Association of Comorbid and Incident Depression and Other Mental Health Conditions With Long-COVID…, 2026, Yenokyan+

SNT Gatchaman

Senior Member (Voting Rights)
Staff member
Association of Comorbid and Incident Depression and Other Mental Health Conditions With Long-COVID: Results From the Johns Hopkins COVID Long Study
Karine Yenokyan; Eryka Wentz; Zhanmo Ni; Thea Kammerling; Madeline Sagona; Andrea DeVito; Shruti H Mehta; Bryan Lau; Priya Duggal

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.

Web | DOI | PDF | Journal of Medical Virology | Paywall
 
While our findings align with other studies showing increased odds of developing long‐COVID among individuals with mental health disorders, our results indicated that these elevated odds are not unique to those with mental health comorbidities. Specifically, we found no meaningful difference in the odds of developing long‐COVID between participants with pre‐existing mental health comorbidities and those with other non‐mental health comorbidities.

These findings challenge the hypothesis that preexisting mental health conditions are responsible for long‐COVID. This is particularly important because the occurrence of long‐COVID outside of mental or psychological factors has often been overlooked or dismissed.

Our results demonstrated a strong relationship between the number of post‐acute infection new or continuing symptoms and the odds of developing incident depression and/or anxiety symptoms. This could be due to biological mechanisms or the impact of managing multiple long‐COVID symptoms while facing difficulties in recovery coupled with uncertain recovery timelines.
 
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