Prospective association between long COVID and COVID-related post-traumatic stress disorder among a population-based cohort of adults diagnosed with COVID-19 in Michigan

OBJECTIVE: To better understand the mental health impacts of Long COVID, we examine the prospective association between Long COVID and risk of COVID-related post-traumatic stress disorder (PTSD) symptoms. METHODS: We used baseline and follow-up data from the Michigan COVID-19 Recovery Surveillance Study, a population-based study of adults diagnosed with polymerase chain reaction-confirmed COVID-19 between March 2020 and May 2022 in Michigan (n = 3492). Baseline data were collected a median of 4.4 months (interquartile range (IQR): 3.4-5.7 months) and follow-up data were collected a median of 18.4 months (IQR: 15.0-21.3 months) after initial COVID-19 onset. We defined Long COVID at baseline as having not recovered to usual state of health 90 days or more after initial COVID-19 onset and having COVID-related PTSD symptoms at follow-up based on a six-item version of the PTSD Checklist for Civilians anchored to each individual's COVID-19 diagnosis. We ran modified Poisson regression models adjusting for sociodemographic characteristics, pre-existing comorbidities, COVID-19 illness severity, survey mode, and phase of the pandemic when diagnosed with COVID-19. RESULTS: At baseline, 17.0% of adults diagnosed with COVID-19 had Long COVID, and 10.1% of adults reported COVID-related PTSD symptoms at follow-up. In the fully adjusted model, the risk of COVID-related PTSD symptoms was 2.08 times higher (95% confidence interval: 1.65-2.63) among adults with Long COVID than among adults without Long COVID. CONCLUSION: Long COVID is prospectively associated with a higher risk of COVID-related PTSD symptoms suggesting a need to strengthen mental health screening, monitoring, and interventions among adults with this condition.