{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:26:58Z","timestamp":1786688818175,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-COVID-19 condition is a major source of long-term morbidity after SARS-CoV-2 infection. Patients hospitalized for COVID-19 may be at particularly high risk because hospitalization often reflects greater acute disease severity and comorbidity burden. However, evidence on risk factors in previously hospitalized populations remains inconsistent due to differences in outcome definitions, follow-up periods, and analytical approaches. This systematic review and meta-analysis aimed to identify risk factors associated with post-COVID outcomes among patients previously hospitalized for COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis was conducted following PRISMA 2020 principles. PubMed\/MEDLINE, Scopus, Web of Science Core Collection, and the WHO COVID-19 Global Literature Database were searched for studies published between 1 January 2020 and 24 February 2026. Eligible studies included hospitalized patients with confirmed or probable COVID-19, assessed post-acute outcomes at least 4 weeks after acute infection, hospitalization, recovery, or discharge, and evaluated at least one candidate risk factor. Adjusted effect estimates were prioritized, and random-effects meta-analyses were performed when at least two comparable estimates were available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven studies were included in the qualitative synthesis, and seven contributed to quantitative meta-analysis. Five risk-factor groups were pooled: female sex, acute disease severity or respiratory support, intensive care unit (ICU) admission, vaccination status, and hypertension. Female sex was associated with higher odds of post-COVID outcomes (OR 1.94, 95% CI 1.60\u20132.35;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 6.9%). The strongest association was observed for greater acute disease severity or advanced respiratory support (OR 2.55, 95% CI 1.77\u20133.68;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 13.0%). ICU admission (OR 1.88, 95% CI 1.24\u20132.83), no or incomplete vaccination (OR 1.90, 95% CI 1.33\u20132.72), and hypertension (OR 1.60, 95% CI 1.16\u20132.20) were also associated with increased odds. Additional predictors, including obesity, age, smoking, dysgeusia, symptom burden, and neurological or psychiatric comorbidity, were summarized narratively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among previously hospitalized COVID-19 patients, the most consistent risk factors for post-COVID outcomes were female sex, greater acute disease severity or respiratory support, ICU admission, no or incomplete vaccination, and hypertension. These findings support risk-based post-discharge follow-up, although the evidence remains limited by heterogeneous outcome definitions and the small number of studies available for several risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1911482","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:32:01Z","timestamp":1786685521000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for post-COVID-19 condition among previously hospitalized COVID-19 patients: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Samal","family":"Kassymbek","sequence":"first","affiliation":[{"name":"Research Institute of Preventive Medicine named after Academician E. Dalenov, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aigul","family":"Abduldayeva","sequence":"additional","affiliation":[{"name":"Research Institute of Preventive Medicine named after Academician E. Dalenov, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay","family":"Safonov","sequence":"additional","affiliation":[{"name":"Research Institute of Preventive Medicine named after Academician E. Dalenov, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnur","family":"Doszhanova","sequence":"additional","affiliation":[{"name":"Research Institute of Preventive Medicine named after Academician E. Dalenov, Astana Medical University","place":["Astana, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"B1","volume-title":"A Clinical Case Definition Of Post Covid-19 Condition By A Delphi Consensus","year":"2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1016\/S1473-3099(21)00703-9","article-title":"A clinical case definition of post-COVID-19 condition by a Delphi consensus","volume":"22","author":"Soriano","year":"2022","journal-title":"Lancet Infect Dis."},{"key":"B3","volume-title":"Clinical overview of Long COVID","year":""},{"key":"B4","volume-title":"Covid-19 Rapid Guideline: Managing The Long-Term Effects Of Covid-19","year":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: major findings, mechanisms and recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat Rev Microbiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"101762","DOI":"10.1016\/j.eclinm.2022.101762","article-title":"The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: a systematic review and meta-analysis","volume":"55","author":"O'Mahoney","year":"2023","journal-title":"EClinicalMedicine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e005427","DOI":"10.1136\/bmjgh-2021-005427","article-title":"Characterising long COVID: a living systematic review","volume":"6","author":"Michelen","year":"2021","journal-title":"BMJ Glob Health."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e2111417","DOI":"10.1001\/jamanetworkopen.2021.11417","article-title":"Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: a systematic review","volume":"4","author":"Nasserie","year":"2021","journal-title":"JAMA Netw Open."