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.