson, MA; Samuel B. Ewald, MS; Alize J. Ferrari, PhD; Abraham D. Flaxman, PhD; Nancy Fullman, MPH; Amiran Gamkrelidze, PhD; John R. Giles, PhD; Gaorui Guo, MPH; Simon I. Hay, DPhil; Jiawei He, MSc; Monika Helak, BA; Erin N. Hulland, MPH; Maia Kereselidze, PhD; Kris J. Krohn, MPH; Alice Lazzar-Atwood, BSc; Akiaja Lindstrom, MEpi; Rafael Lozano, MD; Deborah Carvalho Malta, PhD; Johan Månsson, MS; Ana M. Mantilla Herrera, PhD; Ali H. Mokdad, PhD; Lorenzo Monasta, DSc; Shuhei Nomura, PhD; Maja Pasovic, MEd; David M. Pigott, PhD; Robert C. Reiner Jr, PhD; Grace Reinke, MA; Antonio Luiz P. Ribeiro, MD; Damian Francesco Santomauro, PhD; Aleksei Sholokhov, MSc; Emma Elizabeth Spurlock, MPH; Rebecca Walcott, MPH; Ally Walker, MA; Charles Shey Wiysonge, MD; Peng Zheng, PhD; Janet Prvu Bettger, DSc; Christopher J. L. Murray, DPhil; Theo Vos, PhD.

