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Meta-Analysis Systematic Review Journal Article Ppublish 288 citations

PubMed: 36774332 DOI: 10.1016/j.vaccine.2023.02.008

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis.

Vaccine 41(11):1783-1790

Authors: Atsuyuki Watanabe, Masao Iwagami, Jun Yasuhara, Hisato Takagi, Toshiki Kuno

Affiliations

  • Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
  • Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  • Center for Cardiovascular Research, The Abigail Wexner Research Institute and The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
  • Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
  • Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.

Abstract

BACKGROUND

The relationship between coronavirus disease 2019 (COVID-19) vaccination and long COVID has not been firmly established. We conducted a systematic review and meta-analysis to evaluate the association between COVID-19 vaccination and long COVID.

METHODS

PubMed and EMBASE databases were searched on September 2022 without language restrictions (CRD42022360399) to identify prospective trials and observational studies comparing patients with and without vaccination before severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We also included studies reporting symptomatic changes of ongoing long COVID following vaccination among those with a history of SARS-CoV-2 infection. Odds ratios (ORs) for each outcome were synthesized using a random-effects model. Symptomatic changes after vaccination were synthesized by a one-group meta-analysis.

RESULTS

Six observational studies involving 536,291 unvaccinated and 84,603 vaccinated (before SARS-CoV-2 infection) patients (mean age, 41.2-66.6; female, 9.0-67.3%) and six observational studies involving 8,199 long COVID patients (mean age, 40.0 to 53.5; female, 22.2-85.9%) who received vaccination after SARS-CoV-2 infection were included. Two-dose vaccination was associated with a lower risk of long COVID compared to no vaccination (OR, 0.64; 95% confidence interval [CI], 0.45-0.92) and one-dose vaccination (OR, 0.60; 95% CI, 0.43-0.83). Two-dose vaccination compared to no vaccination was associated with a lower risk of persistent fatigue (OR, 0.62; 95% CI, 0.41-0.93) and pulmonary disorder (OR, 0.50; 95% CI, 0.47-0.52). Among those with ongoing long COVID symptoms, 54.4% (95% CI, 34.3-73.1%) did not report symptomatic changes following vaccination, while 20.3% (95% CI, 8.1-42.4%) experienced symptomatic improvement after two weeks to six months of COVID-19 vaccination.

CONCLUSIONS

COVID-19 vaccination before SARS-CoV-2 infection was associated with a lower risk of long COVID, while most of those with ongoing long COVID did not experience symptomatic changes following vaccination.

MeSH

Coronavirus, Sars-Cov-2, Vaccines, Vaccination, Covid-19, Infections, Post-Acute Covid-19 Syndrome

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