Mental and physical health differences between youth infected and uninfected by SARS-CoV-2: data from 2021 to 2023

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OBJECTIVE: The COVID-19 pandemic had a profound impact on children's well-being. This study examines the mental and physical health of youth infected with SARS-CoV-2 in comparison to uninfected youth and infected youths' functioning across pandemic waves. METHODS: Baseline parent-proxy and self-report questionnaire data from SARS-CoV-2-infected and uninfected youth were collected as part of a multisite, prospective, longitudinal observational study to evaluate clinical manifestations of SARS-CoV-2 infection in youth. Measures included the Developmental Profile-4, PROMIS scales, and the CoRonavIruS health Impact Survey. RESULTS: Data on 684 infected and 147 uninfected youth (median age = 8.9 years) were analyzed. There was no difference between groups regarding developmental concerns. When controlling for age/gender, caregivers of infected youth reported worse youth global health, physical functioning, cognitive functioning, pain interference, fatigue, and sleep disturbance compared to caregivers of uninfected youth, ps < .05. Infected youth reported worse fatigue and sleep disturbance compared to uninfected youth, ps < .05. Anxiety, depressive symptoms, and peer relationships did not differ between groups. Infected youth categorized as "at risk" were more likely to be female, older, have a pre-existing condition, were infected during the wild-type SARS-CoV-2 wave, or were infected more than 90 days prior to baseline. CONCLUSIONS: Baseline data from a large cohort study indicate that the physical functioning of youth infected with SARS-CoV-2 was worse than that of uninfected youth, but mental health concerns were comparable. Data may reflect the direct impact of SARS-CoV-2 on physical health and the overall impact of the COVID-19 pandemic on all youths' mental health. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04830852.