Assessing the Effects of Long-COVID on Mental Health in the United States: A Population Based Study

Background The term long-COVID is commonly used to refer to protracted symptoms following COVID-19 infection that persist beyond four weeks from onset. Long-COVID conditions have been associated with reduced quality of life. This study estimates the impact of long-COVID on anxiety and depression in the US, using survey data from nearly a million Americans. Methods The Household Pulse Survey, provides the first population based nationally representative data on the prevalence of long-COVID, starting with the survey’s June 2022 wave. A population-based survey allows us to conduct counterfactual research using control groups. Difference-in-differences models are applied to predict anxiety and depression in the population that contracted COVID-19 and had symptoms of long-COVID vis-à-vis control groups. Results Nearly 51.8% of those surveyed reported testing positive for COVID-19 and of these 27.3% reported suffering from long-COVID. Anxiety and depression rates were twice as high in those with long-COVID. Our sub-group analysis reveals that in general COVID-19 is associated with higher rates of anxiety and depression among younger adults and females, and those on the lower income and education scale. Whites, Blacks and Hispanics had higher odds of anxiety and depression symptoms compared to Asians in both the COVID-19 and long-COVID groups. Interestingly, long-COVID was associated with more negative mental health outcomes among males, where reported mortality rates were higher. Conclusion This study fills a significant gap in the literature on the mental health effects of long-COVID. Our results, based on a large population level data, point to a significant association between COVID-19, especially long-COVID, and cognitive impairment and mental health problems