Psychological Distress May Increase Risk of Long COVID

A new study suggests that certain types of common psychological distress may make people more likely to experience the debilitating effects of long COVID.

While our primary care concierge doctors in Jupiter don’t want to add to anyone’s stress, it’s important to know why everyone should continue to try to protect themselves as much as possible from contracting COVID-19, especially if they fall into one of the higher-risk groups.

The mystery of long COVID

By now, everyone is familiar with the constellation of symptoms that linger long past recovery from COVID-19, which can include:

  • extreme fatigue
  • chest pain
  • muscle pain
  • brain fog
  • dizziness
  • heart palpitations
  • headache
  • fever
  • chronic cough
  • shortness of breath
  • insomnia
  • stomach pain
  • gastroenteritis
  • loss of smell and taste

Frustrating condition

Complaints vary by individual and can include as many as 200 different debilitating symptoms.

The Washington Post reports that data from the U.S. Census Bureau collected in June, which was analyzed by the National Center for Health Statistics, found that nearly one in every five Americans who developed COVID-19 still have long COVID symptoms.

And there are no tests to help definitively diagnose the syndrome, or reliable treatments to help people recover.

“Globally, no one understands what’s going on,” Laurent Uzan, a French sports cardiologist who treats younger people with long COVID, told The Post.

“We don’t give people a miracle cure. It’s a real war for them, daily,” he said.

Latest findings

Nevertheless, researchers continue to pin down a cause for long COVID.

Last month, a study by released by researchers at Harvard T.H. Chan School of Public Health, found that psychological distress, including depression, anxiety, worry, perceived stress, and loneliness before COVID-19 infection was associated with an increased risk of long COVID.

The study, published in the journal JAMA Psychiatry, showed that the increased risk was independent of other factors such as smoking, asthma, or other health behaviors or physical health conditions.

The team looked at survey responses from nearly 3,000 Americans and Canadians from April 2020 to November 2021. Of that group, around 1,400 participants said they had long COVID, defined as symptoms lasting four weeks or longer.

They found that those who reported some type of psychological distress before infection had a 32-46 percent increased risk of developing long COVID, compared to those who did not report any such distress. Those with two or more types of psychological distress had a 50 percent increase in risk.

“We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID,” study leader Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School, said in a statement.

“Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension,” she said.

Senior study author, Andrea Roberts, a senior research scientist in the Department of Environmental Health at Harvard Chan School, added, “The factors that we identified are more strongly associated with risk of long COVID than pretty much anything else anyone’s found.”

‘All in their head?’

Does this mean these reports of long COVID are imaginary? Quite the contrary. Scientists have known for decades that psychological stress makes people more susceptible to physical illness.

“The results shouldn’t be misinterpreted as supporting post-COVID conditions as psychosomatic,” Jacqueline Becker, a clinical neuropsychologist at the Icahn School of Medicine at Mount Sinai who wasn’t involved in the research, told NBC News.

“Having a mental health issue is always going to be more likely to predispose you to health problems later on, whether it’s COVID, long COVID, or a different post-viral illness,” she said.

Wang and her team surmised that two different factors are involved in the increased risk.

First, stress has been proven to activate molecules that produce inflammation in the body, leading to cell damage throughout the body.

Second, stress has been shown to suppress the immune response, making it harder to fight off viruses and other illnesses. Even obesity, type 2 diabetes, and heart disease have been linked to emotional distress.

Mind-body connection

“Your brain and your immune system are very tightly interconnected,” Roberts explained.

“Studies have shown when you’re depressed or anxious, your immune system doesn’t work as well against targets like viruses and bacteria,” she said.

Furthermore, the study’s results only underscore the critical need for better availability of mental health services in this country.

“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,” Roberts added.

We would also stress the importance of taking precautions to avoid COVID-19, such as masking in indoor settings and being up to date on vaccines and boosters.

Despite recent statements—including from President Biden—that the pandemic is “over,” approximately 400 Americans are still dying every day from the disease.

In the words of Tedros Adhalom Ghebreyesus, director general of the World Health Organization (WHO), “We can see the finish line [of the pandemic], but now is not the time to stop running.”

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