PATIENTS who experience psychological distress, including anxiety, loneliness, worry, perceived stress, and depression prior to COVID-19 infection, are at higher risk of developing long COVID. Study lead Siwen Wang, Department of Nutrition, Harvard Chan School of Public Health, Boston, Massachusetts, USA, stated: “Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension.”
Long COVID is defined as experiencing COVID-19 related symptoms (such as brain fog, fatigue, respiratory, neurological, digestive, or heart symptoms) for more than 4 weeks after infection. At this time, there is little to no knowledge regarding traits that can lead to long COVID, and the symptoms can last for months or years. Although patients with milder symptoms can experience long COVID, severe illness is associated with an increased risk.
Mental health conditions have been shown to increase the risk of hospitalisation after COVID-19 infection, but have also been associated with more severe, and longer duration of other acute respiratory tract infections, as well as Lyme disease, fibromyalgia, and chronic fatigue syndrome. For this study, Wang and her team asked 54,000 participants about their psychological distress prior to infection. After 1 year, 3,000 had contracted COVID-19. They were then asked about their symptoms and symptom duration.
The researchers concluded that psychological distress before the infection was associated with a 32–46% increase in risk of developing long COVID, and a 14–51% increase in risk of daily life impairment due to long COVID symptoms. This risk was not associated to other health behaviours such as smoking, or physical health conditions such as asthma. Therefore, psychological health needs to be considered a risk factor for long COVID, in addition to physical risk factors. Researcher Andrea Roberts stated: “These results also reinforce the need to increase public awareness of the importance of mental health and to get mental health care for people who need it, including increasing the supply of mental health clinicians and improving access to care.”