ArticleThe Lancet regional health. Europe2021
Prevalence of persistent symptoms after treatment for lyme borreliosis: A prospective observational cohort study.
Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 56 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Association between spirochaetal infection and neurodegenerative diseases: a systematic review and quantitative synthesis of observational studies.Journal of medical microbiology · 2026Pooled it
- Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis.German medical science : GMS e-journal · 2025Guideline
- Treatment of post-treatment Lyme disease symptoms-a systematic review.European journal of neurology · 2024Pooled it
- A second yearly booster dose of the VLA15 Lyme borreliosis vaccine candidate in healthy individuals.Nature communications · 2026Trial
- Curiouser and curiouser: understanding the intersection of inter- and intra-specific diversity during theInfection and immunity · 2026Review
- Post-Treatment Lyme Disease Syndrome in Six European Countries Using Data from the Burden of Lyme Disease (BOLD) Study.Pathogens (Basel, Switzerland) · 2026Article
- Patient-Reported Health-Related Quality of Life Impact and Symptom Severity in Patients with Lyme Borreliosis in the Burden of Lyme Disease (BOLD) Study.Pathogens (Basel, Switzerland) · 2026Article
- The Journey of Adult Patients with Lyme Disease in the United States: A Qualitative Interview Study and Patient-Reported, Health-Related Quality-of-Life Assessment.Advances in therapy · 2026Article
- Designing studies for post-treatment Lyme disease and other infection-associated chronic illnesses.Brain : a journal of neurology · 2026Review
- Epidemiology, diagnosis and emerging therapies for Lyme disease of the Northern Hemisphere.International journal of emergency medicine · 2026Review
- Lyme borreliosis.Nature reviews. Disease primers · 2026Review
- Evaluation of immunoreactive epitopes in the sera and cerebrospinal fluid of patients with post-treatment Lyme disease syndrome.Scientific reports · 2026Article
- Seeing the forest through the trees: Harmonizing infection-associated chronic illnesses research.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Healthcare Consumption and Work Absenteeism of Individuals With and Without Persistent Complaints After COVID-19: The Role of Cognitive-Behavioural Factors, Neuropsychological Functioning and Depressive Symptoms.International journal of behavioral medicine · 2026Article
- Patient roadmap and economic burden of chronic tick-borne illness and post-treatment Lyme disease syndrome in Ireland, and public health issues arising.Frontiers in public health · 2026Article
- Long-term Cardiac Sequelae in Lyme Carditis: A Review.Current cardiology reviews · 2026Review
- Evidence-domain translation in the Lyme disease controversy over persistent post-treatment symptoms.Frontiers in cellular and infection microbiology · 2026Article
- Nonspecific Symptoms Attributable to Lyme Disease in High-Incidence Areas, United States, 2017-2021.Emerging infectious diseases · 2025Article
- Prevalence and clinical characteristics of Norwegians who report persistent health complaints attributed to tick bites or tick-borne diseases.BMC infectious diseases · 2025Article
- Temporal Dynamic Interplay of Mouse Proteome during ProtozoanJournal of proteome research · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConcerns about long-lasting symptoms attributed to Lyme borreliosis (LB) are widespread in the Western world, while such symptoms are highly prevalent in the general population.
methodsIn the largest prospective study to date, adults with physician-confirmed LB were included at the start of antibiotic treatment. Primary outcomes, prevalence of persistent symptoms and symptom severity, were assessed using three-monthly standardised questionnaires during one year. Persistent symptoms were defined as impaired scores for fatigue (CIS, subscale fatigue), cognitive impairment (CFQ) or pain (SF-36, subscale bodily pain) ≥6 months, with onset <6 months. Outcomes were compared with a longitudinal general population and a tick-bite cohort without LB as a reference.
findingsOf 1135 LB patients (94•8% erythema migrans, 5•2% disseminated LB), 1084 fulfilled primary analysis criteria, as well as 1942 population and 1887 tick-bite controls. Overall prevalence of persistent symptoms in LB patients was 27•2% (95%CI, 24•7%-29•7%); 6•0% and 3•9% higher than in population (21•2%, 95%CI, 19•3%-23•1%;
interpretationIn treated LB patients, persistent symptoms were significantly more prevalent and symptoms were more severe than in individuals without LB, although the background prevalence was substantial. This suggests an association, either direct or indirect, between persistent symptoms and LB in a relatively small subset of patients.
fundingZonMw; Dutch Ministry of Health, Welfare and Sport.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.