Psychological symptoms predict long coronavirus disease 2019: a prospective analysis from the Women's Health...

Those with mental illnesses are likely at higher risk of developing coronavirus disease 2019 (COVID-19), and elderly are disproportionately impacted and as a result suffer more from long COVID. The aim of this analysis was to determine the associations of preexisting depressive and anxiety symptoms with developing COVID-19 positivity, long COVID-19, and compliance with the use of protective measures against contracting COVID-19.

A subsample (n = 18,820) of the Women's Health Initiative study cohort completed longitudinal questionnaires on depressive and anxiety symptoms between 1993 and 2021 and reported on COVID-19 testing and compliance-related questions in 2020 and 2021. Logistic regression analyses were used to prospectively determine associations of a history of mental health symptoms with COVID-related outcomes.

Reported history of depressive and anxiety symptoms was not associated with COVID-19 positivity. However, higher anxiety scores were associated with higher odds of long COVID (OR = 1.05 [95% CI: 1.03-1.07]). Women with both depressive and anxiety symptoms versus neither symptom had 78% higher odds of long COVID (OR = 1.78 [95% CI: 1.13-2.81 P = 0.001]). The odds of compliance with COVID-19 mitigation measures was significantly lower among women with previous long-term depressive symptoms (OR = 0.67 [95% CI: 0.55-0.82]), with both long-term depressive and anxiety symptoms (OR = 0.75 (95% CI: 0.61-0.93) P < 0.0001), and with higher long-term perceived stress score (OR = 0.94 [95% CI: 0.92-0.97]). However, a higher short-term anxiety score during early COVID was weakly associated with the higher odds of compliance of prevention mitigation measures (OR = 1.03 [95% CI: 1.02-1.03]).

Older women with past mental health symptoms may be at higher risk of developing long COVID and having lower compliance with COVID prevention measures.