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Published on: December 6, 2024

Long-term trajectories of social adjustment and emotional/behavioral problems in pediatric post-acute COVID-19

Yun-Jie Tsai1, Luan-Yin Chang2, Susan Shur-Fen Gau1,3

  • 1Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, 10002, Taiwan.

Scientific Reports
|July 6, 2026
PubMed

Insights

Children infected with COVID-19 experienced initial emotional and behavioral issues, but most symptoms resolved within three years. However, some long-term effects on prosocial functioning in girls persist.

Area of Science:

  • Pediatric Health
  • Infectious Diseases
  • Child Psychology

Background:

  • COVID-19 is linked to negative mental health in children, but long-term outcomes are not well understood.
  • Limited evidence exists on the sustained emotional and behavioral effects of COVID-19 in pediatric populations.

Purpose of the Study:

  • To investigate the long-term emotional and behavioral trajectories in children after COVID-19 infection.
  • To compare post-acute symptoms with pre-infection baselines and assess recovery over three years.

Main Methods:

  • Longitudinal study of 69 children (aged 6-16) with confirmed COVID-19, followed for three years.
  • Parental assessments of emotional, behavioral, and school functioning at baseline, 3 months, and 3 years post-infection.
  • Comparison with a matched control group (n=94).

Main Results:

  • Children with COVID-19 showed significant impairments in school function, internalizing problems, conduct issues, irritability, and focus post-infection.
  • Most impairments largely resolved to pre-COVID levels by the three-year follow-up.
  • Female participants showed persistent impairment in prosocial functioning; longer time since infection correlated with fewer school problems and lower internalizing symptoms.

Conclusions:

  • Post-COVID-19 pediatric patients exhibit significant acute impairments in functioning and behavior.
  • Recovery trajectories are heterogeneous, with some deficits persisting, particularly in prosocial functioning for females.
  • The study highlights the need for monitoring long-term mental health in children post-COVID-19.

Keywords:
ChildrenEmotional/behavioral impairmentMental healthPost-COVID trajectory

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