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Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review
Yong-Bo Zheng1, Na Zeng2, Kai Yuan3
1Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China; Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
Insights
Nearly a quarter of pediatric COVID-19 survivors experience long COVID, with generalized symptoms being most common. Older age and severe illness increase risk, necessitating ongoing monitoring and intervention for these children.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- Millions of children survive COVID-19 but face risks of long COVID.
- Understanding the prevalence and risk factors for long COVID in pediatric survivors is crucial.
Purpose of the Study:
- To systematically review literature on long COVID in pediatric survivors.
- To determine the pooled prevalence and identify risk factors for long COVID in this population.
Main Methods:
- Systematic search of PubMed, Embase, and Cochrane Library up to December 2022.
- Random effects model used to estimate pooled prevalence.
- Subgroup analyses and meta-regression conducted to explore influencing factors.
Main Results:
- Pooled prevalence of any long COVID was 23.36% in 12,424 pediatric survivors.
- Generalized, respiratory, neurologic, and psychiatric symptoms were most common.
- Older age, multisystem inflammatory syndrome, and severe illness were associated with higher long COVID prevalence.
Conclusions:
- Approximately 25% of pediatric COVID-19 survivors develop multisystem long COVID, persisting even after one year.
- Targeted monitoring and interventions are essential for high-risk pediatric survivors.
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.
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