{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:55:55Z","timestamp":1785412555447,"version":"3.56.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>While the COVID-19 pandemic has significantly impacted mental health, limited information exists on the relationship between COVID-19 infection and mental health disorders in children and adolescents. This study explored the association between COVID-19 infection, infection severity, and the risk of depression and anxiety among school-aged youth. Data from the 2019\u20132021 Utah All Payers Claims Database (APCD) was used to identify children and adolescents (aged 6\u201315 years in 2019) covered by private insurance or Medicaid. Depression and anxiety diagnoses in 2021 were identified using diagnosis codes. Entropy balancing was applied to balance baseline differences between youth with and without a COVID-19 infection in 2020. Weighted logistic regression was conducted to identify factors associated with incidence of depression and anxiety. A total of 154,579 subjects were included, with an average age of 10.8 years (SD: 2.8); 48% were female. Youth with a COVID-19 infection had a 49% higher likelihood of having new depression or anxiety diagnoses in 2021 (OR = 1.49, p\u2009&lt;\u20090.01). Compared to youth without COVID-19 infection, those with moderate symptoms had a 40% higher likelihood (OR = 1.40, p\u2009&lt;\u20090.01), and those with severe symptoms had a 60% higher likelihood (OR = 1.60, p\u2009&lt;\u20090.01) of developing depression or anxiety. This population-level study found that COVID-19 infection, especially severe cases, is associated with an increased risk of depression and anxiety in children and adolescents. These findings underscore the importance of targeted mental health interventions for youth impacted by the infection.<\/jats:p>","DOI":"10.1371\/journal.pone.0331984","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T17:37:49Z","timestamp":1757353069000},"page":"e0331984","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence of depression and anxiety in children and adolescents following COVID-19 infection"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8147-1159","authenticated-orcid":true,"given":"Jaewhan","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carson R.","family":"Ewing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlee","family":"Larson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chathuri","family":"Illapperuma-Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeka Elvis","family":"Duru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youngwoo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"pone.0331984.ref001","volume-title":"The state of mental health in America 2019","author":"Mental Health America","year":"2019"},{"key":"pone.0331984.ref002","volume-title":"The state of mental health in America 2023","author":"Mental Health America","year":"2023"},{"issue":"8","key":"pone.0331984.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00787-021-01758-x","article-title":"The impact of school closure and social isolation on children in vulnerable families during COVID-19: a focus on children\u2019s reactions","volume":"31","author":"L Larsen","year":"2022","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"11","key":"pone.0331984.ref004","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaac.2020.05.009","article-title":"Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19","volume":"59","author":"ME Loades","year":"2020","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"pone.0331984.ref005","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jaacop.2023.12.004","article-title":"Impact of SARS-CoV-2 (COVID-19) infections on mental health diagnoses in youth with chronic illness","volume":"2","author":"M McVoy","year":"2023","journal-title":"JAACAP Open"},{"key":"pone.0331984.ref006","article-title":"Post\u2013COVID-19 mental health distress in 13 million youth: a retrospective cohort study of electronic health records","author":"Y Zhang-James","year":"2024","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"22","key":"pone.0331984.ref007","doi-asserted-by":"crossref","first-page":"8479","DOI":"10.3390\/ijerph17228479","article-title":"Exploring the impact of COVID-19 on mental health outcomes in children and adolescents: a systematic review","volume":"17","author":"F Nearchou","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0331984.ref008","doi-asserted-by":"crossref","first-page":"628707","DOI":"10.3389\/fpsyg.2021.628707","article-title":"The mental health impacts of COVID-19 on pediatric patients following recovery","volume":"12","author":"D Liu","year":"2021","journal-title":"Front Psychol"},{"issue":"4","key":"pone.0331984.ref009","doi-asserted-by":"crossref","first-page":"772","DOI":"10.3390\/biomedicines10040772","article-title":"The impact of SARS-CoV-2 infection on youth mental health: a narrative review","volume":"10","author":"C Brasso","year":"2022","journal-title":"Biomedicines"},{"issue":"4","key":"pone.0331984.ref010","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.jadohealth.2023.05.022","article-title":"Youth mental health outcomes up to two years after SARS-CoV-2 infection long-COVID or long-pandemic syndrome: a retrospective cohort study","volume":"73","author":"Y Bilu","year":"2023","journal-title":"J Adolesc Health"},{"issue":"2","key":"pone.0331984.ref011","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/camh.12501","article-title":"Review: mental health impacts of the COVID-19 pandemic on children and youth - 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