Introduction
The coronavirus disease 19 (COVID 19) which spread worldwide during few
years ago, caused great challenge in health, economy, social and
environment (1). This mysterious virus represents with very
heterogeneous organ involvements. The most prevalent presentations are
fever, cough and anosmia (2). In spite of most early reports considered
mild infection in children, gradually increasing concerns was developed
about long-term complications of disease (3, 4). Early in 2020, there
were several reports of a disease mimicking Kawasaki in children, which
present with fever and muco-cutaneous as well as multi-organ
involvement. Majority of patients with this new emerging syndrome,
represent with cardiac involvement and require intensive care unit (ICU)
admission (5). After that, many data were released about severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children
with more morbidity and mortality.
Autopsy examination in patients who dead due to COVID 19 has shown
different grades of fibro proliferative procedures and diffuse alveolar
injury. Therefore, it seems that COVID 19 survivors might be at risk for
respiratory sequel and persistent impaired pulmonary function tests.
According to expected pathophysiology, restrictive pattern is more
probable. Available data has revealed that abnormal diffusing capacity
for carbon monoxide (DLCO), which is relevant with severity of acute
illness, is the most prevalent result in pulmonary function test (PFT)
of post-acute patients. While ground grass opacities is most common in
high-resolution computed tomography (HRCT) of them (6, 7). A recent
meta-analysis has shown that 77% of infected patients with SARS-Cov2
had abnormal lung computed tomography (CT) in acute phase (2). Several
studies reported persistent post-COVID 19 respiratory symptoms. In one
study, 25-42% of patients reported moderate to severe dyspnea, 4-8
weeks after hospital discharge (8).
Because of continues growth and development of respiratory system in
pediatrics especially during infancy and early childhood, they are more
vulnerable to pulmonary sequel (9).
Pulmonary function test is one of methods, which can evaluate long-term
pulmonary sequel in survived COVID 19 patients. This is safe, objective
and more favorable than imaging. This tool is useful in assessment of
degree of airway restriction and obstruction (9).
To the best of our knowledge, there is not any systematic review and
meta-analysis regarding long-term respiratory outcome in pediatric
population post-SARS-CoV-2 infection. Since future of pediatric
survivors of COVID 19 is uncertain, we have conducted present systematic
review and meta-analysis to summarize available evidence and define the
gapes, which may initiate future studies.
Methods :