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Meta-Analysis
. 2022 Jun 23;12(1):9950.
doi: 10.1038/s41598-022-13495-5.

Long-COVID in children and adolescents: a systematic review and meta-analyses

Sandra Lopez-Leon  1   2 , Talia Wegman-Ostrosky  3 , Norma Cipatli Ayuzo Del Valle  4 , Carol Perelman  5 , Rosalinda Sepulveda  6 , Paulina A Rebolledo  7   8 , Angelica Cuapio  9 , Sonia Villapol  10   11
Affiliations
Meta-Analysis

Long-COVID in children and adolescents: a systematic review and meta-analyses

Sandra Lopez-Leon et al. Sci Rep. .

Abstract

The objective of this systematic review and meta-analyses is to estimate the prevalence of long-COVID in children and adolescents and to present the full spectrum of symptoms present after acute COVID-19. We have used PubMed and Embase to identify observational studies published before February 10th, 2022 that included a minimum of 30 patients with ages ranging from 0 to 18 years that met the National Institute for Healthcare Excellence (NICE) definition of long-COVID, which consists of both ongoing (4 to 12 weeks) and post-COVID-19 (≥ 12 weeks) symptoms. Random-effects meta-analyses were performed using the MetaXL software to estimate the pooled prevalence with a 95% confidence interval (CI). Heterogeneity was assessed using I2 statistics. The Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) reporting guideline was followed (registration PROSPERO CRD42021275408). The literature search yielded 8373 publications, of which 21 studies met the inclusion criteria, and a total of 80,071 children and adolescents were included. The prevalence of long-COVID was 25.24%, and the most prevalent clinical manifestations were mood symptoms (16.50%), fatigue (9.66%), and sleep disorders (8.42%). Children infected by SARS-CoV-2 had a higher risk of persistent dyspnea, anosmia/ageusia, and/or fever compared to controls. Limitations of the studies analyzed include lack of standardized definitions, recall, selection, misclassification, nonresponse and/or loss of follow-up, and a high level of heterogeneity.

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Conflict of interest statement

The authors are solely responsible for all content, and funders played no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript. S.L.L. is an employee of Novartis Pharmaceutical Company; the statements presented in the paper do not necessarily represent the position of the company. The remaining authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA diagram with exclusion criteria. Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) screening process flow. Out of 8373 identified studies and after applying the inclusion and exclusion criteria, 21 studies were included in the quantitative synthesis.
Figure 2
Figure 2
The pooled prevalence of long-COVID by symptoms in children and adolescents. Meta-analyses revealed that the prevalence of more than 40 long-COVID symptoms in children and adolescents. The presence of one or more symptoms following a SARS-CoV-2 infection was 25.24%.
Figure 3
Figure 3
Forest plot of pooled prevalence of long-COVID overall in children and adolescents.
Figure 4
Figure 4
Pooled odds ratios with 95% CI in cases vs. controls. The size of each box indicates the effect of each study by symptom assigned using the odds ratios (95% CI) by age and domain.
See this image and copyright information in PMC

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