Persistent symptoms following SARS-CoV-2 infection among children and young people: a meta-analysis...., 2021, Behnood et al

Full title: Persistent symptoms following SARS-CoV-2 infection among children and young people: a meta-analysis of controlled and uncontrolled studies

Abstract

Background
Data on the long-term impact of SARS-CoV-2 infection in children and young people (CYP) is conflicting. We assessed evidence on long-term post-COVID symptoms in CYP examining prevalence, risk factors, type and duration. Methods: Systematic search of published and unpublished literature using 13 online databases between 01/12/2019 – 31/07/2021. Eligible studies reported CYP ≤19 years with confirmed or probable SARS-CoV-2 with any symptoms persisting beyond acute illness. Random effects meta-analyses examined pooled risk difference in symptom prevalence (controlled studies only) and pooled prevalence (uncontrolled studies also included). Meta-regression examined study characteristics hypothesised to be associated with symptom prevalence. Prospectively registered: CRD42021233153.

Findings
Twenty two of 3357 unique studies were eligible, including 23,141 CYP. Median duration of follow-up was 125 days (IQR 99-231). Pooled risk difference in post-COVID cases compared to controls (5 studies) were significantly higher for cognitive difficulties (3% (95% CI 1, 4)), headache (5% (1, 8)), loss of smell (8%, (2, 15)), sore throat (2% (1, 2)) and sore eyes (2% (1, 3)) but not abdominal pain, cough, fatigue, myalgia, insomnia, diarrhoea, fever, dizziness or dyspnoea. Pooled prevalence of symptoms in post-COVID participants in 17 studies ranged from 15% (diarrhoea) to 47% (fatigue). Age was associated with higher prevalence of all symptoms except cough. Higher study quality was associated with lower prevalence of all symptoms, except loss of smell and cognitive symptoms.

Interpretation
The frequency of the majority of reported persistent symptoms was similar in SARS-CoV-2 positive cases and controls. This systematic review and meta-analysis highlights the critical importance of a control group in studi7777es on CYP post SARS-CoV-2 infection.

Open access, https://www.journalofinfection.com/article/S0163-4453(21)00555-7/fulltext

 

I still wish they'd focus more on severity/impact and longevity of symptoms, rather than the mere presence of symptoms.

 

Also please note two responses so far describing the poor methodology and resulting under-count of LC in children from just one of the papers included in the meta-analysis.

Response 1
Response 2

 

Article in Medical News Today:
Young people less likely to have long COVID than early studies suggested

"The authors note that the higher-quality studies found a lower prevalence of all long-term symptoms.

One of the study authors, Dr. Shamez Ladhani, a pediatric infectious disease consultant at St. George’s Hospital, London, commented, “The vast majority of kids with COVID-19 will recover completely, but we do need better tools to identify (and resources to investigate and support) the small proportion of kids with persistent symptoms.”

Dr. Swann noted that the few symptoms found more frequently in CYP “can help us identify children who are persistently affected after SARS-CoV-2 and support their recovery.”

“Let’s stop the scaremongering and get the public messaging right.”​

– Dr. Shamez Ladhani"​