History of psychological distress can trigger long Covid, study says

You may be up to 50% more likely to develop long covid if you suffer from common psychiatric problems such as anxiety or depression, according to a recent study.

You signs of illness they can include breathing problems, mental confusion, chronic cough, changes in taste and smell, severe fatigue, difficulties performing daily life functions, and sleep disruptions that can last for months, even years, after the infection has cleared the body.

People who self-identified as having anxiety, depression or loneliness, or who felt extremely stressed or worried about the coronavirus, were more likely to experience Covid-19 for a long time, according to the study. study published this month in JAMA Psychiatry.

“We found that participants with two or more types of psychological distress prior to infection had a 50% higher risk of contracting long-term Covid,” said study co-author Siwen Wang, a researcher in the department of nutrition at the Chan School of Public Health Harvard TH. in Boston, United States.

About 40 million adults over the age of 18 in the United States live with an anxiety disorder, while more than 21 million suffer from major depression, according to national statistics. Many mental health conditions often overlap, with simultaneous diagnoses, experts say. More than a fifth of adults in the US (22%) and UK (23%) say they often or always feel lonely, said one study from the Kaiser Family Foundation.

“Experiencing higher levels of psychological distress before a Covid infection also increased the risk of contracting long-term Covid by 50%,” said Siwen. “These people also reported more symptoms seen in long Covid.”

It’s possible that some could use the study’s findings to support the hypothesis that post-Covid illness is psychosomatic, a belief prevalent in the early days of the pandemic, said Wesley Ely, professor of medicine and critical care at Vanderbilt University Medical Center, in Nashville, Tennessee. He did not participate in the study.

Rather, the study’s message should be that people with existing psychological distress are closer to the long-term Covid “disaster,” said Ely, co-director of the Vanderbilt Center for Critical Illness, Brain Dysfunction and Survival.

“Imagine 10 people are running a race and you give five people a head start,” Ely said. “These are the people who have already had a mental health issue – they are just closer to the unfortunate finish line of having long Covid.”

mind-body connection

The idea that mental suffering can affect the body in a negative way is not new. It is also a two-way street: having a chronic disease is strongly associated with the development of depression and other psychological disorders.

With common non-infectious disorders such as heart disease, “depression/anxiety/emotional distress appears to play a role,” said Joseph Bienvenu, a professor in the department of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine in Baltimore, in an -mail. He did not participate in the study.

People with major depression may develop blood pressure problems and may be more likely to have a heart attack. Chronic depression, stress, and anxiety have all been linked to insomnia, and lack of quality sleep is a major culprit in the development of obesity, type 2 diabetes, and other disorders.

And psychological distress has been shown to weaken the immune system, said study co-author Angela Roberts, an associate professor of pulmonary and critical care medicine at Stanford University in California.

“Your brain and your immune system are very intertwined,” Roberts said. “Studies have shown that when you’re depressed or anxious, your immune system doesn’t work as well against targets like viruses and bacteria.”

Some patients continue to suffer

To make the new study, the researchers worked with nearly 55,000 people with no history of Covid-19 who were enrolled in three large longitudinal studies: the Nurses’ Health Study II, the Nurses’ Health Study 3 and the Growing Up Today Study. Participants in these studies tend to be predominantly female and white, which may limit how generalizable the results can be to a broader population, the study said.

Participants were asked about their mental health in April 2020, right at the beginning of the pandemic. They continued to fill out mental health forms each month for six months, then quarterly. At the end of a year, the researchers narrowed the pool of subjects to nearly 3,200 people who had developed Covid-19 and met the study’s requirements.

“This study is particularly good because the participants’ baseline characteristics were independently assessed in time for their later Covid symptoms,” said Bienvenu of Johns Hopkins.

Compared with people without mental distress, those with depression and loneliness were 1.32 times more likely to develop prolonged symptoms of Covid. Participants who worried a lot about the coronavirus — predominantly people of color, women and asthmatics — were 1.37 times more likely to develop long-term Covid, the study found.

THE anxiety was associated with a higher risk — 1.42 times more likely — but people with higher levels of perceived stress were nearly 50% more likely to develop post-Covid symptoms, said Siwen, a co-author of the study.

All associations between psychological distress and prolonged Covid remained significant, even after the researchers adjusted for demographics, body weight, smoking, and a history of asthma, cancer, diabetes, and high blood pressure or cholesterol.

Furthermore, all types of psychological distress, except loneliness, were associated with an increased risk of being unable to complete daily life actions due to prolonged Covid symptoms.

While many cases of long-term Covid are mild and resolve within a few months, other patients continue to suffer for a long time. Some still haven’t regained their quality of life more than two years after the pandemic, according to Aaron Friedberg, a clinical assistant professor of internal medicine who works on the Post-Covid Recovery Program at Ohio State University’s Wexner Medical Center in Columbus.

“They can’t think, they can’t breathe. We have people whose illness is so severe that they basically can’t get out of bed,” Friedberg told CNN in a previous interview. “I saw a person recently who is still not working because of Covid symptoms two years later.”