The study included 139 patients evaluated at Kennedy Krieger’s Pediatric Post-COVID-19 Rehabilitation Clinic.
Clinicians used mental health screening surveys to assess symptoms reported by the patients.
The screenings also included measures of key aspects of quality of life including: physical functioning, emotional functioning, social functioning, and school functioning.
More than 1 in 3 children reported that they were experiencing elevated symptoms of anxiety or depression (i.e. worry, sleep problems, and mood irritability).
Dr Laura Malone, director of the clinic and co-investigator in this research, said that half of these children had no prior mental health concerns or diagnosis.
Dr Malone said: “Long COVID is a complex condition.
“We’re seeing children and teens who were doing well before their COVID infection now struggling to attend school, socialise, or even enjoy basic activities.”
The study found that 1 in 4 children had new anxiety symptoms, and 1 in 7 had new depressive symptoms, despite no prior diagnosis—a sign long COVID is triggering new mental health challenges.
On average, children reported a quality of life similar to peers with cancer or cystic fibrosis, underscoring the severe functional impact of the condition.
The strongest predictor of poor quality of life was a “sense of ineffectiveness,” like feeling unable to succeed in life or enjoy activities, the researchers found.
Dr Malone said: “These children are losing confidence in themselves and their ability to participate in daily life.
“That loss of function can be just as devastating as the physical symptoms. It is important to identify and treat both to improve quality of life for children with long COVID.”
While previous studies have hinted at long COVID’s mental health toll, this is one of the first to use standardised, validated measures of mental health issues in a paediatric long COVID population.
The study also warns that traditional screening tools may not capture the full picture, as physical symptoms of long COVID (like fatigue or dizziness) can overlap with those of anxiety or depression.
