Chronic stress and post-traumatic stress in long COVID: a comparative survey study

Abstract Long COVID (LC) is a prevalent condition among SARS-CoV-2 infections. Yet, in-depth research on adverse stress responses in LC remains limited. The primary aim of this study was to investigate chronic stress and post-traumatic stress due to the COVID-19 pandemic specifically experienced in LC, as both have been suggested to interplay with the manifestation of LC. Using data from N =549 participants in an online survey ( n female =349, n male =199, n diverse =1; age: M =39.24, SD =16.58), we compared three subgroups regarding chronic stress and COVID-19-related traumatic stress as primary outcomes, and psychological distress as secondary outcome: 1) participants with LC ( n =283), 2) participants with past COVID-19 without LC ( n =102), and 3) participants without past COVID-19 ( n =164). In addition, we fitted a binary logistic regression model to examine factors associated with LC. Participants with LC reported elevated levels across all outcomes compared to the other subgroups ( d =0.57-1.24, p < .001-.008), which did not significantly differ from each other. Female gender ( OR : 7.772, p < .001) and symptomatic acute COVID-19 emerged as risk factors for LC ( OR : 2.776-7.951, p < .001-.036), while a completed primary COVID-19 vaccination series acted as a protective factor for LC ( OR : 0.481, p < .025). The duration of LC symptoms revealed no significant association with the outcomes examined. Our findings contribute to a better understanding of factors influencing health in LC, notably identifying an increased susceptibility to chronic stress and COVID-19-related traumatic stress within LC. Future treatment approaches are encouraged to include psychological interventions with stress and trauma focused elements.