|Title||Long-term sequelae and health-related quality-of-life associated with Lyme disease: A systematic review|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Mac S, Bahia S, Simbulan F, Pullenayegum EM, Evans GA, Patel SN, Sander B|
|Journal||Clin Infect Dis|
|Keywords||borrelia burgdorferi, Lyme borreliosis, Lyme disease, quality-of-life, systematic review|
Lyme disease (LD) is the most commonly reported vector-borne disease, but its clinical consequences remain uncertain. We conducted a systematic review of the long-term sequelae and health-related quality-of-life (HRQoL) associated with LD in North America and Europe. We performed searches in six electronic databases up to December 2018 following PRISMA guidelines, including observational studies reporting long-term sequelae, HRQoL, and prognostic factors. We included 46 studies, published between 1994 and 2019. Based on 21 studies reporting attributable outcomes, higher proportions of sequelae reported from exposed patients were: neck pain, myalgia, arthralgia, paresthesia, sleep disorder, poor appetite and concentration difficulties. Patients with PTLDS reported impaired HRQoL compared to the general US population. Included studies were highly heterogeneous in terms of study design, settings, patient characteristics and quality. Patients with LD are more likely to report non-specific long-term sequelae, especially those experiencing persistent symptoms post-treatment. Opportunities exist for prospective longitudinal studies to better understand LD outcomes.