Symptoms burden of long COVID on the individual with pre-existing depression: A longitudinal cohort study

Background Mental health is receiving increasing attention in the field of long COVID. This study aims to compare the differences in long COVID symptoms between individuals with pre-existing depression and those without and assess the impact of pre-existing depression on the risk of long COVID and on the number of symptoms. Methods Data were from the Survey of Health, Ageing and Retirement in Europe (SHARE), participants aged 50 and older. Pre-existing depression was assessed by the EURO-D scale (October 2019-March 2020). Long COVID symptoms were reported by participants (June/August 2020 - June/August 2021). We compared the differences in long COVID symptoms among individuals with pre-existing depression and those without pre-existing depression with the Chi-squared test. P values from all tests were corrected using the Holm-Bonferroni correction. A multilevel (random intercept) hurdle negative binomial model was employed to assess the impact of pre-existing depression on the risk of long COVID and the number of symptoms and to explore effect modification by age, gender, and physical diseases. Results Of the 2063 participants who contracted COVID-19 (mean [SD] age, 68.0[8.5] years; 1259(61%) women. A higher number of individuals with pre-existing depression reported headache (32.2% vs 25.9%; P value = 0.027), body aches/joint pain (38.5% vs 29.4%; P value < 0.001), and confusion(10.6% vs 7.6%; P value < 0.01) than those without pre-existing depression. Pre-existing depression did not have a statistically significant impact on the risk of long COVID (adjusted OR = 1.00; 95% CI = 0.78–1.26). Among individuals reporting long COVID symptoms, Pre-existing depression was significantly related to the number of symptoms associated with long COVID (adjusted RR = 1.16; 95% CI = 1.07–1.25). The effect of pre-existing depression on the number of symptoms is moderated by the comorbid physical conditions. Conclusions This suggests a complex interplay between pre-existing depression and physical health, highlighting the importance of considering mental health factors in the management of long COVID patients.