Children with long-term COVID-19 infections are falling behind academically and having social difficulties, and a new study reveals the condition can quietly disrupt learning, attention and peer relationships during key developmental years.
Research: School difficulties and prolonged COVID-19 infection in children and adolescents. Image credit: Rawpixel.com/Shutterstock.com
Children living with a long-term infection with COVID-19 may have difficulty doing schoolwork and other school activities, a new study published in an academic journal reports. academic pediatrics.
Long-term symptoms of coronavirus disrupt key stages of children’s development
Long-term coronaviruses are defined as a group of chronic diseases that persist for months to years after the outbreak of acute coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
A significant proportion of the world’s population, including children and young people, is living with long-term COVID-19, but accurate prevalence estimates among children remain uncertain. Existing evidence shows that long-term infection with COVID-19 in children affects daily life activities and that symptoms differ between primary school children and adolescents.
School performance and social interaction both contribute significantly to the mental and physical growth and development of children and adolescents. Prolonged childhood symptoms of COVID-19 can potentially impact these areas of children’s development, thereby negatively impacting their health. Despite the potential negative effects, limited research assessing the long-term academic and societal impact of COVID-19 in this vulnerable population is still emerging.
In the study, a team of US researchers analyzed cross-sectional data from the National Institutes of Health-funded Reinforcing Resilience Study (RECOVER) Pediatric Observational Cohort to assess whether prolonged COVID-19 infection affects school-related functional outcomes in children and adolescents by comparing participants with and without long-term COVID-19 infection. Analyzes used matched comparisons and statistical adjustments to account for differences between groups.
Children with long-term COVID-19 infections have a high rate of academic decline
The study enrolled a total of 1,976 participants between the ages of 6 and 17, including 406 school-age children and 1,570 adolescents. Caregiver-reported information about participants’ school-related functional outcomes was analyzed.
An analysis of parent-reported data revealed that approximately 18% of school-aged children and 29% of adolescents with long-term COVID-19 disease experienced a decline in academic performance after the COVID-19 pandemic, compared with 7% and 11% of children without long-term COVID-19 disease.
In both school-age children and youth groups, significantly higher proportions of participants with prolonged COVID-19 experienced moderate or severe difficulty paying attention or having fun with friends compared to participants without prolonged COVID-19.
Approximately 35% of school-age children and 27% of adolescents with prolonged COVID-19 reported being enrolled or currently enrolled in an individualized education program (IEP), which provides special services and education for children with developmental delays, disabilities, reading and math problems, autism, and other special needs, compared to 22% of school-aged children and 15% of adolescents without prolonged COVID-19.
Schools may need targeted support strategies for affected students
This study highlights that both children and adolescents with long-term COVID-19 infections are likely to experience declines in a variety of school-related outcomes, including academic performance, attention, and interactions with peers. These findings suggest functional impairments that affect children’s ability to engage in academic and social roles. Additionally, the study reveals that prolonged exposure to COVID-19 is associated with an increased likelihood of participation 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 educational performance and positive peer interactions, the findings raise concerns that the long-term effects of coronavirus may carry over into adulthood.
One notable finding was the association between prolonged COVID-19 infection and the need for an IEP, highlighting the greater educational and service needs of children with prolonged COVID-19 infection. However, the researchers said this association may be bidirectional and due to the cross-sectional study design, they were unable to establish causality for the observed association.
As they noted, some children may require special education programs due to pre-existing chronic conditions that are also a risk factor for developing long-term coronavirus, while others may require these programs following new or worsened learning and functional difficulties caused by long-term coronavirus. Further research is needed to establish a causal interpretation.
Importantly, the study found that both children and adolescents experienced adverse educational and social outcomes, despite the known variability in long-term coronavirus symptoms in these two age groups. The findings highlight the need to develop appropriate support systems for students with long-term COVID-19 infection at all grades in elementary, middle and high school.
In the United States, schools receiving federal funding are required to identify and provide additional services to students with learning difficulties or disabilities. Researchers believe that many students with long-term COVID-19 infections fall into this category, and that providing some common services could help these students, such as more time for tests and assignments, more frequent breaks during class, and waiving inaccessible physical education requirements.
Future research should include objective cognitive and academic assessments
This study is based on data reported by caregivers, who may be influenced by bias. Furthermore, only a few school-related outcomes were analyzed. This highlights the need for future research to utilize objective neurocognitive assessments related to academic, cognitive, and social performance, and to analyze a broader range of school-related outcomes, such as absenteeism and absenteeism associated with long-term COVID-19 symptoms. Future research should also investigate factors that can mediate the association between long-term COVID-19 infection and school-related functional outcomes.
Some study participants may have health conditions that make them more susceptible to COVID-19 infection or long-term COVID-19 infection. Identifying and analyzing health conditions that could potentially contribute to school-related negative outcomes associated with prolonged COVID-19 could be another important area for future research.
Additionally, long-term COVID-19 status in this study was determined using study indicators based on reported symptoms rather than clinical diagnosis, which may result in some degree of misclassification.
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