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Does SARS-CoV-2 Infection Increase the Frequency and Risk of Neuropsychiatric and Related Conditions? Findings from Difference-in-Differences Analyses
24 Pages Posted: 11 Oct 2024
More...Abstract
Background: The COVID-19 pandemic has been linked to an increase in neuropsychiatric conditions in children and youths. Some studies suggest that SARS-CoV-2 infection may pose additional risks beyond those caused by pandemic stressors. However, prior research has often focused on limited conditions and needed more proper control for infection risk factors. This study aims to compare the full spectrum of neuropsychiatric conditions in COVID-19 positive children and youths (ages 5-12 and 12-21) with a matched COVID-19 negative cohort, accounting for factors influencing infection risk.
Methods: In this retrospective study, we analyzed EHR data from 25 institutions in the RECOVER program. We compared the frequency of neuropsychiatric and related conditions 28 to 179 days post-SARS-CoV-2 infection or negative test from March 2020 to December 2022. The COVID-19 positive cohort included 326,074 participants, while the negative cohort included 887,314 participants, all matched for risk factors and stratified by age. SARS-CoV-2 positivity was confirmed via PCR, serology, or antigen tests, while negativity was based on negative tests and the absence of diagnoses. Risk differences for neuropsychiatric conditions between the two cohorts were calculated.
Outcomes: The COVID-19 positive group had a higher frequency of neuropsychiatric disorders compared to the negative group. Children had higher risks of anxiety, OCD, ADHD, autism, and other conditions. Youths showed elevated risks for anxiety, suicidality, depression, and other symptoms.
Interpretation: The findings suggest that COVID-19 infection poses additional risks for neuropsychiatric conditions, underscoring the need for further research on treatments and preventive strategies tailored to infected individuals.
Funding: This research was funded by the National Institutes of Health (NIH) Agreement OTA OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) research Initiative.
Declaration of Interest: Dr. Jhaveri is a consultant for AstraZeneca, Seqirus, Dynavax, receives an editorial stipend from Elsevier and Pediatric Infectious Diseases Society and royalties from Up To Date/Wolters Kluwer.
Ethical Approval: The Institutional Review Board (IRB) obtained approval under Biomedical Research Alliance of New York (BRANY) protocol #21-08-508, with a waiver of consent and HIPAA authorization.
Keywords: COVID-19, Pediatrics, Neuropsychiatry, PASC, Long-COVID
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