Burden, causation, and particularities of Long COVID in African populations: A rapid systematic review

OBJECTIVES: To determine the prevalence of long COVID, its most common symptoms, comorbidities, and pathophysiological mechanisms in African populations. METHODS: A systematic review of long COVID in African populations was conducted. The random effects model was used to calculate the pooled prevalence rates (95% CI). A narrative synthesis was also performed. RESULTS: We included 14 studies from seven African countries, totaling 6030 previously SARS-CoV-2 infected participants and 2954 long COVID patients. Long COVID had a pooled prevalence of 41% (26-56%). Fatigue, dyspnea, and confusion or lack of concentration were the most common symptoms, with prevalence rates (95% CI) of 41% (26-56%), 25% (12-38%), and 40% (12-68%), respectively. Long COVID was mainly associated with advanced age, being female, more than three long COVID symptoms in the acute phase, initial fatigue and dyspnea, COVID-19 severity, pre-existing obesity, hypertension, diabetes mellitus, and the presence of any chronic illness (P ≤0.05). High microclot and platelet-poor plasma viscosity explained the pathophysiology of long COVID. CONCLUSION: Long COVID prevalence in Africa was comparable to the global prevalence. The most common symptoms were higher in Africa. Comorbidities associated with long COVID may lead to additional complications in African populations due to hypercoagulation and thrombosis. Systematic review registration: PROSPERO CRD42023430024