Affiliations of Authors/Global Burden of Disease Long COVID Collaborators: Institute for Health Metrics and Evaluation, University of Washington, Seattle (Wulf Hanson, Ashbaugh, Carter, Hamilton, Reinig, Simpson, Wu, Albright, Amlag, Aravkin, Bang-Jensen, Bisignano, Castellano, Castro, Chakrabarti, Collins, Dai, Daoud, Dapper, Deen, Erickson, Ewald, Ferrari, Flaxman, Fullman, Giles, Guo, Hay, He, Helak, Hulland, Krohn, Lazzar-Atwood, Lozano, Månsson, Mokdad, Pasovic, Pigott, Reiner Jr, Reinke, Santomauro, Sholokhov, Spurlock, Walker, Zheng, Murray, Vos); Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy (Abbafati); Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands (Aerts, Hellemons); John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri (Al-Aly); Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, Missouri (Al-Aly); Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland (Ballouz, Menges, Puhan); Wolfson Institute of Population Health, Queen Mary University of London, London, England (Blyuss); Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Blyuss, Munblit); Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Bobkova, Shikhaleva); EuroQol Research Foundation, Rotterdam, the Netherlands (Bonsel); Pirogov Russian National Research Medical University, Moscow (Borzakova, Osmanov); Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department, Moscow, Russia (Borzakova); Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy (Buonsenso, De Rose, Sinatti, Valentini); Global Health Research Institute, Catholic University of Sacred Heart, Rome, Italy (Buonsenso); I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Butnaru); Department of Medicine, University of Washington, Seattle (Chu); Center for Policy Impact in Global Health, Duke University, Durham, North Carolina (Diab, Mao); Department of Surgery, Duke University, Durham, North Carolina (Diab); Uppsala University Hospital, Uppsala, Sweden (Ekbom); Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt (El Tantawi); Rector’s Office, I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Fomin); Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden (Frithiof, Hultström, Larsson, Lipcsey, Rubertsson, Wallin); Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Gamirova, Nekliudov, Spiridonova); Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia (Glybochko, Svistunov); Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands (Haagsma); Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran (Haghjooy Javanmard); School of Nursing, Duke University, Durham, North Carolina (Harris, Loflin); Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands (Heijenbrok-Kal, Ribbers, van den Berg-Emons); Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, the Netherlands (Heijenbrok-Kal); Department of Neurology, Medical University Innsbruck, Innsbruck, Austria (Helbok, Rass); Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany (Hillus, Steinbeis, Zoller); Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands (Huijts); Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden (Hultström); Department of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa (Jassat); Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany (Kurth, Witzenrath); Department of Clinical Research and Tropical Medicine, Bernhard-Nocht Institute of Tropical Medicine, Hamburg, Germany (Kurth); Department of Epidemiology, Harvard University, Boston, Massachusetts (Liu); Department of Medical Sciences, Uppsala University, Uppsala, Sweden (Malinovschi); Duke Global Health Institute, Duke University, Durham, North Carolina (Mao, Ogbuoji); Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow (Mazankova, Samitova); Department of Medicine, University of Washington, Seattle (McCulloch); Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran (Mohammadifard, Sarrafzadegan); National Heart and Lung Institute, Imperial College London, London, England (Munblit); ZA Bashlyaeva Children’s Municipal Clinical Hospital, Moscow, Russia (Osmanov, Samitova); Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium (Peñalvo); Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (Peñalvo); Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands (Petersen); Centre of Health Science, University of Faroe Islands, Torshavn (Petersen); Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland (Puhan); Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh (Rahman); Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (Ricchiuto); Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden (Rubertsson); School of Population and Public Health, University of British Columbia, Vancouver, Canada (Sarrafzadegan); Hospital Universitario de La Princesa, Madrid, Spain (Soriano); Centro de Investigación Biomédica en Red Enfermedades Respiratorias (Center for Biomedical Research in Respiratory Diseases Network), Madrid, Spain (Soriano); Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts (van de Water); Nursing and Midwifery Department, Seed Global Health, Boston, Massachusetts (van de Water); German Center for Lung Research, Berlin (Witzenrath); Department of Family Medicine and Community Health, Duke University, Durham, North Carolina (Xu); Department of Political Science, University of Washington, Seattle (Adolph); Center for Statistics and the Social Sciences, University of Washington, Seattle (Adolph); Department of Applied Mathematics, University of Washington, Seattle (Aravkin); Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle (Aravkin, Dai, Flaxman, Hay, Lozano, Mokdad, Pigott, Reiner Jr, Zheng, Murray, Vos); Department of Global Health, University of Washington, Seattle (Chakrabarti, Hulland); Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Duncan); School of Public Health, University of Queensland, Brisbane, Australia (Ferrari, Lindstrom, Mantilla Herrera, Santomauro); National Center for Disease Control and Public Health, Tbilisi, Georgia (Gamkrelidze, Kereselidze); School of Public Health, Queensland Centre for Mental Health Research, Wacol, Australia (Lindstrom); Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil (Malta); West Moreton Hospital Health Services, Queensland Centre for Mental Health Research, Wacol, Australia (Mantilla Herrera); Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy (Monasta); Department of Health Policy and Management, Keio University, Tokyo, Japan (Nomura); Department of Global Health Policy, University of Tokyo, Tokyo, Japan (Nomura); Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (Ribeiro); Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil (Ribeiro); Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia (Santomauro); Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut (Spurlock); Evans School of Public Policy and Governance, University of Washington, Seattle (Walcott); Cochrane South Africa, South African Medical Research Council, Cape Town (Wiysonge); HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban (Wiysonge); Department of Orthopedic Surgery, Duke University, Durham, North Carolina (Bettger).

Author Contributions: Drs Wulf Hanson and Vos had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Bettger, Murray, and Vos are co–senior authors.

Concept and design: Wulf Hanson, Butnaru, Diab, Hultström, Mao, Ogbuoji, Valentini, Hay, Kereselidze, Mokdad, Sholokhov, Spurlock, Bettger, Vos.

Acquisition, analysis, or interpretation of data: Wulf Hanson, Abbafati, Aerts, Al-Aly, Ashbaugh, Ballouz, Blyuss, Bobkova, Bonsel, Borzakova, Buonsenso, Carter, Chu, De Rose, Diab, Ekbom, El Tantawi, Fomin, Frithiof, Gamirova, Glybochko, Haagsma, Haghjooy Javanmard, Hamilton, Harris, Heijenbrok-Kal, Helbok, Hellemons, Hillus, Huijts, Hultström, Jassat, Kurth, Larsson, Lipcsey, Liu, Loflin, Malinovschi, Mao, Mazankova, McCulloch, Menges, Mohammadifard, Munblit, Nekliudov, Ogbuoji, Osmanov, Peñalvo, Petersen, Puhan, Rahman, Rass, Reinig, Ribbers, Ricchiuto, Rubertsson, Samitova, Sarrafzadegan, Shikhaleva, Simpson, Sinatti, Soriano, Spiridonova, Steinbeis, Svistunov, van de Water, van den Berg-Emons, Wallin, Witzenrath, Wu, Xu, Zoller, Adolph, Albright, Amlag, Aravkin, Bang-Jensen, Bisignano, Castellano, Castro, Chakrabarti, Collins, Dai, Daoud, Dapper, Deen, Duncan, Erickson, Ewald, Ferrari, Flaxman, Fullman, Gamkrelidze, Giles, Guo, He, Helak, Hulland, Kereselidze, Krohn, Lazzar-Atwood, Lindstrom, Lozano, Malta, Månsson, Mantilla Herrera, Mokdad, Monasta, Nomura, Pasovic, Pigott, Reiner, Reinke, Ribeiro, Santomauro, Spurlock, Walcott, Walker, Wiysonge, Zheng, Bettger, Murray, Vos.

