Journal article
SSRI/SNRI and long COVID in children and adolescents with neuropsychiatric conditions: a cohort study from the RECOVER Initiative
Nature mental health
06/29/2026
DOI: 10.1038/s44220-026-00675-9
Abstract
Long COVID has been an important health concern in children and adolescents, yet factors associated with its development remain incompletely understood. Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are widely prescribed for pediatric neuropsychiatric conditions and may influence immune and autonomic pathways involved in postinfectious symptoms. Here we show associations between SSRI/SNRI use and long coronavirus disease (COVID)-related outcomes in a retrospective cohort of 110,955 children and adolescents with pre-existing neuropsychiatric conditions across 37 US health systems participating in the National Institutes of Health Researching COVID to Enhance Recovery consortium. SSRI/SNRI use was not associated with clinician-recorded long COVID diagnosis but showed heterogeneous associations with individual symptoms. Lower risks were observed for some symptoms, including fever, chills and hair loss, whereas higher risks were observed for neurological and systemic outcomes, including postural orthostatic tachycardia syndrome, cognitive dysfunction and fatigue. These findings suggest that antidepressant exposure may be associated with differing post-COVID symptom patterns in youth and warrant further investigation.
Details
- Title: Subtitle
- SSRI/SNRI and long COVID in children and adolescents with neuropsychiatric conditions: a cohort study from the RECOVER Initiative
- Creators
- Ting Zhou - University of PennsylvaniaBingyu Zhang - University of PennsylvaniaYiwen Lu - University of PennsylvaniaJiajie Chen - University of PennsylvaniaChengxi Zang - Cornell UniversityHaoyang Li - Cornell UniversityJosephine Elia - Nemours Children's Health SystemRaghuram Prasad - Children's Hospital of PhiladelphiaJonathan Arnold - University of PittsburghSean N. Avedissian - Nebraska Medical CenterL. Charles Bailey - Children's Hospital of PhiladelphiaMichael J. Becich - University of PittsburghWyatt P. Bensken - OchinYuriy Bisyuk - University Medical Center New OrleansH. Timothy Bunnell - Nemours Children's Health SystemLeah Castro - Community CareElizabeth A. Chrischilles - University of IowaDimitri A. Christakis - Seattle Children's HospitalLindsay G. Cowell - The University of Texas Southwestern Medical CenterMollie R. Cummins - University of UtahSoledad Fernandez - The Ohio State UniversityDaniel Fort - Ochsner Health SystemSandy Gonzalez - Miami Children's HospitalSharon J. Herring - Temple UniversityMady Hornig - Feinstein Institute for Medical ResearchWenke Hwang - Department of Public HealthNita Jain - Community CareW. Schuyler Jones - Duke UniversityDavid C. Kaelber - MetroHealth Medical CenterKelly Kelleher - Nationwide Children's HospitalRachel Kenney - New York UniversityJohn E. Leikauf - American Academy of Child and Adolescent PsychiatryRebecca Letts - Community CareMei Liu - University of Florida HealthAaron Thomas Martinez - Community CareHeidi T. May - Intermountain Medical CenterAbu Saleh Mohammad Mosa - University of Alabama at BirminghamNathan M. Pajor - Cincinnati Children's Hospital Medical CenterSuchitra Rao - Children's Hospital ColoradoAmy L. Salisbury - Virginia Commonwealth UniversitySrinivasan Suresh - University of PittsburghAparna C. Swaminathan - Duke UniversityBradley W. Taylor - Medical College of WisconsinNeena Anne Thomas - The Ohio State UniversityDavid A. Williams - University of MichiganMargot Gage Witvliet - Community CareRainu Kaushal - Cornell UniversityFei Wang - Cornell UniversityChristopher B. Forrest - Children's Hospital of PhiladelphiaYong Chen - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Nature mental health
- DOI
- 10.1038/s44220-026-00675-9
- ISSN
- 2731-6076
- eISSN
- 2731-6076
- Publisher
- Springer Nature
- Grant note
- U.S. Department of Health & Human Services | National Institutes of Health (NIH): OT2HL161847-01
This research was funded by the NIH Agreement OTA OT2HL161847-01 (to Y.C.) as part of the RECOVER research Initiative. This study is part of the NIH RECOVER Initiative, which seeks to understand, treat and prevent PASC. For more information on RECOVER, visit https://recovercovid.org/. We thank the National Community Engagement Group, all patient, caregiver and community representatives and all the participants enrolled in the RECOVER Initiative. This content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER Initiative, the NIH or other funders. The views, statements and opinions presented in this publication are solely the responsibility of the author(s) and do not necessarily represent the views of other organizations participating in, collaborating with or funding PCORnet or of the Patient-Centered Outcomes Research Institute. Authorship has been determined according to ICMJE recommendations.
- Language
- English
- Electronic publication date
- 06/29/2026
- Academic Unit
- Pharmacy; Epidemiology
- Record Identifier
- 9985182281902771
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