{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:14:07Z","timestamp":1790140447660,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":324,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n The COVID\u201019 pandemic due to SARS\u2010CoV\u20102 has initiated historically unparalleled global health, social, and economic impacts. Syntheses of the multivariable interdependent effects on the multiple clinical, immunologic, psychosocial, and health service realms are required to guide current and future public health preparedness and policy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic review of a meta\u2010analysis was conducted using the PubMed, Scopus, and Web of Science databases from December 2019 to 2025 to identify observational studies and randomized controlled trials. Quantitative reporting studies of COVID\u201019 outcomes were included. Random\u2010effects model aggregated effect sizes were estimated and tested for heterogeneity with Cochran's Q,\n \u03c4<\/jats:italic>\n 2<\/jats:sup>\n , and\n I<\/jats:italic>\n 2<\/jats:sup>\n . Subgroup, moderator, publication bias, sensitivity, and leave\u2010one\u2010out analyses were conducted for exploration and validation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty\u2010four studies were classified into three categories: clinical outcomes (15 studies), immunogenicity (4 studies), and psychosocial\/health service outcomes (5 studies). There was no statistically significant pooled effect (effect ratio 0.95, 95% CI: 0.55\u20131.62) with severe heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009>\u200999%). Immunogenicity showed a statistically significant positive effect (pooled estimate 0.77, 95% CI: 0.38\u20131.16) with high heterogeneity (I\n 2<\/jats:sup>\n ~96%). Psychosocial effects were highly heterogeneous with non\u2010significant overall effects (estimate \u22121.03, 95% CI: \u22125.74 to 3.69). Sample size was an influential moderator that explained significant between\u2010group heterogeneity.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The outcomes reveal robust immunogenic vaccine impacts and indeterminate psychosocial and clinical impacts, consistent with the heterogeneity and complexity of COVID\u201019 effects. Great heterogeneity highlights methodological standardization and cautious interpretation. This present meta\u2010analysis offers key lessons to guide subsequent study design and manufacture of fair health policy and pandemic readiness.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/crj.70134","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T08:39:08Z","timestamp":1763714348000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["COVID\u201019 Pandemic: A Comprehensive Meta\u2010Review of Global Impacts, Responses, and Future Preparedness"],"prefix":"10.1111","volume":"19","author":[{"given":"Rulin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nurses at Medical College Xijing University Xi'an Shaanxi China"},{"name":"Department of Nursing, Faculty of Medicine and Health Sciences MAHSA University Jenjarom Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4366-298X","authenticated-orcid":false,"given":"Muhammad\u00a0Ahsan","family":"Naeem","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences (Pharmacology) University of Veterinary and Animal Sciences Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa033"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclepro.2021.127705"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010047832"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41541\u2010023\u201000773\u20100"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2021.08.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.894103"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pnp.708"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.worlddev.2020.105233"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.06.004"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czab089"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adq2887"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae420"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0280280"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.41053"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102020\u2010218946"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11050563"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hsr.2023.100099"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004741"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(22)00169\u20102"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab593"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1275843"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1668576"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010069989"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1136031"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)02143\u20107"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2020.102066"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2019.433"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13578"}],"container-title":["The Clinical Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.70134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T04:31:35Z","timestamp":1764563495000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/crj.70134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/crj.70134"],"URL":"https:\/\/doi.org\/10.1111\/crj.70134","archive":["Portico"],"relation":{},"ISSN":["1752-6981","1752-699X"],"issn-type":[{"value":"1752-6981","type":"print"},{"value":"1752-699X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70134"}}