New Study Suggests Common Mental Health Conditions Could Increase Risk of Long COVID
Long COVID is a condition that has largely mystified doctors, including why some people develop it after having COVID-19 while others don’t. Now, a new study has found a link between having certain mental health conditions and developing long COVID.
The study, which was published in JAMA and conducted by researchers at Harvard University, analyzed survey responses from nearly 55,000 people from April 2020 to November 2021. More than 3,000 of those people said they’d had COVID-19 and, of those, about 1,400 said they had developed long COVID.
The researchers found that people who said they had psychological stressors before they got sick—including stress, anxiety, depression, and feelings of loneliness or worry about the virus—had a 32% to 46% higher risk of developing long COVID than participants who said they didn’t experience those emotions in advance of getting the virus. People who shared that they had high levels of several of those emotions had a 50% higher risk.
The links were higher between long COVID and mental health stressors than they were for known long COVID risk factors like obesity and asthma.
Study co-author Siwen Wang, M.D., a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health, says she and her research team wanted to study this because there are so many unknowns about long COVID. “It has been estimated that 8 to 23 million Americans may suffer from long-term COVID-19 symptoms,” she says. “Despite the high prevalence and daily life impairment associated with long COVID, long COVID is still poorly understood and few risk factors have been established.”
OK, but why might certain mental health conditions raise your risk for long COVID and want can you do to lower your risk? Here’s what you need to know.
Why can anxiety, depression, and other mental health stressors raise your risk of developing long COVID?
Unfortunately, the study didn’t explore this—it simply established a link. Still, there are some theories.
Experiencing depression, anxiety, and high levels of stress and worry may increase inflammation in your body and lower your body’s immune system’s ability to work well, raising your risk of getting sick, Dr. Wang says.
“There is also evidence showing that some people with mental health conditions sometimes develop autoantibodies that have also been associated with increased risk of long COVID,” Dr. Wang says. Depression itself also “affects the brain in ways that may explain certain cognitive symptoms in long COVID,” Dr. Wang says.
There has been other research that ties long COVID to pre-existing psychiatric conditions, but this study strengthens that link, says Amesh A. Adalja, M.D., infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security. Still, he says, there are a lot of unknowns. “It remains to be discovered how this association operates and what the underlying physiological mechanism is,” he says.
What is long COVID, again?
Long COVID, aka post-COVID conditions, is an umbrella term for a wide range of new, returning, or ongoing health issues people have after having COVID-19, according to the Centers for Disease Control and Prevention (CDC). Most people with COVID-19 get better within a few days or weeks, so at least four weeks needs to pass since someone is infected before a person can be diagnosed with long COVID, per the CDC.
There are a lot of symptoms that are included in post-COVID conditions, and someone with long COVID can experience one or several of the following, according to the CDC:
Tiredness or fatigue that interferes with daily life
Symptoms that get worse after physical or mental effort
Fever
Difficulty breathing or shortness of breath
Cough
Chest pain
Heart palpitations
Brain fog
Headache
Sleep problems
Lightheadedness
Pins-and-needles feelings
Change in smell or taste
Depression or anxiety
Diarrhea
Stomach pain
Joint or muscle pain
Rash
Changes in menstrual cycles
How to lower your risk of developing long COVID
According to the CDC, the following people are more likely to develop long COVID:
People who have experienced more severe COVID-19, especially those who were hospitalized or needed intensive care
People who had underlying health conditions before they developed COVID-19
People who did not get a COVID-19 vaccine
People who experienced multisystem inflammatory syndrome (MIS) during or after they had COVID-19
But Dr. Wang says that her findings “suggest the need to consider psychological health in addition to physical health as risk factors of long COVID-19.”
Doing your best to be healthy overall, including eating a healthy diet and exercising regularly, and getting your COVID-19 vaccine can help lower your risk of developing long COVID, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. But he says the mental health aspect is important, too. “We absolutely need to be paying more attention to mental health,” Dr. Russo says. “It’s important for healthcare providers and support members to have discussions with individuals to see where they’re at and to help them get appropriate treatment.”
It’s unclear at this point whether getting treatment for mental health conditions will lower your risk for long COVID but doctors stress that it’s important to take care of mental health right now—and always. “We need to increase public awareness of the importance of mental health and focus on getting mental health care for people who need it, increasing the supply of mental health clinicians, and improving access to care,” Dr. Wang says.
This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.
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