Understanding heterogeneity in paediatric long COVID research: an overview of reviews and recommendations for future pandemics
摘要
Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this variability and explore whether methodological characteristics were correlated with reported Long COVID outcome prevalence, in order to inform recommendations to improve reporting in future pandemic-related epidemiological research.
MethodsWe conducted an overview of reviews with a narrative synthesis, identifying systematic reviews and meta-analyses and extracting their included primary studies. We identified reviews of Long COVID in children & young people in PubMed and Embase using a systematic search strategy. We extracted key methodological details including study design, sample size, sample and control group characteristics, data collection and reporting methods, as well as time-point(s) of surveying and frequency of follow-up. We explored correlations between these factors and prevalence of Long COVID via Spearman’s rank correlation coefficients or the Kruskal-Wallis test.
Results69 studies, from identified reviews, met the inclusion criteria with outcome symptom prevalence varying between 0 and 90% at > 3-months post-COVID-19 infection. Only 19% of studies used an established Long COVID definition to guide analyses. There was substantial heterogeneity in the design and outcome reporting of Long COVID studies. We did not find Long COVID prevalence varied by examined methodological factors (p ≥ 0.08 for all correlations).
ConclusionWhile substantial methodological heterogeneity was observed across studies of paediatric Long COVID, no statistically significant correlations were identified between examined methodological factors and reported prevalence. Such variability limits comparability across studies and highlights the need for more standardised definitions, outcome measures, and reporting approaches in future pandemic-related epidemiological research: we discuss reporting guidelines and recommendations for future paediatric epidemiological research during a pandemic.