Introduction
With the coronavirus disease 2019 (COVID-19) pandemic, for its prevention and treatment became a national priority for the countries which led to significant changes and disruptions in the daily activities of people including children and adolescents. Although children make up a lower share of the infected population, the pandemic indirectly affected their mental health. Children and adolescents have suffered from stress and anxiety due to the unknown and negative effects of COVID-19 on their lives and have had uncertainty about the future. This psychosocial pressure can be exacerbated in the case of infection and death of family members, separation from caregivers, or disruption of family support; children with a high level of stress are at risk of impaired cognitive development, anxiety, depression, substance abuse disorders, and mental health challenges in the long term and even in adulthood. 
The consequences of nationwide closure of schools can have wide-ranging effects and consequences on children’s mental health, in addition to physical health and education. Current studies in different countries have shown that not all children are equally vulnerable to the effects of COVID-19; individual, family, and social factors can influence the negative effects of the pandemic. This study aims to identify and categorize the protective and risk factors of mental health in Iranian children during the COVID-19 pandemic. 
Methods
This is a systematic review study. A search was conducted in international databases (PubMed, Scopus, and Web of science), national databases (Magiran and Scientific Information Database [SID]), the databases of international organizations including World Health Organization (WHO), World Bank, United Nation, and UNICEF, and the databases of national organizations including the Ministry of Health and Medical Education, the Ministry of Education, and the Ministry of Cooperatives, Labour, and Social Welfare by the keywords and considering the inclusion criteria based on the PRISMA diagram. The quantitative studies 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 selected from the general population. Based on the results, the protective factors of mental health (anxiety and fear of COVID-19) in children living in Iran 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 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 (Table 1).


The studies showed that the individual and family factors had a relationship with the mental health outcomes of children during the pandemic, but there was no study examining the social factors of mental health in Iranian children during the pandemic.
Discussion
Limited studies have addressed children’s mental health and its social factors in Iran compared to other countries. The existing studies have mainly examined the dimensions of mental health in Iranian children (e.g., anxiety, COVID-19-related anxiety, fear of COVID-19, and aggression); they only addressed the individual and family factors; macro-structural and social factors of children’s mental health have been given less attention. While the COVID-19 pandemic have had short-term and long-term negative effect on the mental health of children and has affected children unequally in different contexts and social structures, there has been no studies to investigate them in Iran. 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.

Ethical Considerations
Compliance with ethical guidelines
This article is a meta-analysis without human or animal samples and has the from the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1399.121).


Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors contributions
All authors equally contributed to preparing this article.

Conflicts of interest
The authors declare no conflict of interest.

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