text: COVID 19 sequelae in adults aged less than 50 years A systematic review There is emerging evidence of long term sequelae in a considerable proportion of COVID 19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed This review aims to evaluate the available evidence of all intermediate and long term COVID 19 sequelae affecting formerly healthy adults A systematic literature search of Embase WHO Scopus Pubmed Litcovid bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO CRD42020208725 Search terms included COVID 19 coronavirus disease 2019 SARS CoV 2 sequelae and consequence Publications on adult participants with a confirmed SARS CoV 2 infection were included Elderly 50 years old and children 18 years old were excluded Bias assessment was performed using a modified Newcastle Ottawa Scale A total of 31 papers were included Study types included prospective and retrospective cohort studies cross sectional studies and case reports Sequelae persistence since infection spanned 14 days to three months Sequelae included persistent fatigue 39 73 of assessed persons breathlessness 39 74 decrease in quality of life 44 69 impaired pulmonary function abnormal CT findings including pulmonary fibrosis 39 83 evidence of peri perimyo myocarditis 3 26 changes in microstructural and functional brain integrity with persistent neurological symptoms 55 increased incidence of psychiatric diagnoses 5 8 versus 2 5 3 4 in controls incomplete recovery of olfactory and gustatory dysfunction 33 36 of evaluated persons A variety of organ systems are affected by COVID 19 in the intermediate and longer term after recovery Main sequelae include post infectious fatigue persistent reduced lung function and carditis Careful follow up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality 