Association of Comorbid and Incident Depression and Other Mental Health Conditions With Long-COVID: Results From the Johns Hopkins COVID Long Study

AI Summary

Pre-existing non-mental and mental health comorbidities were associated with higher odds of developing long-COVID (aOR 1.47 and 1.49, respectively).
Odds of long-COVID among those with mental health comorbidities were not greater than odds for other comorbidities.
A dose-response relation existed: more persistent symptoms strongly increased incident depression or anxiety risk; monitor physical and mental health post-acute COVID.

J Med Virol. 2026 May;98(5):e70970. doi: 10.1002/jmv.70970.

ABSTRACT

Long-term complications following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, known as long-COVID, present significant global health challenges. The factors associated with developing long-COVID remain poorly understood, especially in individuals with pre-existing comorbidities, including mental health conditions. Additionally, the relationship between persistent symptoms and incident depression and anxiety symptoms remains unclear. We analysed baseline data from 9637 participants in the Johns Hopkins COVID Long Study. Logistic regression was utilised to estimate the odds of developing long-COVID in participants with/without pre-existing mental health comorbidities (n = 3351) and incident depression and/or anxiety in participants with persistent symptoms who had only pre-existing non-mental health comorbidities (n = 3036) and those without comorbidities (n = 1781). Participants with pre-existing non-mental health comorbidities had higher odds of developing long-COVID (adjusted odds ratio (aOR) 1.47, 95% confidence interval (CI) 1.20, 1.80) compared to those without comorbidities. Participants with only mental health comorbidities showed similar elevated odds (aOR 1.49, 95% CI 1.14, 1.95). An increasing number of persistent symptoms demonstrated a strong dose-response relationship with developing incident depression and/or anxiety symptoms in both participants with only non-mental health comorbidities and those without comorbidities. Long-COVID affects individuals with and without pre-existing comorbidities; those with pre-existing comorbidities demonstrated increased odds of developing long-COVID. However, the odds among those with mental health comorbidities were not elevated beyond other comorbidities. Monitoring both physical and mental health outcomes is crucial for post-acute COVID-19 patients. Enhanced understanding of the factors associated with long-COVID is essential for improving patient care and developing effective interventions.

PMID:42170694 | DOI:10.1002/jmv.70970

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