Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 28:27:e63634.
doi: 10.2196/63634.

Health and Experiences During the COVID-19 Pandemic Among Children and Young People: Analysis of Free-Text Responses From the Children and Young People With Long COVID Study

Natalia K Rojas  1 , Sam Martin  1 , Mario Cortina-Borja  2 , Roz Shafran  2 , Lana Fox-Smith  2 , Terence Stephenson  2 , Brian C F Ching  3 , Anaïs d'Oelsnitz  2 , Tom Norris  1 , Yue Xu  4 , Kelsey McOwat  5 , Emma Dalrymple  2 , Isobel Heyman  2   6 , Tamsin Ford  6 , Trudie Chalder  7 , Ruth Simmons  5 ; CLoCk Consortium  8 ; Snehal M Pinto Pereira  1
Affiliations

Health and Experiences During the COVID-19 Pandemic Among Children and Young People: Analysis of Free-Text Responses From the Children and Young People With Long COVID Study

Natalia K Rojas et al. J Med Internet Res. .

Abstract

Background: The literature is equivocal as to whether the predicted negative mental health impact of the COVID-19 pandemic came to fruition. Some quantitative studies report increased emotional problems and depression; others report improved mental health and well-being. Qualitative explorations reveal heterogeneity, with themes ranging from feelings of loss to growth and development.

Objective: This study aims to analyze free-text responses from children and young people participating in the Children and Young People With Long COVID study to get a clearer understanding of how young people were feeling during the pandemic.

Methods: A total of 8224 free-text responses from children and young people were analyzed using InfraNodus, an artificial intelligence-powered text network analysis tool, to determine the most prevalent topics. A random subsample of 411 (5%) of the 8224 responses underwent a manual sentiment analysis; this was reweighted to represent the general population of children and young people in England.

Results: Experiences fell into 6 main overlapping topical clusters: school, examination stress, mental health, emotional impact of the pandemic, social and family support, and physical health (including COVID-19 symptoms). Sentiment analysis showed that statements were largely negative (314/411, 76.4%), with a small proportion being positive (57/411, 13.9%). Those reporting negative sentiment were mostly female (227/314, 72.3%), while those reporting positive sentiment were mostly older (170/314, 54.1%). There were significant observed associations between sentiment and COVID-19 status as well as sex (P=.001 and P<.001, respectively) such that the majority of the responses, regardless of COVID-19 status or sex, were negative; for example, 84.1% (227/270) of the responses from female individuals and 61.7% (87/141) of those from male individuals were negative. There were no observed associations between sentiment and all other examined demographics. The results were broadly similar when reweighted to the general population of children and young people in England: 78.52% (negative), 13.23% (positive), and 8.24% (neutral).

Conclusions: We used InfraNodus to analyze free-text responses from a large sample of children and young people. The majority of responses (314/411, 76.4%) were negative, and many of the children and young people reported experiencing distress across a range of domains related to school, social situations, and mental health. Our findings add to the literature, highlighting the importance of specific considerations for children and young people when responding to national emergencies.

Keywords: AI; COVID-19; InfraNodus; artificial intelligence; children and young people; discourse analysis; experiences; free-text responses; long COVID; sentiment analysis; text mining.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: TS is chair of the UK Health Research Authority and therefore recused himself from the research ethics application. TC is part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, King's College London. She has grants from Guy’s St Thomas Charity Grants, NIHR, and UKRI for post–COVID-19 syndromes. TC is a member of the National Institute for Health and Care Excellence committee for post–COVID-19 condition. She has received travel expenses, accommodation costs, and honorarium for several lectures in Europe and has received travel expenses and accommodation costs for attending the American Thoracic Society Conference. She was on the Expert Advisory Panel for COVID-19 Rapid Guidelines. She has written self-help books on chronic fatigue and has conducted workshops on chronic fatigue and postinfectious syndromes. TF’s research group receives payment for research consultancy to Place2Be, a third-sector organization providing mental health training and interventions in UK schools. All other authors declare no other conflicts of interest.

Figures

Figure 1
Figure 1
Participant selection flowchart. CLoCk: Children and Young People With Long COVID.
See this image and copyright information in PMC

References

    1. Ng CS, Ng SS. Impact of the COVID-19 pandemic on children's mental health: a systematic review. Front Psychiatry. 2022 Oct 18;13:975936. doi: 10.3389/fpsyt.2022.975936. https://europepmc.org/abstract/MED/36329921 - DOI - PMC - PubMed
    1. Orben A, Tomova L, Blakemore SJ. The effects of social deprivation on adolescent development and mental health. Lancet Child Adolesc Health. 2020 Aug;4(8):634–40. doi: 10.1016/S2352-4642(20)30186-3. https://europepmc.org/abstract/MED/32540024 S2352-4642(20)30186-3 - DOI - PMC - PubMed
    1. Torjesen I. COVID-19: mental health services must be boosted to deal with "tsunami" of cases after lockdown. BMJ. 2020 May 15;369:m1994. doi: 10.1136/bmj.m1994. - DOI - PubMed
    1. Bignardi G, Dalmaijer ES, Anwyl-Irvine AL, Smith TA, Siugzdaite R, Uh S, Astle DE. Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown. Arch Dis Child. 2021 Jul 19;106(8):791–7. doi: 10.1136/archdischild-2020-320372. http://adc.bmj.com/lookup/pmidlookup?view=long&pmid=33298552 archdischild-2020-320372 - DOI - PMC - PubMed
    1. Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A, Linney C, McManus MN, Borwick C, Crawley E. Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020 Nov;59(11):1218–39.e3. doi: 10.1016/j.jaac.2020.05.009. https://europepmc.org/abstract/MED/32504808 S0890-8567(20)30337-3 - DOI - PMC - PubMed

LinkOut - more resources