ArticleBMJ global health2025
Long COVID prevalence and risk factors in adults residing in middle- and high-income countries: secondary analysis of the multinational Anti-Coronavirus Therapies (ACT) trials.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- SARS-CoV-2 spike-armed vesicular stomatitis virus recapitulates severe COVID-19 acute respiratory distress syndrome in mice.iScience · 2026Article
- Strict long COVID, symptom persistence, and functional decline among community-dwelling older adults in Quito, Ecuador: a cross-sectional study.BMC geriatrics · 2026Article
- Barriers to Long COVID Care in the U.S.: An Application of Levesque et al.'s Access Framework.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Longitudinal study of genome-wide DNA methylation in individuals with and without post-acute symptoms following SARS-CoV-2 infection.Epigenomics · 2026Article
- The role of artificial intelligence in managing COVID-19 and long COVID: a narrative review.Osong public health and research perspectives · 2026Article
- SARS-CoV-2 Spike Protein Amyloid Fibrils Impair Fibrin Formation and Fibrinolysis.Biochemistry · 2025Article
- The long-term effects of COVID-19 on oxygen carrying capacity in adults at the University of Limpopo, South Africa.Frontiers in medicine · 2025Article
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Abstract
backgroundDuring the recent COVID-19 pandemic, reports of long-term persistence or recurrence of symptoms after SARS-CoV-2 infection emerged, which are now collectively referred to as 'long COVID'. Most descriptions of long COVID originate from patients residing in high-income countries. We set out to characterise long COVID in a large-scale clinical trial that was conducted in low-middle, high-middle and high-income countries.
methodsThe Anti-Coronavirus Therapies trials enrolled 6528 adult patients with symptomatic COVID-19 in Argentina, Brazil, Canada, Colombia, Ecuador, Egypt, India, Nepal, Pakistan, Philippines, Russia, Saudi Arabia, South Africa and the United Arab Emirates. Long COVID was defined as the presence of patient-reported symptoms at 180 days after enrolment. Multivariable logistic regression was used to evaluate associations of baseline characteristics with long COVID.
resultsOf 4697 included participants, 1181 (25.1%) reported long COVID symptoms. The most frequently reported symptoms were sleeping disorders (n=601; 12.8%), joint pain (n=461; 9.8%), fatigue (n=410; 8.7%) and headaches (n=382; 8.1%). Long COVID prevalence was higher in participants from lower middle-income compared with high-income countries (29.8% (850/2854) vs 14.4% (102/706); adjusted OR (aOR) 1.53 (1.10 to 2.14); p=0.012). Prevalence also varied between participants of different ethnic backgrounds and was highest (36.1% (775/2145)) for patients of Arab/North African ethnicity. Patients requiring inpatient admission were at increased risk of long COVID (aOR: 2.04 (1.63 to 2.54); p<0.001). Other independent predictors of long COVID were male sex, older age and hypertension. Vaccination, prior lung disease, smoking and diabetes mellitus conferred protective effects.
conclusionSymptoms of long COVID are reported in a quarter of cases of symptomatic COVID-19 in this study and were significantly more prevalent in participants from countries with lower income status and in patients of Arab/North African ethnicity. Research to further assess the health burden posed by long COVID in low- and middle-income countries is urgently needed.
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