The Impact of COVID-19 Infection and Characterization of Long COVID in Adolescents With Anxiety Disorders: A Prospective Longitudinal Study

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 62; no. 7; pp. 707 - 709
• Main Authors: Strawn, Jeffrey R., Mills, Jeffrey A., Schroeder, Heidi K., Neptune, Zoe A., Specht, Ashley, Keeshin, Susana W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2023; Elsevier BV; Published by Elsevier Inc. on behalf of the American Academy of Child and Adolescent Psychiatry
• Subjects: Adolescent; Adolescents; Anxiety; Anxiety - psychology; Anxiety disorders; Anxiety Disorders - psychology; Child; Citalopram; Complications; Coronaviruses; COVID-19; Depression - psychology; Duloxetine; Empirical Letter to the Editor; Families & family life; Gender; Generalized anxiety disorder; Humans; Impressions; Infections; Longitudinal Studies; Measures; Mental depression; Mental health; Minority & ethnic groups; Monte Carlo simulation; Multisystem inflammatory syndrome in children; Neuropsychiatric symptoms; Pandemics; Patients; Pediatrics; Post-Acute COVID-19 Syndrome; Prospective Studies; Psychiatrists; Respiratory diseases; SARS-CoV-2; Separation Anxiety; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity; Sleep disorders; Symptoms; Teenagers
• ISSN: 0890-8567; 1527-5418; 1527-5418
• DOI: 10.1016/j.jaac.2022.12.027

While the coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted pediatric mental health, the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection on youth with anxiety disorders has not been prospectively examined. Further, there are limited prospective data on post-acute sequelae COVID-19, including symptoms that constitute the long COVID neuropsychiatric syndrome. In December 2019, we began a longitudinal study of adolescents aged 12-17 years with DSM-5 primary anxiety disorders treated with either duloxetine or escitalopram. Assessments included all items from the Generalized Anxiety Disorder-7 (GAD-7) and Quick Inventory of Depressive Symptomatology (QIDS) scales at each week and a weekly clinician-rated Clinical Global Impressions-Severity (CGI-S) scale. We examined the longitudinal course of anxiety, including following laboratory-confirmed SARS-CoV-2 infection in affected adolescents. This prospective study of the longitudinal impact of COVID-19 in pediatric anxiety disorders reveals that COVID-19 is associated with worsening anxiety symptoms and a disquieting 33% worsening in syndromic severity. Further, these data raise the possibility that, in anxious youth, COVID-19 is associated with a surfeit of neuropsychiatric symptoms.