Neurocognitive and emotional long-term effects of COVID-19 infections in children and adolescents: results from a clinical survey in Bavaria, Germany

Abstract

Background

While children and adolescents typically experience mild symptoms during the acute phase of the COVID-19 infection, some may develop severe post-infectious symptoms. In our study Post-COVID Kids Bavaria we integrated somatic and psychiatric aspects of the post-COVID syndrome to provide a holistic description of symptoms, provide early treatment, and detect possible risk factors associated with post-infectious neurocognitive and emotional impairments.

Methods

We conducted an observational study involving 85 pediatric patients aged 12–17 years (M = 12.48, 61.2% female) who had confirmed COVID-19 infections and were experiencing persistent symptoms for at least 4 weeks. Our neuropsychological assessment comprised infection-specific patient interviews, psychopathological examinations, emotional well-being and behavioral difficulty questionnaires, and (computerized) tests assessing concentration, attention, and memory skills. Additionally, patients underwent neurologic, pneumologic, gastrointestinal, and cardiologic assessments.

Results

Overall, the majority of patients reported experiencing elevated levels of fatigue (82.4%), loss of motivation (72.9%), concentration and attention deficits (71.8%), a worsened mood (53%), and a higher level of anxiety (31.8%). The most common diagnosis was the post-COVID adjustment disorder (ICD-10 F43.2, U09.9!; 38.8%) followed by the post-COVID attention deficit disorder (ICD-10 F98.80, U09.9!; 23.5%). Neuropsychiatric evaluation primarily identified deficits in sustained attention. There was a significant association between somatic and psychiatric post-COVID diagnoses. Patients with allergies exhibited a higher risk of developing a post-COVID adjustment disorder. For the post-COVID attention deficit disorder, age, sex, obesity, pre-existing psychiatric diagnosis, and the virus variant were relevant factors.

Conclusions

Our findings indicate a diverse array of neuropsychiatric symptoms associated with the post-COVID syndrome, emphasizing the interconnectedness between somatic and neuropsychiatric diagnoses. To optimize treatment, comprehensive strategies involving both somatic and psychiatric professionals are crucial for addressing the syndrome’s complexity and managing symptoms effectively.

Study registration

The study Post-COVID Kids Bavaria was registered with the German Clinical Trials Register (DRKS), funded by the Bavarian State Ministry of Health, Care and Prevention and approved by the Ethics Committee of the University of Regensburg on the 29th of November, 2021 (Reference: 21-2691-101).