Symptom Patterns and Life with long-Term COVID-19 in children and adolescents, (SPLaT-19 SR): a living systematic review of scientific literature
‘Long-COVID’ is a patient-preferred term used to describe signs and symptoms that develop or continue after acute COVID-19. Research into Long-COVID has focused on adults. Less is known about the propensity of children and adolescents (CA) to experience persistent symptoms or other long-term effects. Social media posts discussing Long-COVID in CA describe symptoms including headache, fatigue, breathing problems, dizziness and brain-fog. This clinical picture appears to mirror symptoms observed in adults but has yet to be confirmed by research studies.
This living review synthesises the rapidly emerging and evolving evidence on Long-COVID in CA.
The protocol is registered on PROSPERO-CRD42020226624.Thirteen databases are being searched every 3 months to identify primary studies reporting symptoms and experiences of CA where symptoms / pathology persists for longer than 4 weeks after an acute infection of SARS-CoV-2.
Screening of titles, abstracts and full texts using pre-defined inclusion and exclusion criteria is being performed independently by pairs of reviewers, with discrepancies resolved by discussion or a third reviewer. Data extraction and risk of bias assessment (using standardised tools for each study type) is being carried out by one reviewer and checked by another.
2663 studies, published between Dec 19 and April 21, were identified. 324 full texts were screened and 54 studies were included. There is low-quality evidence of prolonged symptoms / health issues following acute COVID-19 but these are predominantly secondary to the rarely occurring Paediatric-Inflammatory-Multisystem-Syndrome.
To our knowledge, this is the first systematic review describing the long-term effects of COVID-19 in CA and will comprehensively synthesise knowledge of this emerging condition. This knowledge will inform planning of services for CA as well as future research investigating mechanisms, treatments and outcomes for this condition. Such knowledge will also add to the debate about guidelines for vaccination.