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Review Open Access

Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review)

  • Authors:
    • Ioanna Giannopoulou
    • Vasiliki Efstathiou
    • Maria-Ioanna Stefanou
    • Panagiota Korkoliakou
    • James N. Tsoporis
    • Demetrios A. Spandidos
    • Emmanouil Rizos
  • View Affiliations / Copyright

    Affiliations: Second Department of Psychiatry, ‘Attikon’ University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece, Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, 15772 Athens, Greece, Second Department of Neurology, ‘Attikon’ University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece, Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario M5B 1W8, Canada, Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
    Copyright: © Giannopoulou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 137
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    Published online on: March 16, 2026
       https://doi.org/10.3892/etm.2026.13132
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Abstract

Early childhood development depends on stable routines, social interaction and responsive caregiving. The 2019 coronavirus disease pandemic disrupted these supports through lockdowns, reduced early‑education access and elevated caregiver stress. The present review synthesized empirical studies (2020‑2025) of children aged 0‑5 years and found consistent evidence of modest increases in emotional and behavioral difficulties, particularly where caregiver stress or socioeconomic adversity was elevated. Cognitive, language and executive‑function (EF) outcomes were found to be more heterogeneous and appeared most affected in the contexts of reduced stimulation or limited access to early learning, with EF processes showing particular sensitivity to stress‑related and environmental disruptions. Biological findings (cortisol, DNA methylation and infant brain measures) showed a number of converging signals, particularly in higher‑risk contexts, but remained preliminary given modest sample sizes, methodological heterogeneity and limited replication. Overall, this suggested that pandemic‑related disruptions disproportionately affected children in vulnerable family contexts. Therefore, the present study suggested targeted caregiver mental‑health support, preservation of early‑education access during emergencies and longitudinal follow‑up of high‑risk cohorts.
View Figures

Figure 1

Conceptual pathway model integrating
caregiver mental health, biological stress pathways and
environmental inputs as mediators associating pandemic-related
exposures with early childhood developmental outcomes. The present
model summarizes the evidence regarding how pandemic-related
exposures may have influenced socioemotional, cognitive and
biological development. Key exposure categories included family
disruption, caregiver mental health challenges, disruptions to
learning in early childhood (such as reduced access to early
childhood education and limited stimulation), prenatal stress and
maternal SARS-CoV-2 infection. These exposures may influence
developmental outcomes through interconnected pathways involving
caregiver functioning, environmental inputs, prenatal stress
effects and biological embedding (including epigenetic and
neurobiological changes). Observed developmental outcomes included
elevated socioemotional difficulties (such as emotional and
behavioral symptoms or peer problems), modest cognitive,
communication and language delays (particularly among preterm or
high-risk infants) and biological alterations (such as DNA
methylation differences or altered brain structure/connectivity).
The overall pattern indicated possible context-dependent effects,
with the strongest developmental disruptions observed in
socioeconomically disadvantaged or high-stress caregiving
environments. Mild or asymptomatic maternal infection was not
consistently associated with developmental differences. Although
interpretation was limited by methodological variability across
studies, the present model summarizes converging evidence on early
developmental vulnerabilities during the 2019 coronavirus disease
pandemic. Images were generated using BioRender (https://www.biorender.com/). SARS-CoV-2, severe acute
respiratory syndrome coronavirus 2; NR3C1, nuclear receptor
subfamily 3 group C member 1; SLC6A4, solute carrier family 6
member 4.
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Copy and paste a formatted citation
Spandidos Publications style
Giannopoulou I, Efstathiou V, Stefanou M, Korkoliakou P, Tsoporis JN, Spandidos DA and Rizos E: Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review). Exp Ther Med 31: 137, 2026.
APA
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J.N., Spandidos, D.A., & Rizos, E. (2026). Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review). Experimental and Therapeutic Medicine, 31, 137. https://doi.org/10.3892/etm.2026.13132
MLA
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J. N., Spandidos, D. A., Rizos, E."Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review)". Experimental and Therapeutic Medicine 31.5 (2026): 137.
Chicago
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J. N., Spandidos, D. A., Rizos, E."Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review)". Experimental and Therapeutic Medicine 31, no. 5 (2026): 137. https://doi.org/10.3892/etm.2026.13132
Copy and paste a formatted citation
x
Spandidos Publications style
Giannopoulou I, Efstathiou V, Stefanou M, Korkoliakou P, Tsoporis JN, Spandidos DA and Rizos E: Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review). Exp Ther Med 31: 137, 2026.
APA
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J.N., Spandidos, D.A., & Rizos, E. (2026). Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review). Experimental and Therapeutic Medicine, 31, 137. https://doi.org/10.3892/etm.2026.13132
MLA
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J. N., Spandidos, D. A., Rizos, E."Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review)". Experimental and Therapeutic Medicine 31.5 (2026): 137.
Chicago
Giannopoulou, I., Efstathiou, V., Stefanou, M., Korkoliakou, P., Tsoporis, J. N., Spandidos, D. A., Rizos, E."Disrupted beginnings: Neurodevelopmental outcomes of COVID‑19 lockdowns in early childhood (Review)". Experimental and Therapeutic Medicine 31, no. 5 (2026): 137. https://doi.org/10.3892/etm.2026.13132
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