Protective and Risk Factors of Mental Health in Iranian Children During the COVID-19 Pandemic: A Systematic Review Study

Objectives With the emergence of the coronavirus disease 2019 (COVID-19) pandemic in the world, including Iran, the need for its prevention and treatment became a national priority for the countries. Children, as one of the most vulnerable groups, are affected by this pandemic in various dimensions. This study aims to identify and categorize the protective and risk factors of mental health problems in Iranian children during the COVID-19 pandemic. Methods This is a systematic review. A search was conducted in international and national databases for the related studies, and the results were reported based on the PRISMA diagram. The quantitative stud-ies were assessed by Joanna Briggs Institute's Critical Appraisal Checklist. Finally, 9 studies were selected for the review.Results Among the reviewed studies, only one study was conducted in the entire Iran; more than 44% were conducted in Tehran. The study populations of more than 77% of studies were the children select-ed from the general population. The protective factors of mental health problems (anxiety and fear of COVID-19) in children included: High level of self-differentiation, positive parent-child conflict resolution tactics, older age, parents' increased time of staying at home, and high educational level of mothers. On the other hand, the risk factors of mental health problems (anxiety, fear of COVID-19, and aggression) in children were: COVID-19-related anxiety in mothers, anxiety/stress/depression in mothers, children's awareness of COVID-19, infection or death of a relative due to COVID-19, employment of parents as a medical staff, parents' intrusion and hyperarousal, being a single child, and hearing loss.Conclusion Compared to other countries, limited studies have addressed the social determinants of men-tal health problems (anxiety, fear of COVID-19, and aggression) of children in Iran during the pandemic. Identifying and addressing the factors that threaten, exacerbate, or enhance Iranian children's mental health through interventions and social measures can lead to breaking the ineffective cycle of inequality and discrimination, promoting mental health, and reducing harm in the face of future pandemics.