Changes in somatic symptoms among people with severe COVID anxiety, before and after the coronavirus pandemic

Background

Anxiety and somatic symptoms were common during the coronavirus pandemic. People who were highly anxious about COVID-19 may have been at a higher risk of developing new somatic symptoms which persisted after the pandemic. Here we examine changes in somatic symptoms before and after the pandemic among people who had severe COVID anxiety, and identify factors associated with these changes.

Design

UK adults who met the threshold for severe COVID anxiety were recruited online during the coronavirus pandemic, and were asked to rate their somatic symptoms post-pandemic, and retrospectively before the pandemic with the PHQ-15. Data on demographic and clinical factors were also collected.

Methods

Descriptive statistics and multiple linear regression were used to characterise the sample of 197 people who provided complete data, and to examine factors associated with changes in somatic symptoms.

Results

Mean PHQ-15 score increased significantly from 7.97 before the pandemic to 11.34 afterwards (t= 9.043, p<0.001). Despite this, there were gradual corresponding declines in levels of COVID anxiety and other co-occurring mental health symptoms after the pandemic ended. Multiple linear regression models identified that greater generalised anxiety symptoms and living with someone vulnerable to COVID were the strongest predictors of increased somatic symptoms during the pandemic.

Conclusions

People with severe COVID anxiety reported high rates of somatic symptoms before the pandemic, which then increased significantly after the pandemic. There appears to be a complex interaction between COVID anxiety, pandemic experience, and somatic symptoms which warrants further investigation, and could inform targeted intervention in the future.

What is already known on this subject?

• A host of demographic and psychological factors, such as generalised and health anxiety, contribute to the reporting of somatic symptoms.

• Recent evidence suggests that individuals with COVID-19 specific anxiety are more likely to report somatic symptoms, and that this association was present after controlling for other demographic and psychological factors.

• People who lived with someone vulnerable to COVID-19 during the pandemic reported higher rates of pandemic related stress and mental health symptoms.

What does this study add?

• Individuals with severe levels of COVID anxiety show a higher somatic symptom count compared to the general population.

• Chest pain, dizziness and palpitations were the somatic symptoms which were most frequently reported to have increased over the pandemic by people who had severe levels of COVID anxiety.

• The combination of severe COVID anxiety and living with someone vulnerable to COVID appears to have contributed to a higher risk of worsening somatic symptoms during the pandemic.