Long-COVID & Mental Illness

An interesting study that I encourage you to read – “Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post–COVID-19 Conditions” –  was published in JAMA Psychiatry in September.
 
The study used data from three studies: “Nurses’ Health Study II, Nurses’ Health Study 3, and the Growing Up Today Study” and included 54,960 participants.
 
While there were limitations to the study, including being largely white and female, the findings have relevance for our work in psychiatry and behavioral medicine. The main observation of this study was that the risk of developing long-COVID was positively correlated with preexisting mental illness.
 
This study reports that: “Participants with two or more types of distress prior to infection were at nearly 50% increased risk for post–COVID-19 conditions; All types of distress were associated with increased risk of daily life impairment among individuals with post–COVID-19 conditions.”
 
The researchers conclude that “Future work should examine the biobehavioral mechanism linking psychological distress with persistent post-infection symptoms.”
 
Our work providing psychiatric and behavioral medicine care is vital, and the treatments we provide are life-changing and lifesaving. There are two key messages I hope you will consider from this study. First, our patients are an enriched population for developing long-COVID. This speaks to the need for prevention and counseling our patients to get vaccinated to prevent infection and severe illness. Second, for your patients who have had COVID and may have long-COVID, consider attending to other symptoms such as fatigue, brain fog, insomnia, and the other medically unexplained symptoms of long-COVID in your approach to care.  Acknowledging these distressing (and often disabling symptoms) and helping our patients navigate the healthcare system to find relief may be an important part of their recovery from mental illness.