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. 2025 Jun:281:114528.
doi: 10.1016/j.jpeds.2025.114528. Epub 2025 Mar 7.

Well-Being of Children and Adolescents with and without Special Health Care Needs Following the Lifting of Pandemic-Related Restrictions

Elsa Lorthe  1 , Roxane Dumont  2 , Viviane Richard  2 , Andrea Loizeau  2 , Géraldine Blanchard-Rohner  3 , Stephanie Schrempft  2 , Hélène Baysson  2 , Maria-Eugenia Zaballa  2 , Julien Lamour  2 , Philippe Eigenmann  4 , Stéphanie Garcia-Tarodo  5 , Manel Mejbri  3 , Nathalie Rock  6 , Isabelle Ruchonnet-Métrailler  7 , Mayssam Nehme  8 , Rémy P Barbe  9 , Klara M Posfay-Barbe  10 , Idris Guessous  11 , Silvia Stringhini  12 ; SEROCoV-KIDS study group
Collaborators, Affiliations
Free article

Well-Being of Children and Adolescents with and without Special Health Care Needs Following the Lifting of Pandemic-Related Restrictions

Elsa Lorthe et al. J Pediatr. 2025 Jun.
Free article

Abstract

Objective: To examine the physical, psychological, and social well-being of children with and without special health care needs (SHCN) after pandemic-related restrictions were lifted.

Study design: Drawing on three-wave data from the SEROCoV-KIDS prospective, population-based cohort, we performed an outcome-wide, longitudinal analysis to investigate the association of SHCN (none, moderate, or complex needs) at time 1 (September 2022 through February 2023) with physical, psychological, and social well-being (15 outcomes) at time 2 (May through September 2023), adjusting for characteristics and prior outcome values at time 0 (December 2021 through June 2022).

Results: Of 1993 participants aged 2 through 17 years, 1533 completed the time 1 questionnaire (median age 10, 49.6% female) with 10.6% having moderate needs, and 3.3% complex needs. Although children with SHCN had not been more often infected with SARS-CoV-2 than healthy children, in 2023, they experienced more severe psychosocial consequences, especially poorer well-being, with a gradient according to the complexity of their needs. Children with moderate needs had more difficulties with physical (adjusted odds ratio 2.84 [95% confidence interval 1.42-5.67]) and social functioning (2.20 [1.33-3.65]) as well as externalizing difficulties (3.68 [1.67-8.11]) compared with their healthy peers but showed similar levels of prosocial behavior or social support. Those with complex needs were particularly at risk of poor physical, psychological, and social well-being.

Conclusions: Children and adolescents with SHCN suffered from poor well-being after pandemic-related restrictions were lifted, with no obvious improvement over time. Establishing sustained monitoring and tailored interventions is crucial to improve their persistent suboptimal well-being as we move beyond the pandemic era.

Keywords: COVID-19; chronic condition; clinical vulnerability; medical complexity; mental health; pediatrics; special health care needs.

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Conflict of interest statement

Declaration of Competing Interest Klara M. Posfay-Barbe is a member of the Advisory Boards for pneumococcal vaccine and varicella vaccine at MSD. The other authors have no relevant financial or non-financial interests to disclose. Funding: Jacobs Foundation, Federal Office of Public Health of Switzerland, Private Foundation of the Geneva University Hospitals. The funders of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of this article.