Researchers: Yuval Bloch¹

Background: The COVID-19 pandemic has profoundly affected children’s mental health worldwide. Most studies have attributed these effects to the psychological consequences of social distancing, school closures, and lifestyle disruptions. However, evidence regarding the potential impact of the viral infection itself on psychiatric morbidity in children remains scarce. Although most pediatric cases were mild or asymptomatic, it is unclear whether SARS-CoV-2 infection independently contributes to increased mental health problems.

Objectives: This study aimed to evaluate the association between COVID-19 infection and subsequent psychiatric morbidity in children, and to clarify whether changes in mental health outcomes are linked to viral infection itself or to broader environmental changes during the pandemic.

Method: We conducted a population-based cohort study using the anonymized electronic health records of Clalit Health Services, covering hundreds of thousands of children in Israel. Children with a positive COVID-19 PCR test were compared to those with a negative test. Outcomes included new psychiatric diagnoses and the initiation of pharmacological treatments within one year of testing.

Findings: Children who tested positive for COVID-19 demonstrated a higher incidence of newly diagnosed anxiety disorders and attention-deficit/hyperactivity disorder (ADHD) compared to those who tested negative. In parallel, there was an increase in prescriptions for anxiolytic and ADHD-related medications among the COVID-positive group. These differences persisted after adjusting for demographic and clinical covariates.

Conclusions: Our findings suggest that COVID-19 infection in children is associated with an elevated risk of psychiatric morbidity, particularly anxiety and ADHD, beyond the psychosocial consequences of pandemic restrictions. Nevertheless, the study design does not allow differentiation between direct biological effects of infection and stress responses related to illness.

Recommendations: Children recovering from COVID-19 represent a vulnerable population at risk for developing mental health disorders. These children warrant careful clinical monitoring, targeted interventions, and long-term follow-up to assess the trajectory and persistence of psychiatric outcomes.

Research end date: 08/2025