Prospective associations between Long COVID and mental health: evidence from a population-based study with a nearly three-year follow-up.

Long COVID was associated with a significantly higher risk of depressive symptoms at approximately 3 years after initial COVID-19 infection.

• Adjusted risk ratio (aRR) for depressive symptoms at follow-up 2 (3 years post-infection): 1.86 (95% CI: 1.34–2.57)
• Analytic sample for depressive symptoms: n = 2,431 Michigan adults with PCR-confirmed COVID-19
• Respondents with baseline depressive symptoms were excluded to allow prospective assessment
• Long COVID was defined as symptoms lasting ≥ 90 days after initial infection, assessed at baseline (median 4.4 months post-infection)

Long COVID was associated with a significantly higher risk of anxiety symptoms at approximately 3 years after initial COVID-19 infection.

• Adjusted risk ratio (aRR) for anxiety symptoms at follow-up 2 (3 years post-infection): 1.60 (95% CI: 1.18–2.16)
• Analytic sample for anxiety symptoms: n = 2,301 Michigan adults with PCR-confirmed COVID-19
• Respondents with baseline anxiety symptoms were excluded to allow prospective assessment
• Modified Poisson regression models were used to estimate risk ratios

Adults with Long COVID had a higher risk of experiencing depressive symptoms specifically at the 3-year follow-up (but not at 1.5 years) compared to no depressive symptoms at either follow-up.

• Adults with Long COVID had a 2.64 times higher risk of depressive symptoms at follow-up 2 only (95% CI: 1.60–4.35) relative to no depressive symptoms at either follow-up
• This analysis used multinomial logistic regression models to examine mental health outcomes across both follow-up periods
• Follow-up 1 occurred at 1.5 years post-infection and follow-up 2 at 3 years post-infection

Adults with Long COVID had a higher risk of experiencing persistent anxiety symptoms present at both the 1.5-year and 3-year follow-ups compared to no anxiety symptoms at either follow-up.

• Adults with Long COVID had a 2.48 times higher risk of anxiety symptoms at both follow-ups (95% CI: 1.38–4.47) relative to no anxiety symptoms at either follow-up
• This finding suggests a pattern of chronic or persistent anxiety among those with Long COVID
• Multinomial logistic regression models were used to distinguish outcome trajectories across the two follow-up periods

The study used a population-based cohort design with a nearly three-year follow-up period to prospectively assess Long COVID and mental health outcomes.

• Participants were Michigan adults with PCR-confirmed COVID-19
• Long COVID was assessed at baseline (median 4.4 months post-infection) and defined as symptoms lasting ≥ 90 days
• Depressive and anxiety symptoms were evaluated at two follow-up points: 1.5 years (follow-up 1) and 3 years (follow-up 2) after infection
• Analytic samples were n = 2,431 for depressive symptoms and n = 2,301 for anxiety symptoms after excluding those with baseline symptoms