More than 20 months after doctors identified the first human cases of COVID-19, the disease’s impact continues to be felt all over the world. As patients recover from the disease and try to return to their everyday lives, what kind of long-term side effects—cardiovascular and otherwise—should they anticipate?

The team behind a new systematic review and meta-analysis in Scientific Reports explored this very question, reviewing evidence from 15 different studies and listing every long-term effect they could find.

“Symptoms, signs, or abnormal clinical parameters persisting two or more weeks after COVID-19 onset that do not return to a healthy baseline can potentially be considered long-term effects of the disease,” wrote lead author Sandra Lopez-Leon, MD, PhD, an epidemiologist with Novartis Pharmaceuticals, and colleagues. “Although such alteration is mainly reported in severe and critical disease survivors, the lasting effects also occur in individuals with a mild infection who did not require hospitalization.”

The group examined data from nearly 49,000 adult patients with a confirmed COVID-19 diagnosis. Approximately 80% of all infected patients developed at least one long-term side effect related to COVID-19. The most common long-term side effects were fatigue (58%), headache (44%), attention disorder (27%), hair lost (25%) and dyspnea (24%). While 11% of patients developed an elevated resting heart rate, 11% also developed heart palpitations. Cases of diabetes (4%), stroke (3%), new hypertension (1%) and myocarditis (1%) were also reported among the patient population.