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Long-term outcomes of COVID-19 infection in children and young people: a systematic review and meta-analysis [version 1; peer review: awaiting peer review]

Twohig, Helen; Bajpai, Ram; Corp, Nadia; Faux-Nightingale, Alice; Mallen, Christian; Robinson, Toni; Somayajula, Glenys; van-Der-Windt, Danielle; Welsh, Victoria; Burton, Claire

Authors

Toni Robinson



Contributors

Bajpai Ram
Other

Bajpai Ram
Other

Bajpai Ram
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Burton Claire
Other

Corp Nadia
Other

Corp Nadia
Other

Corp Nadia
Other

Faux-Nightingale Alice
Other

Faux-Nightingale Alice
Other

Faux-Nightingale Alice
Other

Mallen Christian
Other

Mallen Christian
Other

Robinson Toni
Other

Somayajula Glenys
Other

Somayajula Glenys
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Twohig Helen
Other

Welsh Victoria
Other

Welsh Victoria
Other

Welsh Victoria
Other

Welsh Victoria
Other

Welsh Victoria
Other

Welsh Victoria
Other

Abstract

Background
Children and young people (CYP) may experience prolonged symptoms following COVID-19, commonly termed ‘Long-COVID’. The characteristics of Long-COVID in CYP are unclear, as are the sequalae of acute COVID-19. We aimed to systematically synthesise evidence of the long-term outcomes of COVID-19 in CYP.

Methods
13 electronic databases were searched until January 2022. Inclusion criteria: observational studies reporting outcomes occurring four-weeks or more after COVID-19 in children <18 years old. Exclusion criteria: outcomes of Paediatric Inflammatory Multisystem Syndrome. Title, abstract and full text screening were conducted independently by two reviewers. Data extraction and risk of bias assessment was by one reviewer with independent verification. Critical appraisal tools appropriate for study type were employed. Results were narratively synthesised with meta-analysis to generate summary estimates of risk of prolonged symptoms in CYP.

Results
94 studies were included in this systematic review. Of these, 66 studies recruited from hospital settings and 8 studies recruited solely from community settings. Over 100 symptoms were reported, the most common being fatigue, headache and cognitive symptoms. Summary estimates of prevalence of prolonged symptoms were higher for hospital samples (31.2%, 95% CI 20.3% to 43.2%) than for community samples (4.6%, 95% CI 3.4% to 5.8). Reported sequalae of COVID-19 in CYP included stroke, type-1 diabetes, Guillan-Barre syndrome, and persistent radiological or blood test abnormalities. Most studies reporting these sequalae were case reports / case series and the quality of evidence in these studies was low.

Conclusions
Prolonged symptoms following COVID-19 in children are variable and multi-systemic. Rates of prolonged symptoms in community samples are lower than hospital samples. There is currently limited good quality data on other sequalae in CYP. Heterogeneity in methods of diagnosis of COVID-19, symptom classification, assessment method and duration of follow-up made synthesis less secure.

Journal Article Type Article
Acceptance Date Apr 24, 2024
Publication Date Apr 24, 2024
Deposit Date Apr 29, 2024
Journal NIHR Open Research
Print ISSN 2633-4402
Publisher Taylor and Francis
Peer Reviewed Peer Reviewed
Volume 4
Issue 22
DOI https://doi.org/10.3310/nihropenres.13549.1
Public URL https://keele-repository.worktribe.com/output/799938
Additional Information Supplementary data to Long-term outcomes of COVID-19 infection in children and young people: a systematic review and meta-analysis available https://researchdata.keele.ac.uk/86/