Melsew Setegn Alie ^1* Getayeneh Antehunegn Tesema ^2,3 Gossa Fetene Abebe ⁴ Desalegne Girma ⁵

• ¹ School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
• ² Institute of Public Health, University of Gondar, Gondar, Amhara Region, Ethiopia
• ³ School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
• ⁴ Department of nursing, college of medicine and health Science, mizan tepi, Mizan, SNNPR, Ethiopia
• ⁵ Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia

Background: Survivors of COVID-19 frequently encounter enduring and substantial challenges affecting their physical, mental, and financial well-being, which can significantly diminish their overall quality of life. The persistence of symptoms or the emergence of new ones after a SARS-CoV-2 diagnosis has led to a complex clinical issue known as "long COVID" (LC). This situation has placed additional strain on global healthcare systems, highlighting the necessity for ongoing clinical management of these patients. While multiple studies were conducted on long sequelae of COVID-19, there is no systematic review and meta-analysis in Sub-Saharan Africa.Objective: This study aimed to systematically synthesize evidence on the persistent sequelae of COVID-19 and their predictors in Sub-Saharan Africa.Methods: A thorough search was conducted across multiple databases, including PubMed/MEDLINE, Web of Science, Google/Google Scholar, African online journals, and selected reference lists, from the inception of these databases until January 12, 2024. A meta-analysis of proportions was conducted using the random-effects restricted maximum-likelihood model.Additionally, the association between different factors was analyzed to determine the pooled factors that influence long-term COVID-19 outcomes.A comprehensive analysis of 16 research papers, involving a total of 18104 participants, was conducted. The overall pooled prevalence of COVID-19 sequelae was found to be 42.1% (95%CI; 29.9-55.4). The long-term health sequelae reported in this review included persistent pulmonary sequelae (27.5%), sleep disturbance (22.5%), brain fog (27.4%), fatigue (17.4%), anxiety (22.3%), and chest pain (13.2%). Furthermore, a significant association was observed between comorbidities and long-term COVID-19 sequelae (POR= 4.34 (95% CI: 1.28-14.72)).: COVID-19 can have lasting effects on various organ systems, even after a person has recovered. These effects can include brain fog, pulmonary symptoms, sleep disturbances, anxiety, fatigue, and other neurological, psychiatric, respiratory, cardiovascular, and general symptoms. It's important for individuals who have recovered from COVID-19 to receive careful follow-up care to assess and address any potential organ damage and maintain their quality of life.