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This meta\u2010analysis, which searched Web of Science, Embase, PubMed, and Cochrane Library for reports published up to December 25, 2025, aimed to evaluate trends in the prevalence of\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    infections across these three periods to guide clinical practice and public health responses. A total of 70 studies were included, and methodological quality was assessed using the Joanna Briggs Institute criteria. The pooled prevalence of\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    infections before, during, and after COVID\u201019 was calculated in R 4.5.0, with Freeman\u2010Tukey double arcsine transformation for extreme proportions. The prevalence of\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    infections before COVID\u201019, during COVID\u201019, and after COVID\u201019 was 21.72% (95% CI: 17.09, 26.73), 10.73% (95% CI: 7.57, 14.35), and 28.64% (95% CI: 22.74, 34.93), respectively. Age\u2010stratified analysis revealed the highest prevalence consistently in children &gt; 6\u00a0years (pre\u2010pandemic: 46.35%; during\u2010pandemic: 27.32%; post\u2010pandemic: 41.36%) and the lowest in infants &lt; 1\u00a0year (8.21%, 4.87%, and 7.81%, respectively). Seasonally, pre\u2010pandemic prevalence peaked in summer (33.34%) and autumn (31.00%). During the pandemic, overall rates declined but remained highest in autumn (15.51%). Post\u2010pandemic, prevalence rebounded broadly, peaking in autumn (37.97%). In conclusion, this study summarises\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    trends in children and adolescents before and after COVID\u201019, indicating a delayed resurgence following the pandemic, and highlights the need for further research to explain these patterns and improve future pandemic preparedness.\n                  <\/jats:p>","DOI":"10.1002\/rmv.70151","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:12:22Z","timestamp":1776233542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiological Changes in\n                    <i>Mycoplasma pneumoniae<\/i>\n                    Infections in Children and Adolescents Before and After COVID\u201019: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"36","author":[{"given":"Hao","family":"Gou","sequence":"first","affiliation":[{"name":"Clinical 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