This site is intended for health professionals only

Poor mental health increases long Covid risk, finds study

Poor mental health increases long Covid risk, finds study

People with symptoms of depression or anxiety, stress or loneliness before infection may be at increased risk of developing long Covid, a study has found.

Researchers from Harvard School of Public Health studying more than 54,000 participants from the start of the pandemic found that high levels of psychological distress before catching Covid raised the risk of long-term symptoms by 32-46%.

Over the year of the study around 3,000 of those taking part contracted Covid and were asked about their symptoms and how long they lasted.

The team compared the responses between those who developed long Covid and those that did not, with questions that had been asked about mental health at the start of the study.

They also found that psychological distress was associated with 15%–51% greater risk of an impact on daily life due to long Covid.

The increased risk was independent of smoking, asthma and other health behaviours and conditions, they reported in JAMA Psychiatry.

‘We were surprised by how strongly psychological distress before a Covid-19 infection was associated with an increased risk of long Covid,’ said study leader Siwen Wang.

‘Distress was more strongly associated with developing long Covid than physical health risk factors such as obesity, asthma and hypertension.

They noted that in other acute respiratory tract infections, such as flu or common cold, mental health conditions are associated with greater severity and longer duration of symptoms and previous studies have also suggested that distress is associated with chronic symptoms following Lyme disease and in chronic fatigue syndrome and fibromyalgia.

But they stressed, the results should not be misinterpreted as supporting a hypothesis that post Covid-19 conditions are psychosomatic.

One potential link between psychological distress and long Covid may be chronic systemic inflammation and immune dysregulation, they wrote.

Co-author Andrea Roberts said: ‘We need to consider psychological health in addition to physical health as risk factors of long COVID-19. These results also reinforce the need to increase public awareness of the importance of mental health and to get mental health care for people who need it, including increasing the supply of mental health clinicians and improving access to care.’

Data from the Office for National Statistics shows the prevalence of self-reported long Covid is greatest among people aged 35 to 69 years, females, people living in more deprived areas, those working in social care, teaching and education or healthcare, and those with another activity-limiting health condition or disability. 

Last month, NHS England said it would be up to ICSs to decide how support general practice in dealing with the growing problem of long Covid.


Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.


Please note, only GPs are permitted to add comments to articles

Matt Hancock 9 September, 2022 9:53 pm

Dont think this is rocket science. Add it to the list with fibro , me etc

Patrufini Duffy 12 September, 2022 4:26 pm

Wow. It took them that long to correlate sertraline to long covid. Wow.