Long COVID: A Protocol for Systematic Review and Meta-analysis of Symptomatology and Treatment Approaches

Abstract Background:The burden of SAR COV-2 infection is not limited to the acute viraemia and its symptomatology but extends far beyond to include the long COVID, also known as post-COVID-19 syndrome,which may soon reach public health significance. We set out to produce a protocol for reliable and accurate systematic review and meta-analysis of the symptomatology and treatment approaches of long COVID globally.Methods:We developed a search strategy using MeSH terms, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Researchgate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the pooled prevalence of the symptoms of long COVID. The secondary outcomes include the summary effect sizes of the treatment approaches to the long COVID; the geographic, race, gender and age variations in symptomatology, and the quality of life of patients with long COVID. Identified studies will be screened, deduplicated, selected and data items extracted using DistillerSR software. All studies will be assessed for methodological, clinical and statistical heterogeneity. Assessment of meta-bias in the selected studies will be performed using the NIH Quality assessment tool for observational studies. Publication bias will be assessed using the funnel plot and Egger’s regression intercept. The pooled prevalence will be expressed with SE and 95% CI. The strength of evidence from this analysis will be assessed using the NIH Quality Assessment for Systematic Reviews and Meta-analysis.Discussion: This analysis will map globally the symptoms of long COVID and its correlates, exploring the influences of geographic locations, race, age and gender, thereby enabling a severity index on a global scale. It will examine in detail the treatment approaches to the long COVID and their impacts on the quality of life of patients. The evidence from this study will inform health policies toward the management of post-COVID-19 syndrome. The outcome of this study will be published in peer-reviewed scientific journal.Trial Registration Number:This protocol is registered with PROSPERO, registration number CRD42021236457