Pediatric long COVID: relationships with premorbid history of anxiety or depression and health-related quality of life

Objective Up to 25% of youth may develop long COVID following COVID-19 infection. Mood changes are commonly reported; however, few studies use validated measures. This study describes prevalence of self-reported anxious and depressive symptoms among youth with long COVID. We also examined the association of these symptoms with prior mental health diagnosis and health-related quality of life. Methods We conducted a retrospective study of pediatric patients (n=139) evaluated in a pediatric post-COVID-19 rehabilitation clinic who met criteria for long COVID. Patients were included if they completed the Pediatric Quality of Life Inventory (PedsQL), the Multidimensional Anxiety Scale for Children, second edition (MASC 2), and/or the Children’s Depression Inventory, second edition (CDI 2). Relationships between prior anxiety or mood disorder and current depressive and anxious symptoms were assessed using chi-square tests. Relationships between depressive and anxious symptoms and health-related quality of life were examined using multiple linear regression. Results Almost 40% of patients had elevated scores for anxious or depressive symptoms. Prior anxiety or mood disorder diagnosis was associated with higher scores. Depression scores, and specifically the Ineffectiveness subscale, were inversely associated with PedsQL scores. Conclusions Prevalence of anxious and depressive symptoms in this clinical sample was high. Screening measures for mood and anxiety overlap with physical symptoms of long COVID and use of collateral information is recommended. The relationship between the Ineffectiveness subscale and the PedsQL warrants further investigation to evaluate if they assess the same domain or if negative perception of abilities contributes to health-related quality of life.