Study finds link between poor mental health and long Covid | Long Covid

People who were very stressed, anxious, lonely or depressed before catching the coronavirus are more prone to long Covid than those in good mental health, a major study has found.

A Harvard analysis of health data from nearly 55,000 US volunteers, most of whom were women, found that high levels of psychological distress before Covid infection increased long-term disease risk by 32 to 46 %.

The findings underscore the urgent need to support people with mental health conditions and the importance of building mental health resilience in the population more broadly to reduce the impact of long Covid.

“Depression, stress and loneliness are very, very common, and the fact that they significantly increase the risk of long Covid is notable,” said Andrea Roberts, principal investigator at Harvard TH Chan School of Public Health. “The associations were stronger with these risk factors than with other things we know are associated with long Covid, such as obesity, hypertension and asthma.”

A significant minority of people who catch Covid develop long-term, often debilitating conditions such as fatigue, shortness of breath, brain fog and heart problems. About one in six middle-aged people and one in 13 young adults in the UK have symptoms that persist for more than three months. There are thought to be multiple causes, ranging from abnormal immune responses to damaged tissues and residual viruses lurking in the body.

Although the relationship between mental well-being and long Covid is unclear, psychological distress can lead to chronic inflammation and disrupt the immune system, potentially making people more vulnerable to long Covid, researchers note in JAMA Psychiatry.

The Harvard team used questionnaires to rank the mental well-being of 54,960 American volunteers from the Nurses’ Health Studies and the Growing Up Today Study. Most of the volunteers were white nurses between the ages of 40 and 70. As of April 2020, none had tested positive for Covid, but over the following year more than 3,000 caught the virus and recorded their symptoms.

Those who scored higher on depression, stress, anxiety, loneliness and worry before catching Covid were more likely to report symptoms lasting longer than a month. These persistent symptoms were 49% more likely in people with two or more forms of psychological distress than in those who reported none. A similar finding was seen in people whose symptoms lasted at least two months.

All Covid symptoms except coughing and problems with smell or taste were more common among those who were distressed before catching the virus. Depending on the type of distress, volunteers were 15% to 51% more likely to say the long Covid had altered their daily life compared to those who had no mental health issues before testing positive.

The results do not mean that mental health problems cause long Covid: more than 40% of those who developed long Covid in the study had no signs of distress before infection.

Mental health is known to affect certain illnesses. Stress has been linked to a greater susceptibility to colds and other respiratory tract infections. Last year, researchers in London reported that poor mental health before the pandemic increased the risk of long Covid, as did being older, female, overweight, in poor general health and in pain. of asthma. A separate study of people with multiple sclerosis found that people with anxiety or depression took longer to recover from Covid.

Siwen Wang, a Harvard epidemiologist and the study’s first author, said it’s important that people with poor mental health have good access to high-quality care. “Future research should determine whether better management of psychological distress can prevent people from getting long Covid or improve their symptoms,” she said.

Claire Steves, professor of aging and health at King’s College London, who was part of a team that found a link between mental health and the long Covid last year, said the Harvard study underscored the need to strengthen support for vulnerable people and improve mental health. resilience of the general population. “It is important to clarify that this association does not imply that prior mental health conditions cause long Covid, but rather that mental health conditions increase the vulnerability of individuals, due to a decrease in reserve, so that physiological changes manifest themselves in everyday life.”

Adrian James, president of the Royal College of Psychiatrists, said: “People with severe mental illness are at higher risk of developing a range of physical health conditions, including long Covid. We are still learning about the impact of the virus on people’s physical and mental health, but we know that the long Covid can cause debilitating symptoms. People with long-term Covid need to be able to access the healthcare they need, including appropriate specialist mental health services.

“It is also vital that research into the impacts of the long Covid in people with pre-existing mental illness continues, if we are to ensure the best level of patient care across the board.

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