A new study led by researchers at Mass General Brigham has found that children and adolescents living in households with economic instability and adverse social conditions are more likely to experience long COVID. The research, published in JAMA Pediatrics, analyzed data from the federally funded RECOVER Initiative, which included 903 school-aged children and 3,681 adolescents with a history of SARS-CoV-2 infection from 52 sites across the United States.
The study examined how 24 different social risk factors—grouped into five domains including economic stability, social context, caregiver education access and quality, neighborhood environment, and healthcare access—are linked to long COVID risk in young people. According to the findings, children facing food insecurity or living in environments with low social support and high levels of discrimination had a significantly higher chance of developing prolonged symptoms after COVID-19 infection.
"Long COVID in children is especially concerning because of the potential for long-term health effects that could persist into adulthood," said Tanayott Thaweethai, PhD, co-first author from Massachusetts General Hospital Biostatistics. "Public health interventions that target social risk factors-such as food insecurity and lack of social support-are critical to reduce the burden of long COVID and safeguard the overall health of children as they continue to acquire COVID-19."
The researchers noted that while previous studies have looked at adults or focused on how adverse social determinants affect initial COVID-19 illness risk, this work highlights millions of children worldwide who may suffer ongoing symptoms. The analysis showed that economic instability—such as difficulty covering expenses—and poor social context were most strongly associated with increased long COVID risk. Conversely, food security appeared protective even when families faced other financial challenges.
The authors suggest that healthy diets might lower inflammation and help protect against long COVID but emphasize further research is needed to determine if addressing these adverse conditions can reduce future disease risks.
