Evidence map›Paper›PMID 36719840›Full record

SynthesisArchives of disease in childhood2023

Robustness of reported postacute health outcomes in children with SARS-CoV-2 infection: a systematic review.

Julian Hirt, Perrine Janiaud, Viktoria Luise Gloy, Stefan Schandelmaier, Tiago V Pereira, Despina Contopoulos-Ioannidis, Steven N Goodman, John Ioannidis, Klaus Munkholm, Lars G Hemkens

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Archives of disease in childhood, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Definitions and symptoms of the post-COVID syndrome: an updated systematic umbrella review.European archives of psychiatry and clinical neuroscience · 2025
    Pooled it
  2. Pooled it
  3. Short and Long-Term Wellbeing of Children following SARS-CoV-2 Infection: A Systematic Review.International journal of environmental research and public health · 2022
    Pooled it
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Julian HirtDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0001-6589-3936
Perrine JaniaudDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0001-7684-8014
Viktoria Luise GloyDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
Stefan SchandelmaierDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0002-8429-0337
Tiago V PereiraApplied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Despina Contopoulos-IoannidisDivision of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Steven N GoodmanDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.
John IoannidisDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0003-3118-6859
Klaus MunkholmDepartment of Clinical Research, Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, University of Southern Denmark, Odense, Denmark.
Lars G HemkensDepartment of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland Lars.Hemkens@usb.ch.ORCID 0000-0002-3444-1432

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo systematically assess the robustness of reported postacute SARS-CoV-2 infection health outcomes in children.

methodsA search on PubMed and Web of Science was conducted to identify studies published up to 22 January 2022 that reported on postacute SARS-CoV-2 infection health outcomes in children (<18 years) with follow-up of ≥2 months since detection of infection or ≥1 month since recovery from acute illness. We assessed the consideration of confounding bias and causality, as well as the risk of bias.

results21 studies including 81 896 children reported up to 97 symptoms with follow-up periods of 2.0-11.5 months. Fifteen studies had no control group. The reported proportion of children with post-COVID syndrome was between 0% and 66.5% in children with SARS-CoV-2 infection (n=16 986) and between 2.0% and 53.3% in children without SARS-CoV-2 infection (n=64 910). Only two studies made a clear causal interpretation of an association between SARS-CoV-2 infection and the main outcome of 'post-COVID syndrome' and provided recommendations regarding prevention measures. The robustness of all 21 studies was seriously limited due to an overall critical risk of bias.

conclusionsThe robustness of reported postacute SARS-CoV-2 infection health outcomes in children is seriously limited, at least in all the published articles we could identify. None of the studies provided evidence with reasonable certainty on whether SARS-CoV-2 infection has an impact on postacute health outcomes, let alone to what extent. Children and their families urgently need much more reliable and methodologically robust evidence to address their concerns and improve care.

Indexed as

COVID-19BiasChildHumansOutcome Assessment, Health CareSARS-CoV-2COVID-19infectious disease medicine

Identifiers

PMID36719840
PMCPMC10314012

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.