Complications of Covid-19: A Systematic Review and Meta-Analysis

Abstract

Objectives: COVID-19, primarily a respiratory disease, can have complications that affect all organ systems of the body. There is a paucity of systematic reviews on all the complications. In this systematic review and meta-analysis, we set out to summarize the complications of COVID-19 in all body systems and their prevalence. Methods: PubMed and Google Scholar were searched for eligible articles using predefined criteria. Database searching and extraction were performed by independent reviewers. Results: We identified 74 case reports/series and 15 observational studies. In both the case reports/series and observational studies, pulmonary complications were the most commonly reported, particularly pneumonia, followed by neurological complications in case reports/case series and hematological complications in observational studies. Atrial arrhythmias (1.7%) and acute myopericarditis (1.7%), liver injury (3.3%), acute kidney injury (8.8%), deep venous thrombosis (2.2%), ischemic stroke (12.2%), herpes zoster (1.1%), and diabetic ketoacidosis (1.1%) were the most reported cardiovascular, gastrointestinal, renal, hematological, neurological, dermatological, and endocrine complications respectively in case reports/series. However, acute myocarditis (100%), hypoproteinemia (15.9-28.8%), transient acute renal failure (49.9-90.1%), acute coagulopathy (16.5-28.4%), and ischemic stroke (1.3-3.9%) had the highest pooled prevalence for cardiovascular, gastrointestinal, renal, hematological, and neurological complications respectively in observational studies. Conclusion: The complications of COVID-19 are multi-systemic with pulmonary complications being the most commonly reported. Notwithstanding, healthcare professionals should be aware that COVID-19 is a differential diagnosis for even the rare but equally debilitating complications and should screen patients who develop these complications to rule out COVID-19 during the pandemic and beyond. J Microbiol Infect Dis 2021; 11(2): 45-57.

Keywords

• Covid-19
• Systematic review
• SARS-CoV-2
• Complications
• Sequelae

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