Publication date: Jul 06, 2026
COVID-19 has been associated with adverse mental health outcomes in children. However, evidence regarding the long-term trajectories of post-acute symptoms remains limited. We examined long-term emotional and behavioral trajectories in children following COVID-19 infection. Eighty-four children (aged 6-16) with a confirmed COVID-19 were initially enrolled. Of these, 69 completed the three-year follow-up assessment and were included in the present analyses. Parents completed assessments approximately three months post-infection, retrospectively rating their child’s behavior preceding infection and during the two weeks prior to the post-COVID assessment. An age- and sex-matched control group (n = 94) completed identical assessments. The COVID-19 group was reassessed approximately three years post-infection. Results showed that the COVID group showed significant impairments in school functions, internalizing problems, conduct problems, irritability and focus in post-COVID conditions compared to pre-COVID baseline. At three-year follow-up, most impairments resolved to pre-COVID levels. However, prosocial functioning among females remained impaired. Additionally, longer time since infection correlated with fewer school function problems (r = -0. 26, p = 0. 041) and lower levels of internalizing symptoms (r = -0. 26, p = 0. 038). In conclusion, post-COVID-19 children exhibited marked post-acute impairments in school functioning, increased emotional and behavioral problems followed by heterogeneous recovery trajectories.
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| Concepts | Keywords |
|---|---|
| Females | Children |
| Parents | Emotional/behavioral impairment |
| Pediatric | Mental health |
| Prosocial | Post-COVID trajectory |
| Weeks |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | infection |
| disease | MESH | included |
| disease | MESH | post-COVID conditions |
| pathway | REACTOME | Reproduction |
| disease | MESH | syndrome |
| drug | DRUGBANK | Factor IX Complex (Human) |
| disease | MESH | PCC |
| disease | MESH | fatigue |
| disease | MESH | headaches |
| disease | MESH | muscle pain |
| disease | MESH | cognitive impairments |
| disease | MESH | anxiety |
| disease | MESH | inflammation |
| disease | MESH | dysbiosis |
| disease | MESH | neuroinflammation |
| disease | MESH | insomnia |
| disease | MESH | mental disorders |
| disease | MESH | anosmia |
| disease | MESH | neurological disorder |
| disease | MESH | IBM |
| disease | MESH | viral infection |
| disease | MESH | Severe Acute Respiratory Syndrome |
| disease | MESH | Dis |
| disease | MESH | neurological manifestations |
| disease | MESH | affective disorders |
| disease | MESH | ADHD |
| drug | DRUGBANK | Trestolone |
| drug | DRUGBANK | Methylphenidate |
| disease | MESH | face |
| drug | DRUGBANK | Haloperidol |
| drug | DRUGBANK | L-Cysteine |