Objective: We aimed to systematically evaluate the long-term neurological effects of COVID-19 among recovered patients, to help in planning in the pandemic recovery phase.

Background: During the early stages of the COVID-19 pandemic, neuropsychiatric symptoms emerged as a prominent feature of coronavirus outbreaks. However, the persistence of neurological symptoms in the post-acute and chronic phases remained unclear.

Methods: We conducted comprehensive searches in five electronic databases. Out of 6,570 titles, we included 55 studies that reported neurological symptoms in the post-acute or later phases after COVID-19 infection. This comprised data from a total of 360,272 patients within the first 6 months after infection. We calculated pooled prevalence using Open-Meta[analyst].

Results: The most frequent neuropsychiatric symptom within the first 6 months after infection was fatigue, with a pooled prevalence of 45.1% (95% CI, 41.5%–48.6%). This was followed by memory disorders at 35.3% (95% CI, 23% to 47.6%), objectively measured sleep disorders at 32% (95% CI, 26%–38.1%), concentration impairment at 22.3% (95% CI, 15.8%–28.8%), stress at 20% (95% CI, 11.4%–28.6%), anxiety at 17.8% (95% CI, 14.5%–21.2%), and dizziness at 17.6% (95% CI, 15.5%–20.1%). Between-study heterogeneity was high (I2 =96.99%–99.83%). A subgroup analysis of the studies was conducted based on the study design, but this heterogeneity was not resolved. After conducting a meta-regression analysis of studies based on age, we found that there was no significant correlation between the age of patients and the effect estimate in terms of the prevalence of these conditions.

Conclusion: Neurological symptoms are common and persist in COVID-19 survivors, suggesting a substantial burden of these issues. This highlights the need for multidisciplinary services and resource allocation in the post-COVID era.