Drafting of the manuscript: Wulf Hanson, Bobkova, Butnaru, Carter, Fomin, Gamirova, Glybochko, Helbok, Loflin, Reinig, Ricchiuto, Shikhaleva, Simpson, Sinatti, Spiridonova, Svistunov, Wu, Albright, Amlag, Castellano, He, Krohn, Lindstrom, Mokdad, Murray, Vos.

Critical revision of the manuscript for important intellectual content: Wulf Hanson, Abbafati, Aerts, Al-Aly, Ashbaugh, Ballouz, Blyuss, Bonsel, Borzakova, Buonsenso, Chu, De Rose, Diab, Ekbom, El Tantawi, Frithiof, Haagsma, Haghjooy Javanmard, Hamilton, Harris, Heijenbrok-Kal, Helbok, Hellemons, Hillus, Huijts, Hultström, Jassat, Kurth, Larsson, Lipcsey, Liu, Loflin, Malinovschi, Mao, Mazankova, McCulloch, Menges, Mohammadifard, Munblit, Nekliudov, Ogbuoji, Osmanov, Peñalvo, Petersen, Puhan, Rahman, Rass, Ribbers, Rubertsson, Samitova, Sarrafzadegan, Soriano, Steinbeis, Valentini, van de Water, van den Berg-Emons, Wallin, Witzenrath, Xu, Zoller, Adolph, Aravkin, Bang-Jensen, Bisignano, Castro, Chakrabarti, Collins, Dai, Daoud, Dapper, Deen, Duncan, Erickson, Ewald, Ferrari, Flaxman, Fullman, Gamkrelidze, Giles, Guo, Hay, Helak, Hulland, Kereselidze, Krohn, Lazzar-Atwood, Lozano, Malta, Månsson, Mantilla Herrera, Mokdad, Monasta, Nomura, Pasovic, Pigott, Reiner, Reinke, Ribeiro, Santomauro, Sholokhov, Spurlock, Walcott, Walker, Wiysonge, Zheng, Bettger, Murray, Vos.

Statistical analysis: Wulf Hanson, Blyuss, Bonsel, Buonsenso, Carter, Diab, Haagsma, Heijenbrok-Kal, Hultström, Kurth, Ogbuoji, Ricchiuto, Simpson, Soriano, Wu, Albright, Aravkin, Castellano, Castro, Collins, Dai, Flaxman, Giles, Guo, He, Kereselidze, Lazzar-Atwood, Mokdad, Pigott, Reiner, Spurlock, Zheng, Vos.

Obtained funding: Frithiof, Hultström, Kurth, Ogbuoji, Petersen, Puhan, Ribbers, van den Berg-Emons, Witzenrath, Hay, Mokdad, Pigott.

Administrative, technical, or material support: Wulf Hanson, Ashbaugh, Borzakova, Buonsenso, Butnaru, De Rose, Diab, Ekbom, Haghjooy Javanmard, Hamilton, Harris, Hillus, Kurth, Larsson, Lipcsey, Malinovschi, Mao, Mohammadifard, Munblit, Nekliudov, Ogbuoji, Osmanov, Peñalvo, Puhan, Rahman, Reinig, Samitova, Steinbeis, Valentini, Wallin, Witzenrath, Wu, Adolph, Amlag, Bang-Jensen, Chakrabarti, Collins, Daoud, Deen, Flaxman, Gamkrelidze, Guo, Hay, Helak, Krohn, Månsson, Mantilla Herrera, Mokdad, Monasta, Nomura, Pigott, Reinke, Ribeiro, Santomauro, Spurlock, Walcott, Walker, Wiysonge, Zheng.

