Other organizations, such as the National Institutes of Health (N.I.H.), also define long-COVID as post-acute symptoms after 4 weeks 8. This includes ongoing symptomatic COVID-19 (from 4 to 12 weeks) and post‑COVID-19 syndrome (12 weeks or more) 7. On February 2nd, 2022, the National Institute for Health and Care Excellence (NICE) published a guideline defining long-COVID as signs and symptoms that continue or develop after acute COVID‑19. In October 2021, the WHO proposed a clinical definition for post-COVID-19 through a Delphi consensus stating it generally occurs three months from the onset of COVID-19, with symptoms lasting at least two months and cannot be explained by an alternative diagnosis 6. Long-COVID is a heterogeneous multisystemic condition for which there is still no precise definition and includes signs and symptoms that persist, develop, or fluctuate after SARS-CoV-2 infection. MIS-C is a condition where different body parts become inflamed 4, it occurs in less than 0.01% of children infected and requires intensive care support in 68% of cases 5. Both consequences can even appear in asymptomatic patients 4. Severe COVID-19 is less common in children than in adults 3 however, at least two long-term consequences occur following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children: multisystem inflammatory syndrome (MIS-C) and long-COVID. However, many individuals experience debilitating COVID-19 symptoms months later, requiring additional medical attention and follow-up. Until now, the focus was primarily aimed at the acute phase of the disease. Still, treatments have been developed during this time, and effective vaccines have been widely administered to the population, both children and adults, protecting millions from severe disease and death 2. ![]() Consequently, millions of cases and thousands of deaths have been reported worldwide 1. It has been over 2 years since the coronavirus disease 2019 (COVID-19) pandemic was first declared. ![]() Limitations of the studies analyzed include lack of standardized definitions, recall, selection, misclassification, nonresponse and/or loss of follow-up, and a high level of heterogeneity. Children infected by SARS-CoV-2 had a higher risk of persistent dyspnea, anosmia/ageusia, and/or fever compared to controls. The literature search yielded 8373 publications, of which 21 studies met the inclusion criteria, and a total of 80,071 children and adolescents were included. The prevalence of long-COVID was 25.24%, and the most prevalent clinical manifestations were mood symptoms (16.50%), fatigue (9.66%), and sleep disorders (8.42%). ![]() The Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) reporting guideline was followed (registration PROSPERO CRD42021275408). Heterogeneity was assessed using I 2 statistics. Random-effects meta-analyses were performed using the MetaXL software to estimate the pooled prevalence with a 95% confidence interval (CI). We have used PubMed and Embase to identify observational studies published before February 10th, 2022 that included a minimum of 30 patients with ages ranging from 0 to 18 years that met the National Institute for Healthcare Excellence (NICE) definition of long-COVID, which consists of both ongoing (4 to 12 weeks) and post-COVID-19 (≥ 12 weeks) symptoms. The objective of this systematic review and meta-analyses is to estimate the prevalence of long-COVID in children and adolescents and to present the full spectrum of symptoms present after acute COVID-19.
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