Quality of life and mental health in children with long COVID

ABSTRACT

Background

Pediatric Long COVID (PLC) is a heterogeneous condition, which can have a substantial impact on daily life of children and adolescents. This study aimed to evaluate health related quality of life (HRQoL), and mental and social health of children with PLC, in relation to children with other chronic health conditions (CHC) and from the general population (GP) during the pandemic.

Methods

Dutch children (8-18 years) with PLC (n = 106, 31% male) were included between May 2021 and March 2023. Reference data was available from a CHC-cohort (n = 90, 56% male) and GP-cohort (n = 844, 47% male) during the first wave of the pandemic (April–May, 2020). Participants completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 and Patient-Reported Outcomes Measurement Information System (PROMIS) instruments (Anxiety, Anger, Depressive symptoms, Sleep-Related Impairment (SRI), and Peer Relationships). Mean scores were analyzed using adjusted ANCOVA. Relative risks (RR (95% CI)) were calculated for impaired HRQoL and severe PROMIS scores.

Results

Children with PLC report high proportions of impaired HRQoL (84%, RR = 3.67 (2.35–5.74)), and have significantly lower PedsQL scores than children with CHC. Children with PLC also exhibit worse PROMIS T-scores of Anxiety, Depressive Symptoms, and SRI than children from the CHC- and GP-cohorts (mean difference range 2.2–9.8 (95%CI 0.6–11.7)), and significantly higher risks of severe anxiety (17%), depressive symptoms (18%), and SRI (17%).

Conclusions

PLC can severely impact HRQoL and mental and social health in children. Screening of these outcomes and individualized management of children with PLC should be a vital part of clinical care for these highly burdened patients.

Plain language summary

Pediatric Long COVID (PLC) can significantly affect children’s daily lives, but its impact on well-being is not yet fully understood. This study investigated the quality of life, mental health, and social well-being of children with PLC compared to those with other chronic conditions and the general population. Using self-report questionnaires, we found that children with PLC experience worse quality of life and are at higher risk of severe anxiety, depression, and sleep problems. These findings highlight the need for better screening and personalized care to support children with PLC. Understanding the challenges they face can help improve medical care and ensure they receive the right support for their recovery and well-being.