RT Journal Article SR Electronic T1 Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis JF European Respiratory Review JO EUROPEAN RESPIRATORY REVIEW FD European Respiratory Society SP 220071 DO 10.1183/16000617.0071-2022 VO 31 IS 166 A1 Bang Zheng A1 Luke Daines A1 Qing Han A1 John R. Hurst A1 Paul Pfeffer A1 Manu Shankar-Hari A1 Omer Elneima A1 Samantha Walker A1 Jeremy S. Brown A1 Salman Siddiqui A1 Jennifer K. Quint A1 Christopher E. Brightling A1 Rachael A. Evans A1 Louise V. Wain A1 Liam G. Heaney A1 Aziz Sheikh YR 2022 UL http://err.ersjournals.com/content/31/166/220071.abstract AB Persistent breathlessness >28 days after acute COVID-19 infection has been identified as a highly debilitating post-COVID symptom. However, the prevalence, risk factors, mechanisms and treatments for post-COVID breathlessness remain poorly understood. We systematically searched PubMed and Embase for relevant studies published from 1 January 2020 to 1 November 2021 (PROSPERO registration number: CRD42021285733) and included 119 eligible papers. Random-effects meta-analysis of 42 872 patients with COVID-19 reported in 102 papers found an overall prevalence of post-COVID breathlessness of 26% (95% CI 23–29) when measuring the presence/absence of the symptom, and 41% (95% CI 34–48) when using Medical Research Council (MRC)/modified MRC dyspnoea scale. The pooled prevalence decreased significantly from 1–6 months to 7–12 months post-infection. Post-COVID breathlessness was more common in those with severe/critical acute infection, those who were hospitalised and females, and was less likely to be reported by patients in Asia than those in Europe or North America. Multiple pathophysiological mechanisms have been proposed (including deconditioning, restrictive/obstructive airflow limitation, systemic inflammation, impaired mental health), but the body of evidence remains inconclusive. Seven cohort studies and one randomised controlled trial suggested rehabilitation exercises may reduce post-COVID breathlessness. There is an urgent need for mechanistic research and development of interventions for the prevention and treatment of post-COVID breathlessness.A sizable proportion of patients with COVID-19 experienced post-COVID breathlessness, and the prevalence estimate varied by population characteristics and methodological approaches. Further research on mechanisms and interventions for this sequela is needed. https://bit.ly/3P5ayv6