text: Post COVID syndrome A case series and comprehensive review The existence of a variety of symptoms with a duration beyond the acute phase of COVID 19 is referred to as post COVID syndrome PCS We aimed to report a series of patients with PCS attending a Post COVID Unit and offer a comprehensive review on the topic Adult patients with previously confirmed SARS CoV 2 infection and PCS were systematically assessed through a semi structured and validated survey Total IgG IgA and IgM serum antibodies to SARS CoV 2 were evaluated by an electrochemiluminescence immunoassay A systematic review of the literature and meta analysis were conducted following PRISMA guidelines Univariate and multivariate methods were used to analyze data Out of a total of 100 consecutive patients 53 were women the median of age was 49 years IQR 37 8 55 3 the median of post COVID time after the first symptoms was 219 days IQR 143 258 and 65 patients were hospitalized during acute COVID 19 Musculoskeletal digestive i e diarrhea and neurological symptoms including depression by Zung scale were the most frequent observed in PCS patients A previous hospitalization was not associated with PCS manifestation Arthralgia and diarrhea persisted in more than 40 of PCS patients The median of anti SARS CoV 2 antibodies was 866 2 U mL IQR 238 2 1681 Despite this variability 98 patients were seropositive Based on autonomic symptoms by COMPASS 31 two clusters were obtained with different clinical characteristics Levels of anti SARS CoV 2 antibodies were not different between clusters A total of 40 articles 11 196 patients were included in the meta analysis Fatigue muscle weakness dyspnea pain and discomfort anxiety depression and impaired concentration were presented in more than 20 of patients reported In conclusion PCS is mainly characterized by musculoskeletal pulmonary digestive and neurological involvement including depression PCS is independent of severity of acute illness and humoral response Long term antibody responses to SARS CoV 2 infection and a high inter individual variability were confirmed Future studies should evaluate the mechanisms by which SARS CoV 2 may cause PCS and the best therapeutic options 