SSRI/SNRI and Long COVID in children and adolescents with neuropsychiatric conditions: A cohort study from the RECOVER Initiative

• June 2026
• Nature Mental Health

Publication Details

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 (RECOVER) 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 (POTS), 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.

Authors

Ting Zhou, Bingyu Zhang, Yiwen Lu, Jiajie Chen, Chengxi Zang, Haoyang Li, Josephine Elia, Raghuram Prasad, Jonathan Arnold, Sean N. Avedissian, L. Charles Bailey, Michael J. Becich, Wyatt P. Bensken, Yuriy Bisyuk, H. Timothy Bunnell, Leah Castro, Elizabeth A. Chrischilles, Dimitri A. Christakis, Lindsay G. Cowell, Mollie R. Cummins, Soledad Fernandez, Daniel Fort, Sandy Gonzalez, Sharon J. Herring, Mady Hornig, Wenke Hwang, Nita Jain, W. Schuyler Jones, David C. Kaelber, Kelly Kelleher, Rachel Kenney, John E. Leikauf, Rebecca Letts, Mei Liu, Aaron Thomas Martinez, Heidi T. May, Abu Saleh Mohammad Mosa, Nathan M. Pajor, Suchitra Rao, Amy L. Salisbury, Srinivasan Suresh, Aparna C. Swaminathan, Bradley W. Taylor, Neena Anne Thomas, David A. Williams, Margot Gage Witvliet, Rainu Kaushal, Fei Wang, Christopher B. Forrest, Yong Chen

Keywords

Not available