SSRI/SNRI and Long COVID in children and adolescents with neuropsychiatric conditions: A cohort study from the RECOVER Initiative
Zhou, T; Zhang, B; Lu, Y; et al., Nature Mental Health, June 2026
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Short Summary
RECOVER researchers looked at whether taking selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) around the time of having COVID-19 was linked to Long COVID in children, teenagers, and young adults. SSRIs and SNRIs are medicines used to manage mood and mental health symptoms. Researchers reviewed the electronic health records (EHRs) of more than 110,000 young people (ages 5 to 20) who had neuropsychiatric conditions and COVID-19. Neuropsychiatric conditions are disorders that affect how the brain works and how a person thinks, feels, or acts. Researchers compared young people who took SSRIs or SNRIs to those who did not. The study found that taking SSRIs or SNRIs was not linked to a higher or lower chance of receiving a Long COVID diagnosis. However, young people taking these medicines were less likely to experience fever, chills, or hair loss after having COVID-19. Young people taking these medicines were more likely to experience extreme tiredness (fatigue), memory problems, and postural orthostatic tachycardia syndrome (POTS, which is a condition that can cause a fast heart rate when standing up). These findings are important because they suggest that children, teens, and young adults taking SSRIs or SNRIs may have different long-term symptoms after getting COVID-19, which doctors should monitor.
This summary was prepared by the RECOVER Initiative.
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 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.
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
Epidemiology; Paediatrics; Psychiatric disorders