Among a cohort who never had COVID-19 but tested positive within 1 year after baseline, depression, anxiety, stress, loneliness, and concerns about infection were linked to a 33% to 50% increased risk of self-reported postinfection symptoms lasting at least 4 weeks, as well as functional impairment, finds a study published today 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 first author Siwen Wang, MD, a researcher in the Department of Nutrition at Harvard T.H. Chan School of Public Health, in a Harvard news release. "Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension."

A team led by Clarkson University researchers analyzed data from three large ongoing, predominantly female Nurses' Health Study II, Nurses' Health Study 3, and the Growing Up Today Study. Participants completed at least one follow-up survey about their symptoms, COVID-19 test results, and any related hospitalizations from April 2020 to November 2021 (6 monthly, then quarterly for 336 days). Median time from baseline to infection was 30 weeks.