ADVERTISEMENT
Psychological Distress Raises Risk of ‘Long COVID’
Preexisting psychological distress is linked with a heightened risk of developing COVID-19-related symptoms that last 4 weeks or more, or so-called “long COVID,” suggest study findings published online in JAMA Psychiatry.
“In this prospective study of individuals followed up for more [than] a year starting in April 2020, we found preinfection psychological distress, including symptoms of depression, symptoms of anxiety, worry about COVID-19, loneliness, and perceived stress, was strongly associated with risk of post–COVID-19 conditions among those infected with SARS-CoV-2,” researchers reported. “These associations remained significant after further adjustment for health-related factors.”
Related: Neuropsychiatric Risk After COVID-19 On Par With Other Severe Respiratory Infections
The study included 3193 individuals free of SARS-CoV-2 infection at baseline but who reported a positive SARS-CoV-2 test over the next 12 months. Validated questionnaires measured depression, anxiety, worry about COVID-19, perceived stress, and loneliness at baseline. A total of 1403 participants reported post–COVID-19 conditions beyond 4 weeks.
Depression, anxiety, perceived stress, loneliness, and worry about COVID-19 at baseline were each prospectively associated with a 1.3- to 1.5-fold increased risk of post-COVID-19 conditions. Risk ratios for long COVID were 1.46 with perceived stress, 1.42 with probable anxiety, 1.37 with worry about COVID-19, 1.32 with probable depression, and 1.32 with loneliness. Experiencing two or more types of distress before infection was linked with a nearly 50% increased risk for post-COVID-19 conditions.
Similarly, all types of distress were associated with increased risk of daily life impairment due to long COVID, which was reported by 783 study participants.
“Our results should not be misinterpreted as supporting a hypothesis that post-COVID-19 conditions are psychosomatic,” wrote researchers, who pointed out that more than 40% of people in the study who developed long COVID reported no distress at baseline. The research team went on to add that post-COVID-19 condition symptoms—such as smell and taste problems or difficulty breathing— are often distinct from mental illness symptoms and that exercise in patients with long COVID appears to trigger relapses rather than ease symptoms as it does for mental health conditions.
Inflammation and immune dysregulation, however, may play a role, they speculated.
“Future work should examine the biobehavioral mechanism linking psychological distress with persistent postinfection symptoms,” the researchers advised.
Reference
