Abstract The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with I 2 . Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies ( n = 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14–182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4–34.4%)], followed by fatigue [24.4% (17.5–32.9%)], objective cognitive impairment [20.2% (10.3–35.7%)], anxiety [19.1% (13.3–26.8%)] and post-traumatic stress [15.7% (9.9–24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high ( I 2 = 79.6–98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection. In a systematic review and meta-analysis, Badenoch et al. report frequent neuropsychiatric symptoms persisting up to 6 months after COVID-19, including insomnia, fatigue, anxiety, post-traumatic symptoms, cognitive impairment and mood disorder. Health services should plan for a high requirement for multidisciplinary services (including neurological, neuropsychiatric and psychological management) after COVID-19. Graphical Abstract Graphical Abstract
【저자키워드】 COVID-19, Long COVID, post-acute sequelae of COVID-19, neuropsychiatry, chronic COVID syndrome, 【초록키워드】 Meta-analysis, pandemic, Anxiety, Stress, Hospitalization, fatigue, mental health, severity, Infection, systematic review, Symptom, database, Symptoms, heterogeneity, Prevalence, COVID-19 infection, management, Cognitive impairment, Neuropsychiatric, COVID-19 hospitalization, Insomnia, Psychological, Follow-up, moderate, patients, Evidence, Frequency, post-traumatic, neurological, Anxiety Disorder, Sleep disturbance, control group, 95% confidence interval, help, CINAHL, PsycINFO, control groups, disorder, survivor, controls, consequence, prevalent, was measured, conducted, linear, calculated, indicate, searched, unique, curated, duration of follow-up, peer-reviewed study, reported symptom, Subgroup analysis, 【제목키워드】 Meta-analysis, systematic review, Symptom, Neuropsychiatric, persistent,