Neurodevelopmental treatment needs after severe acute respiratory syndrome coronavirus 2 infection in young children: A cohort study

Objective: This cohort study examined whether documented coronavirus disease 2019 in young children affects the need for neurodevelopmental treatment and its association with developmental diagnoses and other medical conditions. Methods: Children with and without coronavirus disease 2019 were compared before and after an index date, defined as the first confirmed severe acute respiratory syndrome coronavirus 2 infection for participants with an infection and a matched reference date for controls. Data were obtained from a large health maintenance organization. Results: The study included 227,728 children born between 1 January 2017 and 31 January 2022 who were followed up from birth until 1 January 2024. Before the index date, there was no significant difference in the neurodevelopmental treatment between the two groups. After diagnosis, the affected children received significantly more treatments than those without an infection. Diagnosed children also exhibited higher rates of ear, nose, and throat; respiratory; and gastrointestinal conditions both before and after diagnosis. Emotional difficulties, including anxiety and acute stress reactions, were more common post-infection, whereas no increase in developmental diagnoses, such as developmental delay and autism spectrum disorder, was observed. Conclusion: Observations on the same cohort before and after severe acute respiratory syndrome coronavirus 2 exposure suggest that the infection rather than adverse neurodevelopmental outcomes prompted greater parental concern and increased therapeutic support.