Rothensteiner Maria, Leeb Franziska, Götzinger Florian, Tebruegge Marc, Zacharasiewicz Angela
Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria.
Department of Paediatrics and Adolescent Medicine, Medical University Vienna, 1090 Wien, Austria.
Children (Basel). 2024 Aug 12;11(8):972. doi: 10.3390/children11080972.
(1) Background: Data on persisting symptoms after SARS-CoV-2 infection in children and adolescents are conflicting. Due to the absence of a clear pathophysiological correlate and a definitive diagnostic test, the diagnosis of Long COVID currently rests on consensus definitions only. This review aims to summarise the evidence regarding Long COVID in children and adolescents, incorporating the latest studies on this topic. (2) Methods: We designed a comprehensive search strategy to capture all relevant publications using Medline via the PubMed interface, with the initial literature search conducted in April 2023. To be included, publications had to present original data and include >50 participants with Long COVID symptoms aged between 0 and18 years. (3) Results: A total of 51 studies met the inclusion criteria, with most studies originating from Europe (n = 34; 66.7%), followed by the Americas (n = 8; 15.7%) and Asia (n = 7; 13.7%). Various study designs were employed, including retrospective, cross-sectional, prospective, or ambispective approaches. Study sizes varied significantly, with 18/51 studies having fewer than 500 participants. Many studies had methodological limitations: 23/51 (45.1%) studies did not include a control group without prior COVID-19 infection. Additionally, a considerable number of papers (33/51; 64.7%) did not include a clear definition of Long COVID. Other limitations included the lack of PCR- or serology-based confirmation of SARS-CoV-2 infection in the study group. Across different studies, there was high variability in the reported prevalence of Long COVID symptoms, ranging from 0.3% to 66.5%, with the majority of studies included in this review reporting prevalences of approximately 10-30%. Notably, the two studies with the highest prevalences also reported very high prevalences of Long COVID symptoms in the control group. There was a relatively consistent trend for Long COVID prevalence to decline substantially over time. The prevalence of Long COVID appeared to differ across different paediatric age groups, with teenagers being more commonly affected than younger children. Furthermore, data suggest that children and adolescents are less commonly affected by Long COVID compared to adults. In children and adolescents, Long COVID is associated with a very broad range of symptoms and signs affecting almost every organ system, with the respiratory, cardiovascular, and neuropsychiatric systems being most commonly affected. (4) Conclusions: The heterogeneity and limitations of published studies on Long COVID in children and adolescents complicate the interpretation of the existing data. Future studies should be rigorously designed to address unanswered questions regarding this complex disease.
（1）背景：关于儿童和青少年感染新冠病毒后持续症状的数据存在矛盾。由于缺乏明确的病理生理关联和确定性诊断测试，目前“长新冠”的诊断仅基于共识定义。本综述旨在总结有关儿童和青少年“长新冠”的证据，并纳入有关该主题的最新研究。（2）方法：我们设计了一项全面的检索策略，通过PubMed界面使用Medline获取所有相关出版物，初步文献检索于2023年4月进行。要纳入研究，出版物必须呈现原始数据，且纳入50名以上年龄在0至18岁之间有“长新冠”症状的参与者。（3）结果：共有51项研究符合纳入标准，大多数研究来自欧洲（n = 34；66.7%），其次是美洲（n = 8；15.7%）和亚洲（n = 7；13.7%）。采用了各种研究设计，包括回顾性、横断面、前瞻性或双向性研究方法。研究规模差异很大，51项研究中有18项的参与者少于500人。许多研究存在方法学局限性：51项研究中有23项（45.1%）未纳入未感染过新冠病毒的对照组。此外，相当数量的论文（33/51；64.7%）未明确“长新冠”的定义。其他局限性包括研究组中缺乏基于PCR或血清学的新冠病毒感染确认。在不同研究中，报告的“长新冠”症状患病率差异很大，从0.3%到66.5%不等，本综述纳入的大多数研究报告的患病率约为10%至30%。值得注意的是，患病率最高的两项研究在对照组中也报告了非常高的“长新冠”症状患病率。“长新冠”患病率随时间大幅下降的趋势相对一致。“长新冠”患病率在不同儿科年龄组中似乎有所不同，青少年比年幼儿童更常受到影响。此外，数据表明，与成年人相比，儿童和青少年受“长新冠”影响的情况较少。在儿童和青少年中，“长新冠”与影响几乎每个器官系统的非常广泛的症状和体征相关，其中呼吸、心血管和神经精神系统受影响最为常见。（4）结论：已发表的关于儿童和青少年“长新冠”研究的异质性和局限性使现有数据的解释变得复杂。未来的研究应进行严格设计，以解决有关这种复杂疾病的未回答问题。
