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Prevalence of mental health problems among children with long COVID: A systematic review and meta-analysis
Nurulhuda Mat Hassan1,2, Hani Syahida Salim3, Safiya Amaran2
1University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Insights
Children with COVID-19 show increased odds of anxiety, depression, and appetite problems. Early screening and intervention for mental health issues in pediatric post-COVID-19 patients are crucial.
Area of Science:
- Pediatric mental health
- Infectious disease epidemiology
- Long COVID research
Background:
- The COVID-19 pandemic has led to a documented rise in pediatric mental health issues.
- The specific impact of long COVID on children's mental well-being remains under investigation.
- Recognizing long COVID as a risk factor can improve awareness, screening, and early intervention for affected children.
Approach:
- A systematic literature search was conducted across seven databases for English-language studies published between 2019 and May 2022.
- Included studies were cross-sectional, cohort, or interventional, focusing on mental health problems in children with long COVID.
- Data extraction and quality assessment were performed by two independent reviewers, with meta-analysis conducted using R and Revman software for eligible studies.
Key Points:
- Meta-analysis of 13 studies revealed that children with prior COVID-19 infection had over double the odds of anxiety or depression and a 14% increased likelihood of appetite problems compared to uninfected children.
- Pooled prevalence estimates indicated significant rates of anxiety (9%), depression (15%), concentration problems (6%), sleep issues (9%), mood swings (13%), and appetite loss (5%) in the post-COVID-19 pediatric population.
- Heterogeneity among studies and a lack of data from low- and middle-income countries were noted limitations.
Conclusions:
- Post-COVID-19 infection in children is associated with significantly elevated risks of anxiety, depression, and appetite disturbances, potentially linked to long COVID.
- These findings highlight the critical need for systematic mental health screening at one month and three to four months post-COVID-19 infection in pediatric populations.
- Early identification and intervention are essential to mitigate the long-term mental health consequences of COVID-19 in children and adolescents.
Introduction:
The number of children with mental health problems has more than doubled since the COVID-19 pandemic. However, the effect of long Covid on children's mental health is still debatable. Recognising long Covid as a risk factor for mental health problems in children will increase awareness and screening for mental health problems following COVID-19 infection, resulting in earlier intervention and lower morbidity. Therefore, this study aimed to determine the proportion of mental health problems post-COVID-19 infection in children and adolescents, and to compare them with the population with no previous COVID-19 infection.
Methodology:
A systematic search was done in seven databases using pre-defined search terms. Cross-sectional, cohort and interventional studies reporting the proportion of mental health problems among children with long COVID in the English language from 2019 to May 2022 were included. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. Studies with satisfactory quality were included in meta-analysis using R and Revman software programmes.
Results:
The initial search retrieved 1848 studies. After screening, 13 studies were included in the quality assessments. Meta-analysis showed children who had previous COVID-19 infection had more than two times higher odds of having anxiety or depression, and 14% higher odds of having appetite problems, compared to children with no previous infection. The pooled prevalence of mental health problems among the population were as follows; anxiety: 9%(95% CI:1, 23), depression: 15%(95% CI:0.4, 47), concentration problems: 6%(95% CI: 3, 11), sleep problems: 9%(95% CI:5, 13), mood swings: 13% (95%CI:5, 23) and appetite loss: 5%(95% CI:1, 13). However, studies were heterogenous and lack data from low- and middle-income countries.
Conclusion:
Anxiety, depression and appetite problems were significantly increased among post-COVID-19 infected children, compared to those without a previous infection, which may be attributed to long COVID. The findings underscore the importance of screening and early intervention of children post-COVID-19 infection at one month and between three to four months.
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