Prevalence of symptoms of post‐COVID‐19 condition (long COVID) in children hospitalized with COVID‐19: A systematic review of observational studies

Abstract

This systematic review aimed to investigate the prevalence of symptoms of post‐COVID‐19 condition (long COVID), in children hospitalized with COVID‐19. We searched PUBMED and EMBASE on 15 March, 2023, using search strategy: “long COVID” OR “post‐COVID‐19” OR “postacute COVID‐19” OR “long‐term COVID” OR “COVID‐19 sequelae” OR “persistent COVID‐19” OR “chronic COVID‐19”. We included observational studies (case‐control, cross‐sectional, cohort, or case series) that investigated symptoms of post‐COVID‐19 condition (long COVID) in children (<18 years) admitted with COVID‐19. We used the WHO case definition of post‐COVID‐19 condition. Long COVID was defined as persistence of otherwise unexplained symptoms for at least three months after SARS‐CoV‐2 infection. We used the command “metaprop” to perform random‐effects meta‐analysis. Eleven studies involving 2279 patients were included. In the period between ≥3 months and <12 months after acute COVID‐19, the most frequent symptom was exercise intolerance with a pooled prevalence of 29% (95% CI: 7%–57%, I2 = 95%), followed by nonspecific respiratory symptoms (12%, 95% CI: 0%–48%, I2 = 0%), psychological disorders (10%, 95% CI: 1%–25%, I2 = 97%), and nonspecific gastrointestinal symptoms (10%, 95% CI: 0%–37%, I2 = 99%). In the period ≥12 months after the initial infection, the pooled prevalence of post COVID symptoms was lower, with 6% (95% CI: 2%–10%, I2 = 83%) for exercise intolerance and 3% (95% CI: 0%–8%, I2 = 89%) for fatigue. In conclusion, symptoms of post‐COVID condition (long COVID) in hospitalized children affect multiple organ systems, with higher prevalence in the period up to 12 months after the acute phase of COVID‐19.