Childhood trauma and mental health outcomes in Post-COVID Syndrome: Results from a cross-sectional study in Germany

Introduction: Post-COVID syndrome (PCS) affects approximately 6-10 % of COVID-19 survivors, with complex clinical manifestations and poorly understood pathophysiological mechanisms. While childhood trauma is known to impact long-term health outcomes, its influence on PCS and associated quality of life remains unclear. Methods: In this cross-sectional study, we analyzed data from 641 participants (487 with PCS, 154 without) through the DEFEAT online platform. Childhood trauma was assessed using the Child Trauma Questionnaire-Short Form (CTQ-SF). Depression, anxiety, and health-related quality of life were evaluated using PHQ-9, GAD-7, and EQ-5D-3L. Uni- and multivariate analyses were performed. Results: Overall, 38.8 % of participants reported at least one adverse childhood experience (ACE). Emotional abuse was significantly more frequent in PCS patients compared to controls (21.1 % vs. 12.3 %, p = 0.02). PCS patients showed significantly higher rates of depression (18.9 % vs. 7.1 %, p < 0.001) and anxiety (23.8 % vs. 14.3 %, p = 0.004) compared to non-PCS participants. Health-related quality of life was significantly lower in PCS patients (median 64.9 vs. 90.2, p < 0.001). After adjusting for age, gender, and educational level, childhood trauma was associated with increased depression and anxiety specifically in PCS patients. Discussion/conclusion: Our findings suggest that childhood trauma significantly impacts mental health outcomes and quality of life in PCS patients. The strong association between childhood trauma and adverse mental health outcomes specifically in PCS patients highlights the importance of trauma-informed care approaches. These results emphasize the need for targeted screening and personalized interventions addressing both physiological and psychological aspects of PCS recovery in patients with childhood trauma history.