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School Difficulties and Long COVID in Children and Adolescents

Harrison T Reeder1, Lawrence C Kleinman2, Melissa S Stockwell3

  • 1Massachusetts General Hospital Biostatistics (HT Reeder, T Thaweethai, DB Pant, A Krishnamoorthy, and AS Foulkes), Somerville, Mass; Department of Medicine (HT Reeder, T Thaweethai, and AS Foulkes), Harvard Medical School, Boston, Mass.

Academic Pediatrics
|April 5, 2026
PubMed

Insights

Pediatric Long COVID negatively impacts school performance and social interactions in children and adolescents. This highlights the urgent need for tailored school support services for affected youth.

Area of Science:

  • Pediatric Health
  • Infectious Diseases
  • Public Health

Background:

  • Pediatric Long COVID (LC) is a chronic condition following SARS-CoV-2 infection in children and adolescents.
  • While clinical symptoms are increasingly studied, the functional impacts of pediatric LC, particularly in school settings, remain under-described.

Purpose of the Study:

  • To assess the association between pediatric Long COVID and school-related functional outcomes in school-aged children and adolescents.
  • To investigate impacts on academic performance, attention, peer relationships, and the need for Individualized Education Programs (IEPs).

Main Methods:

  • Analysis of cross-sectional data from the NIH-funded Researching COVID to Enhance Recovery (RECOVER) pediatric cohort.
  • Inclusion of school-age children (6-11 years) and adolescents (12-17 years) with and without LC.
  • Matched analyses to estimate risk ratios for outcomes including worsened grades, attention difficulties, limited peer interaction, and IEP status.

Main Results:

  • Children and adolescents with LC showed significantly higher rates of worsened grades compared to peers without LC (adjusted RR 2.18 for school-age, 2.39 for adolescents).
  • Pediatric LC was associated with increased difficulty paying attention, reduced social engagement with friends, and a greater likelihood of requiring an IEP in both age groups.

Conclusions:

  • Long COVID in children and adolescents is demonstrably linked to negative school-related functional outcomes.
  • The findings underscore a critical need for developing and implementing effective school-based services to support students affected by pediatric LC.
Abstract

Keywords:
infection-associated chronic conditionlong covidschool performance

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