Prevalence of mental health problems among children with long COVID: A systematic review and meta-analysis

Abstract

Introduction The number of children with mental health problems has more than doubled since the COVID-19 pandemic. However, the effect of long Covid on children’s mental health is still debatable. Recognising long Covid as a risk factor for mental health problems in children will increase awareness and screening for mental health problems following COVID-19 infection, resulting in earlier intervention and lower morbidity. Therefore, this study aimed to determine the proportion of mental health problems post-COVID-19 infection in children and adolescents, and to compare them with the population with no previous COVID-19 infection. Methodology A systematic search was done in seven databases using pre-defined search terms. Cross-sectional, cohort and interventional studies reporting the proportion of mental health problems among children with long COVID in the English language from 2019 to May 2022 were included. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. Studies with satisfactory quality were included in meta-analysis using R and Revman software programmes. Results The initial search retrieved 1848 studies. After screening, 13 studies were included in the quality assessments. Meta-analysis showed children who had previous COVID-19 infection had more than two times higher odds of having anxiety or depression, and 14% higher odds of having appetite problems, compared to children with no previous infection. The pooled prevalence of mental health problems among the population were as follows; anxiety: 9%(95% CI:1, 23), depression: 15%(95% CI:0.4, 47), concentration problems: 6%(95% CI: 3, 11), sleep problems: 9%(95% CI:5, 13), mood swings: 13% (95%CI:5, 23) and appetite loss: 5%(95% CI:1, 13). However, studies were heterogenous and lack data from low- and middle-income countries. Conclusion Anxiety, depression and appetite problems were significantly increased among post-COVID-19 infected children, compared to those without a previous infection, which may be attributed to long COVID. The findings underscore the importance of screening and early intervention of children post-COVID-19 infection at one month and between three to four months.

Microbes and Mental Illness: Past, Present, and Future

“…Persistent symptoms may include fatigue, post-exertional malaise, and multiple emotional and cognitive impairments (memory impairment, attention deficits, cognitive difficulties, executive dysfunction) [ 422 ]. In addition to cognitive deficits, mental symptoms include anxiety, depression, mood swings, bipolar/manic episodes, obsessive–compulsive disorders, posttraumatic stress, new-onset psychosis, sleep disturbances, substance use disorders, suicidality, and symptom constellations consistent with pediatric acute-onset neuropsychiatric syndrome (PANS; see Section 3.8.5 for additional PANS information) [ 5 , 50 , 81 , 82 , 83 , 84 , 85 , 422 , 425 , 426 , 427 , 428 , 429 , 430 , 431 , 432 ]. One retrospective cohort study using electronic health record data comprising 81 million patients in healthcare organizations primarily in the US showed that the risk of common neuropsychiatric disorders (mood disorders, anxiety disorders) returned to baseline in 1–2 months, but there remained an elevated risk of psychotic disorders, cognitive deficit, dementia, and seizures at two years of follow-up [ 83 ].…”

Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA

“… 3 4 A recent meta-analysis found an increased incidence of anxiety, depression and appetite problems among post-COVID-19 infected children, compared with those without a previous infection. 5 …”

“…3 4 A recent meta-analysis found an increased incidence of anxiety, depression and appetite problems among post-COVID-19 infected children, compared with those without a previous infection. 5 Mental health disorders (MHDs) such as depression and anxiety disorders are the third leading cause of hospitalisation in the USA. 6 7 In 2020, nearly 21 million American adults (8.4% of the adult population) suffer from a major depressive disorder.…”