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Meta-Analysis
. 2023 Dec 28;18(12):e0293600.
doi: 10.1371/journal.pone.0293600. eCollection 2023.

Persistent symptoms are associated with long term effects of COVID-19 among children and young people: Results from a systematic review and meta-analysis of controlled studies

Sanaz Behnood  1 , Fiona Newlands  2 , Lauren O'Mahoney  3 , Mahta Haghighat Ghahfarokhi  4 , Mohammed Z Muhid  5 , Jake Dudley  2 , Terence Stephenson  2 , Shamez N Ladhani  6 , Sophie Bennett  2 , Russell M Viner  2 , Rowan Bhopal  2 , Paige Kolasinska  2 , Roz Shafran  2 , Olivia V Swann  7   8 , Andrea Takeda  9
Affiliations
Meta-Analysis

Persistent symptoms are associated with long term effects of COVID-19 among children and young people: Results from a systematic review and meta-analysis of controlled studies

Sanaz Behnood et al. PLoS One. .

Abstract

Background: Research on the long-term impact on COVID-19 in children and young people (CYP) has been published at pace. We aimed to update and refine an earlier systematic review and meta-analysis to assess the current evidence for Post-COVID-19 Condition in CYP.

Methods: Studies from the previous systematic review were combined with studies from a systematic search from July 2021 to November 2022 (registration PROSPERO CRD42021233153). Eligible studies included CYP aged ≤19 years with confirmed or probable SARS-CoV-2 infection and symptoms persisting at least 12 weeks.

Findings: 55 studies (n = 1,139,299 participants) were included. Over two-hundred symptoms were associated with Post COVID-19 Condition. Gastrointestinal problems, headaches, cough and fever were among the most prevalent symptoms with rates of 50.2%, 35.6%, 34.7% and 25.8% respectively. Twenty-one symptoms from 11 studies were suitable for meta-analysis. There were significantly higher pooled estimates of proportions of symptoms for altered / loss of smell or taste, dyspnoea, fatigue, and myalgia in CYP with confirmed SARS-CoV-2 infection. Heterogeneity was high suggesting substantial variation amongst the included studies.

Conclusions: Many CYP continue to experience symptoms after SARS-CoV-2 infection. Efforts to aid early identification and intervention of those most in need is warranted and the consequences of COVID-19 for CYP call for long-term follow-up.

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Conflict of interest statement

The authors have read the journal’s policy and have the following competing interests: Terence Stephenson is the current Chair of the Health Research Authority (HRA) for England. The Health Research Authority reimburses his university, the University College London, for his time. He has recused himself from research studies in which he is personally involved and which require ethical approval from the HRA. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. PRISMA flow diagram for included studies [21].
*Two studies used the same methodology and population but report data in separate publications by age group. These have been grouped and analysed together. From [67].
Fig 2
Fig 2. Forest plot of risk difference in symptom prevalence between cases and control participants in controlled studies: Altered/loss of smell or taste.
Fig 3
Fig 3. Forest plot of risk difference in symptom prevalence between cases and control participants in controlled studies: Dyspnoea.
Fig 4
Fig 4. Forest plot of risk difference in symptom prevalence between cases and control participants in controlled studies: Fatigue.
Fig 5
Fig 5. Forest plot of risk difference in symptom prevalence between cases and control participants in controlled studies: Myalgia.
See this image and copyright information in PMC

References

    1. Behnood SA, Shafran R, Bennett SD, Zhang AXD, O’Mahoney LL, Stephenson TJ, et al.. Persistent symptoms following SARS-CoV-2 infection amongst children and young people: A meta-analysis of controlled and uncontrolled studies. J Infect. 2022;84: 158–170. doi: 10.1016/j.jinf.2021.11.011 - DOI - PMC - PubMed
    1. Stephenson T, Allin B, Nugawela MD, Rojas N, Dalrymple E, Pinto Pereira S, et al.. Long COVID (post-COVID-19 condition) in children: a modified Delphi process. Arch Dis Child. 2022;107: 674–680. doi: 10.1136/archdischild-2021-323624 - DOI - PMC - PubMed
    1. World Health Organization (WHO). A clinical case definition for post covid-19 condition in children and adolescents by expert consensus. 2023. Feb. Available: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post-COVID-19-cond...
    1. Viner RM, Clark C, Taylor SJC, Bhui K, Klineberg E, Head J, et al.. Longitudinal risk factors for persistent fatigue in adolescents. Arch Pediatr Adolesc Med. 2008;162: 469–475. doi: 10.1001/archpedi.162.5.469 - DOI - PubMed
    1. COVID-19 Schools Infection Survey, England—Office for National Statistics. [cited 18 Apr 2023]. Available: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/...