Reporting on Mental Health and Long COVID— What’s the Relationship?

Written by Shivane Chawla, public engagement masters student, University of Edinburgh and Dr Joanne Ingram, Senior lecturer, University of West Scotland.

The COVID-19 pandemic has widened health inequalities including those in mental health. For example, people with poor mental health tend to have physical health problems like high blood pressure, asthma, cancer, epilepsy or asthma. New research shows that people with poorer mental health are more likely to develop long COVID, adding to their already too large number of physical conditions.

What did the research find?

A recent Harvard research study, consisting mostly of women participants, looked to see if psychological distress (depression, anxiety, loneliness, stress, or worry) before a COVID infection was associated with a risk of having COVID symptoms for more than 4 weeks. This extended timeframe is referred to as “Long COVID”, where several common symptoms include extreme fatigue, shortness of breath and a loss of smell. The study followed 3193 people over a one-year period. The participants were given several self-assessment surveys, one on their baseline level of distress before contracting COVID and then at monthly and quarterly timepoints to assess the rates of COVID infection and on-going symptoms. They found that previous psychological distress, experienced before COVID infection, but during the pandemic (April to September 2020), was associated with increased risk of long COVID conditions.

How was this study covered in the media?

 The Guardian article title “Study Finds Link Between Poor mental health and long COVID” title conveys the research in a way that could be misleading. Firstly, many readers would also think the link between mental health and long COVID would go the other way; that long COVID leads to mental health problems. So, those who only read the headline might have completely misunderstood the findings. Secondly, using the term “mental health” suggests that clinical conditions have been measured i.e. does a person have a diagnosis of depression or not?  Whereas, people only answered basic distress questionnaire. The sub-title clarifies this point well, ‘High levels of distress before coronavirus infection raises risk of long COVID, say Harvard researchers.’

Later in the article, clearer distinction is made between what has been found versus potential interpretations. For example, the article’s authors explicitly note that “The findings do not mean that mental health issues cause long COVID: more than 40% of those who developed long COVID in the study had no signs of distress before infection.” It is that poor mental health in the early stages of the pandemic puts a person at higher risk for developing long COVID. Chronic stress can weaken the immune system and make a person vulnerable to long COVID. The Guardian places the study in the wider context by explaining this point well by noting that stress has been linked to a greater susceptibility to common colds and other respiratory tract infections.