]. However, the heterogeneity in study designs and settings between different studies makes it difficult to draw conclusions. Therefore, we conducted a systematic review and meta-analysis to pool the available data from studies and estimate the prevalence of the chronic pulmonary sequelae of PACS persisting 6–12 months after acute COVID-19. Particularly, we focused on the prevalence of abnormalities demonstrated by objective tools of pulmonary assessment, including PFT and chest CT.].
Disease severity was determined according to the current global guideline with slight modifications for the purpose of our study []. Because the included studies did not employ the universal disease severity criteria and as some did not clearly present data on disease severity using the predefined criteria, patients who required supplemental oxygen therapy were considered as having severe COVID-19.
Regarding PFT data, we extracted the percent predicted values for the diffusion capacity for carbon monoxide , forced vital capacity , and total lung capacity . Subsequently, we obtained data on the prevalence of impairment of these lung function parameters using a cutoff of 80% of the predicted values or lower limit of normal , as presented in the searched studies.
For the searched studies with follow-up chest CT data, the prevalence of pulmonary fibrosis as a sequela of COVID-19 was estimated. Although most studies clearly presented the number of patients who developed pulmonary fibrosis, some studies only reported the prevalence of various individual CT findings, including ground-glass opacity , reticulation, traction bronchiectasis, interstitial thickening, parenchymal band, and consolidation.
]. The proportion of patients without any residual abnormal findings on follow-up CT was also reviewed.We assessed the risk of bias of included studies using a tool developed and validated for prevalence studies [
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