Supervision: Wulf Hanson, Abbafati, Chu, Haghjooy Javanmard, Helbok, Hultström, Kurth, Mazankova, Munblit, Puhan, Rahman, Ribbers, Valentini, Zoller, Amlag, Daoud, Hay, Kereselidze, Mokdad, Pigott, Murray, Vos.

Conflict of Interest Disclosures: Drs Bobkova, Munblit, and Svistunov and Mss Gamirova, Shikhaleva, and Spiridonova reported receiving grants and contracts paid to Sechenov University from the British Embassy in Moscow for the StopCOVID Cohort: Clinical Characterisation of Russian Patients 2020-2021. Dr Haagsma reported receiving grants from the EuroQol Foundation. Dr Lipcsey reported receiving grants from and having contracts with Hjärt-Lungfonden (Swedish Heart Lung Foundation) and being a member of data and safety monitoring boards for the PROFLO and COVID-19 Hyperbaric Oxygen randomized clinical trials. Dr Munblit reported receiving grants paid to Sechenov University from the Russian Foundation for Basic Research and the UK Research and Innovation/National Institute for Health Research; receiving personal fees from Merck Sharp & Dohme and Bayer; and having unpaid leadership positions as co-chair of the International Severe Acute Respiratory and Emerging Infection Consortium Global Pediatric Long COVID Working Group and co-lead of the PC-COS (Post-COVID Condition Core Outcomes) Project. Dr Petersen reported being on the board of the Faroese National Data Protection Authority and receiving equipment, materials, drugs, medical writing, gifts, or other services from Beijing Wantai Biological Pharmacy Enterprise Co Ltd. Dr Puhan reported receiving support from the University of Zurich Foundation and the Department of Health, Canton of Zurich. Dr Flaxman reported having stock options in Agathos Ltd and receiving personal fees from Janssen, Swiss Re, Merck for Mothers, and Sanofi. Ms Fullman reported receiving personal fees from the World Health Organization and receiving funding from Gates Ventures. No other disclosures were reported.

Funding/Support: Erasmus University Medical Center received funding from the ZonMW COVID-19 Programme, Laurens (the Netherlands), and Rijndam Rehabilitation. The Institute for Health Metrics and Evaluation at the University of Washington received funding from the Bill & Melinda Gates Foundation and Bloomberg Philanthropies. Uppsala University received funding from the Knut and Alice Wallenburg Foundation, the Swedish Heart-Lung Foundation, the Swedish Kidney Foundation, the Swedish Society of Medicine, and the Swedish Research Council. The Queensland Centre for Mental Health Research received funding from the Queensland Department of Health. The Iran National Science Foundation, the National Institute of Health Researchers of Iran, and the World Health Organization provided funding for Drs Haghjooy Javanmard, Mohammadifard, and Sarrafzadegan. Cooperation’s p/f Krunborg and Borgartun, the Velux Foundation, the Faroese Research Council, the Faroese Parkinson’s Association, and the Faroese Health Insurance Fund provided funding for Dr Petersen. The National Institute on Aging and the National Institute on Minority Health and Health Disparities provided funding for Dr Xu. The Benificus Foundation provided funding for Dr Adolph. The National Science Foundation provided funding for Drs Aravkin and Reiner. The Ministry of Health (Rome, Italy) and the Institute for Maternal and Child Health IRCCS Burlo Garofolo (Trieste, Italy) provided funding for Dr Monasta. The Ministry of Education, Culture, Sports, Science, and Technology of Japan provided funding for Dr Nomura. The South African Medical Research Council provided funding for Dr Wiysonge.

Role of the Funder/Sponsor: The funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 5.

Additional Contributions: We thank the researchers, health care professionals, caregivers, and people experiencing Long COVID who have shared their knowledge and experiences with us.

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