Prevalence and related factors of child posttraumatic stress disorder during COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND: The COVID-19 pandemic has drastically impacted many aspects of society and has indirectly produced various psychological consequences. This systematic review aimed to estimate the worldwide prevalence of posttraumatic stress disorder (PTSD) in children due to the COVID-19 pandemic, as well as to identify protective or risk factors contributing to child PTSD. METHODS: We conducted a systematic literature search in the PubMed, ProQuest, PsycINFO, Embase, Web of Science, WanFang, CNKI, and VIP databases. We searched for studies published between January 1, 2020 and May 26, 2021, that reported the prevalence of child PTSD due to the COVID-19 pandemic, as well as factors contributing to child PTSD. Eighteen studies were included in our systematic review, of which 10 studies were included in the meta-analysis. RESULTS: The estimated prevalence of child PTSD after the COVID-19 outbreak was 28.15% (95% CI: 19.46–36.84%, I (2) = 99.7%). In subgroup analyses for specific regions the estimated prevalence of post-pandemic child PTSD was 19.61% (95% CI: 11.23–27.98%) in China, 50.8% (95% CI: 34.12–67.49%) in the USA, and 50.08% in Italy (95% CI: 47.32–52.84%). CONCLUSIONS: Factors contributing to child PTSD were categorized into four aspects: personal factors, family factors, social factors and infectious diseases related factors. Based on this, we presented a new framework summarizing the occurrence and influence of the COVID-19 related child PTSD, which may contribute to a better understanding, prevention and development of interventions for child PTSD in forthcoming pandemics.