Children with long Covid are falling behind in school and struggling socially, new research has revealed how the condition can silently disrupt learning, attention and friendships during crucial developmental years.
Study: School difficulties and long Covid in children and adolescents. Image Credit: rawpixel.com/Shutterstock.com
Children living with COVID for a long time may experience difficulty performing academic and other school activities, according to a new study published in the journal academic pediatrics.
Long-Covid symptoms disrupt key stages of child’s development
Long-COVID is defined as a cluster of chronic conditions that persist months to years after acute coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
A significant portion of the global population is living with long-term COVID, including children and adolescents, although exact prevalence estimates among children are uncertain. Existing evidence indicates that pediatric long-COVID affects activities of daily living, with symptoms varying across primary school-aged children and adolescents.
School performance and social interactions both contribute significantly to the mental and physical development of children and adolescents. Pediatric long-term COVID symptoms can potentially challenge these areas of child development, and thus negatively impact their well-being. Despite potential negative consequences, studies evaluating the long-term educational and social impacts of COVID in this vulnerable population are limited and still emerging.
In the current study, a team of researchers from the United States analyzed cross-sectional data from the National Institutes of Health-funded Research COVID to Enhance Recovery (RECOVER) Pediatric Observational Cohort to evaluate whether long-COVID affects school-related functional outcomes in children and adolescents, comparing participants with and without long-COVID. The analysis used matched comparisons and statistical adjustments to account for differences between groups.
Higher rates of academic decline seen in children suffering from prolonged Covid
The study included a total of 1,976 participants aged 6 to 17, including 406 schoolchildren and 1,570 teenagers. Caregiver-reported information on participants’ school-related functional outcomes was analyzed.
Analysis of caregiver-reported data showed that about 18% of schoolchildren with long COVID and 29% of adolescents experienced a decline in academic grades following the COVID-19 pandemic, compared with 7% and 11% of their peers without long COVID.
In both the group of school-aged children and the teen group, a larger proportion of participants with long-term COVID experienced moderate or severe difficulty paying attention and a lack of fun with friends, compared to their peers without long-term COVID.
Nearly 35% of school-age children and 27% of teens with long-COVID reported being in or in the process of participating in an Individualized Education Program (IEP), compared with 22% of school-age children and 15% of teens who do not have long-COVID, which provides special services for children with special needs, including developmental delays, disabilities, reading or math problems, or autism. Or provides education.
Schools may need targeted support strategies for affected students
The study highlights that both children and adolescents with long Covid are more likely to experience declines in a variety of school-related outcomes, including academic grades, attention levels and interactions with friends. These findings suggest functional impairment affecting children’s ability to engage in academic and social roles. Additionally, studies show that having long-COVID increases the likelihood of children with special needs participating in special education programs designed for children with special needs.
Given that the development and well-being of children and adolescents is strongly linked to their educational performance and positive peer interactions, the study findings raise concerns about the potential long-term functional and developmental consequences of long-term COVID-19 that could potentially last into their adulthood.
A notable finding is the association between long-COVID and the need for an IEP, which emphasizes the greater educational and service needs of children with long-COVID. However, the researchers noted that this relationship may be bidirectional and that they were unable to establish the cause of the observed relationship due to the cross-sectional study design.
As noted by them, some children may need special education programs due to existing chronic conditions that were also risk factors for developing Long-COVID, while others may need these programs following new or worsening learning and functional difficulties due to Long-COVID. Further research is needed to establish a causal explanation.
Importantly, the study shows that both children and adolescents experienced adverse educational and social outcomes, despite known differences in long-term COVID symptoms in these two age groups. This finding highlights the need to develop appropriate support systems for students suffering from long COVID across all grades, primary school, middle school and high school.
In the United States, schools receiving federal funding are required to identify students who have learning difficulties or disabilities, and to provide them with additional services. Researchers believe that many students with long COVID meet this need, and the provision of some common services may be helpful for these students, including extended time for tests and assignments, frequent breaks during classes, or exemption from difficult physical education requirements.
Future studies should include objective cognitive and academic assessments
The study relied on caregiver-reported data which may be subject to bias. Furthermore, only some school-related outcomes were analyzed. This highlights the need for future studies that use objective neurocognitive assessments related to academic, cognitive, and social performance and analyze a broader range of school-related outcomes, such as prolonged absences or missed school days related to COVID symptoms. Future studies should also explore factors that may mediate the association between long-term COVID and school-related functional outcomes.
Of the study participants, some may have existing health conditions that predispose them to COVID-19 as well as long-term COVID. Identifying and analyzing health conditions that may potentially contribute to school-related adverse outcomes associated with long-COVID may be another important area for future research.
Additionally, long-COVID status in the study was determined using a research index based on reported symptoms rather than clinical diagnosis, which may introduce some degree of misclassification.
