Pediatric post COVID-19 condition: an umbrella review of the most common symptoms and associated factors

Background: Although the long-term consequences of the Coronavirus Disease-2019 (COVID-19) pandemic are\r\nyet to be fully comprehended, a syndrome symptomatically akin to the COVID-19 disease has been defined, for\r\nchildren and adolescents, in February 2023 by the World Health Organization (WHO) as ‘post COVID-19 condition’\r\n(PCC). Potential consequences of COVID-19 that affect developmental milestones in children and adolescents\r\nshould be comprehended in their magnitude and duration. The aim is to investigate the most common symptoms\r\nand predictors or risk factors for pediatric PCC. Methods: In this umbrella review, the population of interest was\r\ndefined as children and adolescents from 0 to 19 years old presenting PCC symptoms as defined by the WHO in the\r\nInternational Classification of Diseases. The intervention considered was general follow-up activity to monitor the patients’\r\nrecovery status. No comparator was chosen, and the outcomes were symptoms of PCC and predictors or risk factors of\r\ndeveloping PCC. Methodological quality, risk of bias and the level of overlap between studies were assessed. A random-\r\neffects meta-analytic synthesis of respective estimates with inverse variance study weighting was carried out, for the\r\nprimary studies included by the reviews retrieved, regarding predictors or risk factors reported. Results: We identified six\r\neligible systematic reviews, five with meta-analyses, from three databases. The most common symptoms reported\r\nwere fatigue and respiratory difficulties; female sex and older age were the most reported factors associated\r\nwith the development of pediatric PCC. Conclusions: A deeper understanding of pediatric PCC requires well-\r\ndesigned and clearly defined prospective studies, symptom differentiation, and adequate follow-up.