Daily stress and worry are additional triggers of symptom fluctuations in individuals living with Long COVID: Results from an intensive longitudinal cohort study - White Rose Research Online

Prevalence of depression, anxiety, fatigue, and headache before and after long COVID onset: a case–control study in the total population of Region Stockholm - BMC Medicine

Background Post-acute sequelae of SARS-CoV-2 infection, or long COVID, include diverse symptoms and remain a major concern worldwide. This study investigates the occurrence of depression, anxiety, fatigue, and headache 1 year prior to the COVID-19 pandemic (2019), 12 months prior to, and 6 months after long COVID diagnosis in individuals diagnosed with long COVID and matched population-based controls. Methods This case–control study included nonhospitalized individuals diagnosed with long COVID compared with controls without long COVID, matched by age, sex, and neighborhood socioeconomic status. Data were collected from the Stockholm Regional Health Care Data Warehouse (VAL), including diagnoses in 2019, 12 months before, and 6 months after the long COVID diagnosis. Conditional logistic regression was used to calculate odds (OR) ratios and 99% confidence intervals (CI). Results A total of 5589 cases (mean age: 47 years, 69% female) and 47,561 controls were included. Individuals with long COVID had a higher pre-pandemic frequency of the following diagnoses: depression (women: OR 1.57 (1.26–1.97), men: OR 1.40 (0.88–2.23)), anxiety (women: OR 1.65 (1.41–1.93), men: OR 2.10 (1.56–2.84)), fatigue syndrome after viral infection (women: OR 1.96 (0.86–4.48), men: OR 2.22 (0.29–17)), and headache (women: OR 2.45 (1.96–3.05), men: OR 2.89 (1.86–4.50)). Individuals with long COVID also had a higher frequency of these diagnoses 12 months before and 6 months after the long COVID diagnosis was made, regardless of sex. Conclusions Individuals with long COVID had a higher prevalence of depression, anxiety, fatigue, and headache both before and after being diagnosed with long COVID compared with controls without long COVID. The findings suggest an association between mental health vulnerabilities and long COVID, while the frequency of registered mental health diagnoses remained largely similar after the long COVID diagnosis.

Long COVID Disproportionately Reported by Disadvantaged Individuals: A National Survey of U.S. Working-Age Adults - Journal of General Internal Medicine

Background COVID-19 disproportionately affects racial/ethnic minorities and economically disadvantaged persons, which may also apply to sequelae from acute infection. Little is known about those who live with post-acute sequelae of SARS-CoV-2 infection (PASC), including long COVID, especially those without a formal diagnosis. Objective To examine self-reported long COVID symptoms and its associations with individual and state characteristics from a national survey sample of working-age adults. Design Repeated cross-sectional survey analysis. Participants Eighteen- to 64-year-old adults who reported ever having had COVID-19 (n = 409,087). Main Measures We examined long COVID responses from the online Household Pulse Survey (9/22/2022–10/30/2023), administered by the Census Bureau and the National Center for Health Statistics. Long COVID was defined as having “symptoms lasting 3 months or longer that you did not have prior to having coronavirus” (e.g., fatigue, difficulty thinking, shortness of breath) or not. Logistic regression models adjusted for survey week, respondent characteristics (e.g., demographics, acute COVID-19 severity), and state characteristics (e.g., rurality, Health Professional Shortage Areas). We additionally examined concurrent depression and anxiety symptoms. Key Results The HPS response rate was 6.10% during the study timeframe.14 Among those who ever had COVID-19, 27.5% reported long COVID symptoms. Among those with long COVID symptoms, 22.6% reported having severe activity limitations. In fully adjusted models, long COVID symptoms were most commonly reported by Hispanic respondents (ΔPH = 2.3, SE = 0.7), among all racial-ethnic groups. Low socioeconomic status was consistently associated with long COVID symptoms: Income (ΔP<25k vs >=200k+ = 11.9, SE = 0.9); Medicaid-insurance (ΔPMedicaid v Employer-sponsored = 02.9, SE = 0.5); Uninsurance (ΔPUninsured v Employer-sponsored = 1.8, SE = 0.4). Long COVID symptoms were associated with living in more rural states (ΔP = 0.08, SE = 0.02). Long COVID symptoms were additionally associated with concurrent anxiety (ΔPAnx v Not = 8.0, SE = 0.4) and depressive symptoms (ΔPDep v Not = 6.7, SE = 0.6). Conclusions Long COVID symptoms and disability were disproportionately reported among survey respondents who were Hispanic and who were economically-disadvantaged. Rural communities were more so impacted.