Objectives: In response to the novel coronavirus disease (COVID-19), many countries have temporarily closed educational institutions. As of June 10, 2020, more than 1.1 billion students have been affected by pandemic-related school closures. This literature review seeks to highlight key areas in which the mental health of children and adolescents worldwide are impacted by school closures. Methods: A search of Google Scholar and PubMed electronic databases was conducted using search terms including "COVID-19," "school closure," "mental health," and "anxiety" in various permutations. We selected 11 of the 79 initial search results that specifically addressed school-closure effects on the pediatric population, which included 1 longitudinal study, 1 crosssectional study, and 9 commentaries, and then we performed a narrative review.Results: Regarding broad impacts on the general school-age population, several publications identified a significant increase in both sedentary behavior and screen time. Several papers also highlighted the loss of structure afforded by school routine and its disruption of mood, organization, and motivation. Adolescents experience significant anxiety regarding academic performance associated with the disruption of standardized exams and unfamiliar online learning modalities. Increased time spent at home may also present significant risk to students with stressful, unstable, or abusive home environments. School closures also exert a significant impact on existing social disparities. Food insecurity is significantly exacerbated by the loss of scheduled school meals, further compounded by the increased financial burden of a COVID-related economic recession. Similarly, access to health care, including school nurses and mental health services, is limited. Many online learning tools require devices, internet connection, and a suitable learning environment, presenting a severe disadvantage for children of lowerincome households. Conclusions: School closure is an ongoing, unprecedented disruption in the lives of billions of children and adolescents worldwide. As the education system continues to change in response to COVID-19, it is vital to identify and address impacts on the mental health of this population of students, especially in the context of social disparities and inequalities.
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