},{"key":"B10","doi-asserted-by":"publisher","first-page":"698169","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or post-acute sequelae of COVID-19: biological factors contributing to persistent symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Front Microbiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-month consequences of COVID-19 in patients discharged from hospital: a cohort study","volume":"397","author":"Huang","year":"2021","journal-title":"Lancet."},{"key":"B12","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/S0140-6736(21)01755-4","article-title":"1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study","volume":"398","author":"Huang","year":"2021","journal-title":"Lancet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/S2213-2600(22)00127-8","article-title":"Clinical characteristics with inflammation profiling of Long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study","volume":"10","year":"2022","journal-title":"Lancet Respir Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1136\/thoraxjnl-2020-215818","article-title":"\u2018Long-COVID': a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19","volume":"76","author":"Mandal","year":"2021","journal-title":"Thorax."},{"key":"B15","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1186\/s12916-022-02448-4","article-title":"Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective cohort study in Moscow (StopCOVID)","volume":"20","author":"Pazukhina","year":"2022","journal-title":"BMC Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2481","DOI":"10.1038\/s41598-023-28839-y","article-title":"Vaccination status and Long COVID symptoms in patients discharged from hospital","volume":"13","author":"Nascimento","year":"2023","journal-title":"Sci Rep."},{"key":"B17","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.cmi.2021.11.002","article-title":"Female gender is associated with long COVID syndrome: a prospective cohort study","volume":"28","author":"Bai","year":"2022","journal-title":"Clin Microbiol Infect."},{"key":"B18","doi-asserted-by":"publisher","first-page":"9581","DOI":"10.1038\/s41598-022-13077-5","article-title":"\u2018Long COVID' results after hospitalization for SARS-CoV-2 infection","volume":"12","author":"Rigoni","year":"2022","journal-title":"Sci Rep."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1038\/s41598-025-31598-7","article-title":"Prevalence and impact of long COVID on health-related quality of life in previously hospitalized COVID-19 patients: a 2-year follow-up study","volume":"16","author":"Lersritwimanmaen","year":"2025","journal-title":"Sci Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1016\/j.ijid.2022.07.063","article-title":"Persistent symptoms, quality of life, and risk factors in long COVID: a cross-sectional study of hospitalized patients in Brazil","volume":"122","author":"de Oliveira","year":"2022","journal-title":"Int J Infect Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"101624","DOI":"10.1016\/j.eclinm.2022.101624","article-title":"Impact of COVID-19 vaccination on the risk of developing Long COVID and on existing Long COVID symptoms: a systematic review","volume":"53","author":"Notarte","year":"2022","journal-title":"EClinicalMedicine."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.1016\/S0140-6736(22)00941-2","article-title":"Risk of Long COVID associated with delta versus omicron variants of SARS-CoV-2","volume":"399","author":"Antonelli","year":"2022","journal-title":"Lancet."},{"key":"B23","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"B24","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst Rev."},{"key":"B25","volume-title":"The Newcastle-Ottawa Scale For Assessing The Quality Of Non Randomised Studies In Meta-Analyses","author":"Wells","year":""},{"key":"B26","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials."},{"key":"B27","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ."},{"key":"B28","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the Metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"J Stat Softw."},{"key":"B30","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R: a practical tutorial","volume":"22","author":"Balduzzi","year":"2019","journal-title":"Evid Based Ment Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1001\/jamainternmed.2023.0750","article-title":"Risk factors associated with post-COVID-19 condition: a systematic review and meta-analysis","volume":"183","author":"Tsampasian","year":"2023","journal-title":"JAMA Intern Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1056\/NEJMsb2408466","article-title":"Long COVID defined","volume":"391","author":"Ely","year":"2024","journal-title":"N Engl J Med."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.03.006","article-title":"Number of initial symptoms is more related to Long COVID-19 than acute severity of infection: a prospective cohort of hospitalized patients","author":"Chan Sui Ko","year":"2022","journal-title":"Int J Infect Dis."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e1247","DOI":"10.1016\/S2214-109X(22)00286-8","article-title":"Post-COVID-19 condition after hospitalisation for COVID-19 in South Africa: a prospective cohort study","volume":"10","author":"Dryden","year":"2022","journal-title":"Lancet Glob Health."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1911482\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:32:02Z","timestamp":1786685522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1911482\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":34,"alternative-id":["10.3389\/fpubh.2026.1911482"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1911482","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"article-number":"1911482"}}