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Risk of neuropsychiatric and related conditions associated with SARS-CoV-2 infection: a difference-in-differences

Yiwen Lu1,2, Jiayi Tong1,3,4, Dazheng Zhang1,3

  • 1Center for Health AI and Synthesis of Evidence (CHASE), Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Nature Communications
|July 24, 2025
PubMed

Insights

COVID-19 infection increases neuropsychiatric risks in children and youths. SARS-CoV-2 (the virus causing COVID-19) is linked to conditions like anxiety, ADHD, and depression, necessitating further research.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Infectious Diseases

Background:

  • The COVID-19 pandemic has seen a rise in neuropsychiatric issues among young people.
  • Emerging evidence suggests SARS-CoV-2 infection itself may pose risks beyond general pandemic stressors.

Purpose of the Study:

  • To evaluate the spectrum of neuropsychiatric conditions in children and youths post-SARS-CoV-2 infection.
  • To compare outcomes between COVID-19 positive and negative pediatric cohorts, controlling for infection risk factors.

Main Methods:

  • Retrospective analysis of electronic health records from 326,074 COVID-19 positive and 887,314 negative participants (ages 5-20) in the RECOVER program.
  • Matching participants based on risk factors and stratifying by age.
  • Examining neuropsychiatric outcomes 28–179 days post-infection/negative test (March 2020–December 2022).

Main Results:

  • COVID-19 positive children (5-12) showed increased risks for anxiety, OCD, ADHD, and autism.
  • COVID-19 positive youths (12-20) had elevated risks for anxiety, suicidality, depression, and related symptoms.
  • Higher frequencies of neuropsychiatric conditions were observed in the SARS-CoV-2 positive cohort.

Conclusions:

  • SARS-CoV-2 infection may be a contributing factor to neuropsychiatric conditions in children and youths.
  • Findings underscore the need for research into targeted treatments and prevention strategies.
  • This study highlights a significant association between COVID-19 and pediatric neuropsychiatric health.

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