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The Robert Koch Institute is the German government's central institution for the identification, surveillance and prevention of infectious diseases in the Portfolio of the German Ministry of Health. more
The results of the systematic literature search are presented in a PRISMA flowchart. A total of 9,568 articles and preprints from the Cochrane COVID-19 Study Register and 285 articles from the WHO research database on COVID-19 were identified. According to the inclusion and exclusion criteria, 565 studies were included, which form the basis for the following evidence maps.
Map 1 shows the studies on long-term consequences of SARS-CoV-2 infection with regard to the selected health outcomes and the study design. It is noticeable that the available data is overall very heterogeneous. Studies with a longitudinal design occur somewhat more frequently than cross-sectional studies. There are significantly fewer studies for children and adolescents than for adults.
In the next step, available studies with regard to the presence of a control group were examined. For adults, only a few controlled studies are available, especially with a longitudinal design. The majority of studies do not have a control group.
Compared to adults, there are even fewer studies with control groups available for children and adolescents. Accordingly, there is a larger evidence gap than in adults. The majority of studies on children and adolescents do not have a control group, especially ones with a longitudinal design.
Looking at the duration of the studies, it can be seen that the follow-up time for adults is mostly longer than 12 weeks. The median is 13.1 weeks (IQR: 15.4 weeks). However, there are considerable differences with regard to the endpoints investigated. For example, while there are many studies on respiratory outcomes, there is less research on impairment in daily life, quality of life and symptom resolution.
The picture is similar for children and adolescents. Most studies have a study duration of more than 12 weeks. The median is 13.5 weeks (IQR: 15.4 weeks). While many studies are available on respiratory outcomes and fatigue, impairments in daily living and changes in quality of life are less well studied.
In addition to the consequences of a SARS-CoV-2 infection, prognostic factors are also relevant for describing the health status and for prevention. In particular, age, sex, the severity of the original COVID-19 illness as well as previous illnesses were examined. Compared to adults, possible risk factors for long COVID in children and adolescents were rarely considered.
Date: 23.11.2022
