Long-term psychological consequences of long Covid: a propensity score matching analysis comparing trajectories of depression and anxiety symptoms before and after contracting long Covid vs short Covid

Abstract

Background: There is a growing global awareness of the psychological consequences of long Covid, supported by emerging empirical evidence. However, the mergence and long-term trajectories of psychological symptoms following the infection are still unclear. Aims: To examine when psychological symptoms first emerge following the infection with SARS-CoV-2, and the long-term trajectories of psychological symptoms comparing long and short Covid groups. Methods: We analysed longitudinal data from the UCL Covid-19 Social Study (March 2020-November 2021). We included data from adults living in England who reported contracting SARS-CoV-2 by November 2021 (N=3,115). Of these, 15.9% reported having had long Covid (N=495). They were matched to participants who had short Covid using propensity score matching on a variety of demographic, socioeconomic and health covariates (N=962, n=13,325) and data were further analysed using growth curve modelling. Results: Depressive and anxiety symptoms increased immediately following the onset of infection in both long and short Covid groups. But the long Covid group had substantially greater initial increases in depressive symptoms and heightened levels over 22 months follow-up. Initial increases in anxiety were not significantly different between groups, but only the short Covid group experienced an improvement in anxiety over follow-up, leading to widening differences between groups. Conclusions: The findings shed light on the psychobiological pathways involved in the development of psychological symptoms relating to long Covid. The results highlight the need for monitoring of mental health and provision of adequate support to be interwoven with diagnosis and treatment of the physical consequences of long Covid.

The Clinical Observation of Inflammation Theory for Depression: The Initiative of the Formosa Long COVID Multicenter Study (FOCuS)

“…Several longitudinal studies on the trajectories of long COVID psychiatric symptoms have shown that some symptoms, such as anxiety, could recover naturally, but some symptoms, particularly depression and cognitive impairments, tend to be chronic [ 8 - 10 , 12 , 24 , 25 ]. Chronic psychiatric sequelae of long COVID are disabling, exerting a long-lasting destructive impact on well-being, quality of life, and educational and occupational functioning, and causing morbidity [ 23 , 26 , 27 ].…”

“…Notably, the relationship between psychiatric disorders/ symptoms and the COVID-19 disease is bidirectional. Patients with a pre-pandemic existing psychiatric disorder were found to be at increased risk for long COVID psychiatric sequelae [ 24 , 28 ]. Life changes and disruptions, restrictions, social isolations, economic loss, and threats of death during the COVID pandemic also create a huge and compound stressful environment where risk factors for psychiatric disorders are exacerbated [ 29 , 30 ].…”

Depressive and anxiety symptoms during the COVID-19 pandemic: A two-year follow-up

“…Existing literature proposes that inflammatory mechanisms in COVID-19 infection could be responsible for an increase in depressive symptoms [30, 31]. This could certainly resonate with the association only being found for depression, and not for anxiety [32]. Although there was no evidence for the longitudinal association of stringency index with depressive symptoms in the ‘freedom’ period, the association was found for anxiety symptoms.…”

Depressive and anxiety symptoms in adults during the COVID-19 pandemic in England: A panel data analysis over 2 years

“…Existing literature proposes that inflammatory mechanisms in COVID-19 infection could be responsible for an increase in depressive symptoms [32,33]. This could certainly resonate with the association only being found for depression, and not for anxiety [34]. Although there was no evidence for the longitudinal association of stringency index with depressive symptoms in the "freedom" period, the association was found for anxiety symptoms.…”