Perceived stress and associated societal, community, interpersonal, and individual factors in adults with post-COVID-19 condition: the PRIME study.

Background Post-COVID-19 condition (PCC) is a global health concern with a profound impact on physical, mental, and social health, potentially leading to stress. This study compared perceived stress levels between adults with PCC and those without PCC (non-PCC). Additionally, environmental (societal, community, interpersonal) and individual factors were explored for their association with stress. Methods Cross-sectional questionnaire data from participants with SARS-CoV-2 infection were obtained from the prospective PRIME post-COVID cohort (2022). PCC was defined as feeling unrecovered (≥ 3 months) after SARS-CoV-2 infection. Associations between societal, community, interpersonal and individual factors and the outcome perceived stress (measured by the Perceived Stress Scale 14; PSS-14) were assessed in PCC and non-PCC using logistic regressions, adjusted for gender and age. Results In total, 3275 participants were included (PCC: n=1044, non-PCC: n=2231). PCC had higher perceived stress scores (mean± SE: 20.75± 0.27) than non-PCC (mean± SE: 15.65± 0.19), adjusted for age and gender (p<0.001). Factors associated with more perceived stress included lower neighborhood livability and cohesion (societal level), higher absenteeism and presenteeism (community level), less social support, less dense and diverse social network (interpersonal level), being female, having co-morbidities, post-exertional malaise, orthostatic intolerance, loneliness, and lower coping score (individual level). These factors and their effect-sizes were largely comparable between PCC and non-PCC, but nearly all were more prevalent in PCC compared to non-PCC group. Conclusion Adults with PCC perceived higher stress levels compared to adults without PCC, which may be attributable to higher prevalences of a multitude of stress-associated environmental and individual factors.