Peking 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.
National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; School of Public Health, Peking University, Beijing, China; Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Infect Public Health. 2023 May;16(5):660-672. doi: 10.1016/j.jiph.2023.03.005. Epub 2023 Mar 7.
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.
背景：数百万 COVID-19 儿科幸存者在急性 COVID-19 康复后面临长新冠的风险。本研究的主要目的是系统地回顾现有文献，确定儿科 COVID-19 幸存者的长新冠总体患病率和风险因素。
方法：系统检索了 PubMed、Embase 和 Cochrane Library 中截至 2022 年 12 月 11 日评估儿科 COVID-19 幸存者长新冠患病率或与长新冠相关的风险因素的研究。采用随机效应模型估计儿科 COVID-19 患者长新冠的总体患病率。通过分层进行亚组分析和对长新冠估计患病率的荟萃回归，分层因素包括随访时间、平均年龄、性别比、多系统炎症综合征百分比、基线住院率和严重疾病百分比。
结果：基于 40 项研究共 12424 人，任何长新冠的总体患病率为 23.36%（95%CI 15.27-32.53）。最常见的是广义症状（19.57%，95%CI 9.85-31.52），其次是呼吸系统症状（14.76%，95%CI 7.22-24.27）、神经系统症状（13.51%，95%CI 6.52-22.40）和精神科症状（12.30%，95%CI 5.38-21.37）。最广泛报道的特定症状是呼吸困难（22.75%，95%CI 9.38-39.54）、疲劳（20.22%，95%CI 9.19-34.09）和头痛（15.88%，95%CI 6.85-27.57）。在 3-6 个月、6-12 个月和>12 个月时，任何症状的患病率分别为 26.41%（95%CI 14.33-40.59）、20.64%（95%CI 17.06-24.46）和 14.89%（95%CI 6.09-26.51）。年龄在 10 岁以上、有多系统炎症综合征或有严重临床症状的个体在多系统中表现出更高的长新冠患病率。年龄较大、女性、身体或精神健康状况较差、或感染严重或症状较多的个体更有可能成为儿科幸存者中的长新冠患者。
结论：近四分之一的儿科幸存者患有多系统长新冠，即使在感染后 1 年也是如此。需要对儿科幸存者进行持续监测、全面预防和干预，特别是对有高风险因素的个体。
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