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SSRI/SNRI and long COVID in children and adolescents with neuropsychiatric conditions: a cohort study from the

Ting Zhou1,2, Bingyu Zhang1,3, Yiwen Lu1,3

  • 1The Center for Health Analytics and Synthesis of Evidence, University of Pennsylvania, Philadelphia, PA USA.

Nature. Mental Health
|August 7, 2026
PubMed

Insights

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) showed varied associations with long COVID symptoms in youth. Antidepressant use was linked to some symptom reductions but increased risks for others, like fatigue and cognitive issues.

Area of Science:

  • Pediatric Health
  • Neuroscience
  • Infectious Diseases

Background:

  • Long COVID presents a significant health concern for children and adolescents.
  • The factors contributing to Long COVID development in pediatric populations are not fully understood.
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used for pediatric neuropsychiatric disorders and may impact immune and autonomic functions relevant to post-infectious symptoms.

Purpose of the Study:

  • To investigate the association between SSRI/SNRI use and Long COVID outcomes in children and adolescents.
  • To explore how antidepressant use influences the pattern of individual Long COVID symptoms in a pediatric cohort.

Main Methods:

  • Retrospective cohort study involving 110,955 children and adolescents with pre-existing neuropsychiatric conditions.
  • Data collected from 37 US health systems within the National Institutes of Health Researching COVID to Enhance Recovery consortium.
  • Analysis of clinician-recorded diagnoses and individual symptom associations with SSRI/SNRI use post-COVID-19 infection.

Main Results:

  • SSRI/SNRI use was not associated with a clinician-recorded diagnosis of Long COVID.
  • Heterogeneous associations were observed between SSRI/SNRI use and individual Long COVID symptoms.
  • Lower risks were noted for symptoms like fever, chills, and hair loss.
  • Higher risks were observed for neurological and systemic outcomes, including postural orthostatic tachycardia syndrome, cognitive dysfunction, and fatigue.

Conclusions:

  • Antidepressant exposure, specifically SSRIs/SNRIs, may be associated with distinct patterns of post-COVID-19 symptoms in youth.
  • These findings highlight the complex interplay between neuropsychiatric medication and Long COVID symptomatology.
  • Further research is warranted to elucidate the mechanisms and clinical implications of these associations.

Keywords:
EpidemiologyPaediatricsPsychiatric disorders

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