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Meta-Analysis
. 2023 May;16(5):660-672.
doi: 10.1016/j.jiph.2023.03.005. Epub 2023 Mar 7.

Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review

Yong-Bo Zheng  1 , Na Zeng  2 , Kai Yuan  3 , Shan-Shan Tian  3 , Ying-Bo Yang  4 , Nan Gao  4 , Xuan Chen  4 , An-Yi Zhang  3 , Alexandra L Kondratiuk  5 , Pei-Pei Shi  6 , Fang Zhang  7 , Jie Sun  8 , Jing-Li Yue  3 , Xiao Lin  3 , Le Shi  3 , Ajit Lalvani  5 , Jie Shi  9 , Yan-Ping Bao  10 , Lin Lu  11
Affiliations
Meta-Analysis

Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review

Yong-Bo Zheng et al. J Infect Public Health. 2023 May.

Abstract

Background: Millions of COVID-19 pediatric survivors are facing the risk of long COVID after recovery from acute COVID-19. The primary objective of this study was to systematically review the available literature and determine the pooled prevalence of, and risk factors for long COVID among the pediatric survivors.

Methods: Studies that assessed the prevalence of, or risk factors associated with long COVID among pediatric COVID-19 survivors were systematically searched in PubMed, Embase, and Cochrane Library up to December 11th, 2022. Random effects model was performed to estimate the pooled prevalence of long COVID among pediatric COVID-19 patients. Subgroup analyses and meta-regression on the estimated prevalence of long COVID were performed by stratification with follow-up duration, mean age, sex ratio, percentage of multisystem inflammatory syndrome, hospitalization rate at baseline, and percentage of severe illness.

Results: Based on 40 studies with 12,424 individuals, the pooled prevalence of any long COVID was 23.36 % ([95 % CI 15.27-32.53]). The generalized symptom (19.57 %, [95 % CI 9.85-31.52]) was reported most commonly, followed by respiratory (14.76 %, [95 % CI 7.22-24.27]), neurologic (13.51 %, [95 % CI 6.52-22.40]), and psychiatric (12.30 %, [95% CI 5.38-21.37]). Dyspnea (22.75 %, [95% CI 9.38-39.54]), fatigue (20.22 %, [95% CI 9.19-34.09]), and headache (15.88 %, [95 % CI 6.85-27.57]) were most widely reported specific symptoms. The prevalence of any symptom during 3-6, 6-12, and> 12 months were 26.41 % ([95 % CI 14.33-40.59]), 20.64 % ([95 % CI 17.06-24.46]), and 14.89 % ([95 % CI 6.09-26.51]), respectively. Individuals with aged over ten years, multisystem inflammatory syndrome, or had severe clinical symptoms exhibited higher prevalence of long COVID in multi-systems. Factors such as older age, female, poor physical or mental health, or had severe infection or more symptoms were more likely to have long COVID in pediatric survivors.

Conclusions: Nearly one quarter of pediatric survivors suffered multisystem long COVID, even at 1 year after infection. Ongoing monitoring, comprehensive prevention and intervention is warranted for pediatric survivors, especially for individuals with high risk factors.

Keywords: COVID-19; Children; Inflammatory multisystem syndrome; Long COVID.

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Conflict of interest statement

Conflict of interest The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow chart of the selection process.
Fig. 2
Fig. 2
Estimation of prevalence of long COVID among pediatric patients.
Fig. 3
Fig. 3
Estimation of reported long COVID symptoms examined by five or more studies.
Fig. 4
Fig. 4
Subgroup analysis of prevalence of long COVID in pediatric patients during different follow-up duration.
Fig. 5
Fig. 5
Subgroup analysis of prevalence of long COVID in pediatric patients.
See this image and copyright information in PMC

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