School closures during COVID-19: an overview of systematic reviews

<p><strong>Objectives:</strong>&nbsp;To assess the benefits and drawbacks of school closures and in-school mitigations during the COVID-19 pandemic.</p> <p><strong>Design:</strong>&nbsp;Overview of systematic reviews (SRs).</p> <p><str...

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Hauptverfasser: Hume, S, Brown, SR, Mahtani, KR
Format: Journal article
Sprache:English
Veröffentlicht: BMJ Publishing Group 2023
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author Hume, S
Brown, SR
Mahtani, KR
author_facet Hume, S
Brown, SR
Mahtani, KR
author_sort Hume, S
collection OXFORD
description <p><strong>Objectives:</strong>&nbsp;To assess the benefits and drawbacks of school closures and in-school mitigations during the COVID-19 pandemic.</p> <p><strong>Design:</strong>&nbsp;Overview of systematic reviews (SRs).</p> <p><strong>Search methods:</strong>&nbsp;We searched six databases and additional resources on 29 July 2022: MEDLINE, Embase, Google Scholar, Cochrane Library, COVID-END inventory of evidence synthesis, and Epistemonikos.</p> <p><strong>Eligibility criteria:</strong>&nbsp;We selected SRs written in English that answered at least one of four specific questions concerning the efficacy and drawbacks of school closures. Their primary studies were conducted in primary and secondary schools, including pupils aged 5&ndash;18. Interventions included school closures or mitigations (such as mask usage) introduced in schools.</p> <p><strong>Data collection and analysis:</strong>&nbsp;We used AMSTAR 2 to assess confidence in the included SRs, and GRADE was used to assess certainty of evidence. We performed a narrative synthesis of the results, prioritising higher-quality SRs, those which performed GRADE assessments and those with more unique primary studies. We also assessed the overlap between primary studies included in the SRs.</p> <p><strong>Main outcome measures:</strong>&nbsp;Our framework for summarising outcome data was guided by the following questions: (1) What is the impact of school closures on COVID-19 transmission, morbidity or mortality in the community? (2) What is the impact of COVID-19 school closures on mental health (eg, anxiety), physical health (eg, obesity, domestic violence, sleep) and learning/achievement of primary and secondary pupils? (3) What is the impact of mitigations in schools on COVID-19 transmission, morbidity or mortality in the community? and (4) What is the impact of COVID-19 mitigations in schools on mental health, physical health and learning/achievement of primary and secondary pupils?</p> <p><strong>Results:</strong>&nbsp;We identified 578 reports, 26 of which were included. One SR was of high confidence, 0 moderate, 10 low and 15 critically low confidence. We identified 132 unique primary studies on the effects of school closures on transmission/morbidity/mortality, 123 on learning, 164 on mental health, 22 on physical health, 16 on sleep, 7 on domestic violence and 69 on effects of in-school mitigations on transmission/morbidity/mortality.</p> <p>Both school closures and in-school mitigations were associated with reduced COVID-19 transmission, morbidity and mortality in the community. School closures were also associated with reduced learning, increased anxiety and increased obesity in pupils. We found no SRs that assessed potential drawbacks of in-school mitigations on pupils. The certainty of evidence according to GRADE was mostly very low.</p> <p><strong>Conclusions:</strong>&nbsp;School closures during COVID-19 had both positive and negative impacts. We found a large number of SRs and primary studies. However, confidence in the SRs was mostly low to very low, and the certainty of evidence was also mostly very low. We found no SRs assessing the potential drawbacks of in-school mitigations on children, which could be addressed moving forward. This overview provides evidence that could inform policy makers on school closures during future potential waves of COVID-19.</p>
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spelling oxford-uuid:51303d73-556f-4a91-983e-a76cbd2b96172023-07-11T07:27:20ZSchool closures during COVID-19: an overview of systematic reviewsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:51303d73-556f-4a91-983e-a76cbd2b9617EnglishSymplectic ElementsBMJ Publishing Group2023Hume, SBrown, SRMahtani, KR<p><strong>Objectives:</strong>&nbsp;To assess the benefits and drawbacks of school closures and in-school mitigations during the COVID-19 pandemic.</p> <p><strong>Design:</strong>&nbsp;Overview of systematic reviews (SRs).</p> <p><strong>Search methods:</strong>&nbsp;We searched six databases and additional resources on 29 July 2022: MEDLINE, Embase, Google Scholar, Cochrane Library, COVID-END inventory of evidence synthesis, and Epistemonikos.</p> <p><strong>Eligibility criteria:</strong>&nbsp;We selected SRs written in English that answered at least one of four specific questions concerning the efficacy and drawbacks of school closures. Their primary studies were conducted in primary and secondary schools, including pupils aged 5&ndash;18. Interventions included school closures or mitigations (such as mask usage) introduced in schools.</p> <p><strong>Data collection and analysis:</strong>&nbsp;We used AMSTAR 2 to assess confidence in the included SRs, and GRADE was used to assess certainty of evidence. We performed a narrative synthesis of the results, prioritising higher-quality SRs, those which performed GRADE assessments and those with more unique primary studies. We also assessed the overlap between primary studies included in the SRs.</p> <p><strong>Main outcome measures:</strong>&nbsp;Our framework for summarising outcome data was guided by the following questions: (1) What is the impact of school closures on COVID-19 transmission, morbidity or mortality in the community? (2) What is the impact of COVID-19 school closures on mental health (eg, anxiety), physical health (eg, obesity, domestic violence, sleep) and learning/achievement of primary and secondary pupils? (3) What is the impact of mitigations in schools on COVID-19 transmission, morbidity or mortality in the community? and (4) What is the impact of COVID-19 mitigations in schools on mental health, physical health and learning/achievement of primary and secondary pupils?</p> <p><strong>Results:</strong>&nbsp;We identified 578 reports, 26 of which were included. One SR was of high confidence, 0 moderate, 10 low and 15 critically low confidence. We identified 132 unique primary studies on the effects of school closures on transmission/morbidity/mortality, 123 on learning, 164 on mental health, 22 on physical health, 16 on sleep, 7 on domestic violence and 69 on effects of in-school mitigations on transmission/morbidity/mortality.</p> <p>Both school closures and in-school mitigations were associated with reduced COVID-19 transmission, morbidity and mortality in the community. School closures were also associated with reduced learning, increased anxiety and increased obesity in pupils. We found no SRs that assessed potential drawbacks of in-school mitigations on pupils. The certainty of evidence according to GRADE was mostly very low.</p> <p><strong>Conclusions:</strong>&nbsp;School closures during COVID-19 had both positive and negative impacts. We found a large number of SRs and primary studies. However, confidence in the SRs was mostly low to very low, and the certainty of evidence was also mostly very low. We found no SRs assessing the potential drawbacks of in-school mitigations on children, which could be addressed moving forward. This overview provides evidence that could inform policy makers on school closures during future potential waves of COVID-19.</p>
spellingShingle Hume, S
Brown, SR
Mahtani, KR
School closures during COVID-19: an overview of systematic reviews
title School closures during COVID-19: an overview of systematic reviews
title_full School closures during COVID-19: an overview of systematic reviews
title_fullStr School closures during COVID-19: an overview of systematic reviews
title_full_unstemmed School closures during COVID-19: an overview of systematic reviews
title_short School closures during COVID-19: an overview of systematic reviews
title_sort school closures during covid 19 an overview of systematic reviews
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AT brownsr schoolclosuresduringcovid19anoverviewofsystematicreviews
AT mahtanikr schoolclosuresduringcovid19anoverviewofsystematicreviews