According to the Centers for Disease Control and Prevention (CDC), over 20 percent of Americans who were infected with the coronavirus developed long Covid, defined as experiencing Covid-related symptoms such as fatigue, brain fog, or respiratory, cardiovascular, neurological, or digestive symptoms for more than a month after the initial infection. Although severe acute infections increase the risk of developing long Covid, many people with milder Covid-19 cases are now struggling with this often debilitating – and little understood – condition.
Now, a new study led by Harvard T.H. Chan School of Public Health has found that psychological distress, including depression, anxiety, stress, worry, and loneliness, before the initial Covid-19 infection is associated with an increased risk for long Covid.
“We were surprised by how strongly psychological distress before a Covid-19 infection was associated with an increased risk of long Covid,” said study lead author Siwen Wang, a research fellow in Nutrition at the Harvard Chan School. “Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension.”
Scientists have long known that mental health influences the severity and outcomes of a variety of diseases, including respiratory ones, such as influenza or common cold. To clarify the effects of psychological distress before Covid infections on developing long Covid, the scientists enrolled a cohort of 54,000 participants in April 2020 and assessed their mental health. During the following year, 3,000 of the participants were infected with Sars-Cov-2, and the researchers followed them up to investigate their Covid symptoms and symptom duration.
They discovered that psychological distress before Covid-19 was associated with a 32 to 46 increased risk of long Covid, and a 15 to 51 percent greater risk of struggling with daily life impairments due to this condition.
“To the best of our knowledge, this is the first prospective study to show that a wide range of social and psychological factors are risk factors for long Covid and daily life impairment due to long Covid,” said study senior author Andrea Roberts, an expert in Environmental Health at Harvard.
“We need to consider psychological health in addition to physical health as risk factors of long Covid-19. 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,” she concluded.
The study is published in the journal JAMA Psychiatry.