Life stressors can contribute to worsening long-COVID symptoms
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Stressors in life can contribute to poor functional, cognitive and neuropsychiatric outcomes up to a year after being hospitalized with COVID-19, researchers reported in the Journal of Neurological Science.
“Some life stressors have a stronger modulating influence on neuropsychiatric symptoms and quantitative measures of functional status, mood and cognition than do well-known predictors such as age and severity of index COVID-19 illness,” Jennifer A. Frontera, MD, study coauthor and professor of neurology at New York University Grossman School of Medicine, told Healio.
Post-acute sequelae of COVID-19, or long COVID, are symptoms that continuously occur post-infection for months to a year at a time. However, according to Frontera and colleagues, there are limited data that evaluate predictors of long-term outcomes after hospitalization for COVID-19.
They conducted a prospective, longitudinal cohort study of patients hospitalized with COVID-19 and assessed the effect of four predictors on 6- and 12-month outcome metrics — demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics and life stressors.
Of 790 COVID-19 patients who survived hospitalization, 242 completed the 12-month follow-up, and 121 (50%) reported experiencing at least one life stressor within the month before the 12-month follow-up.
According to results, the most common reported stressors were new personal illness (23%), financial insecurity (17%), social isolation (13%) and death or an illness of someone close. The presence of stressors was strongly related to worse anxiety (OR, 1.37; 95% CI, 1.06-1.77), depression (OR, 1.42; 95% CI, 1.03-1.96), fatigue (OR, 1.47; 95% CI, 1.16-1.87) and sleep (OR, 1.43; 95% CI, 1.14-1.8) scores.
Frontera said it is important for clinicians to understand the bidirectional relationship between life stressors and COVID-19-related recovery.
“Many of these life stressors are modifiable and can be addressed by a social worker or other local city and state services,” she told Healio. “Having a comprehensive or holistic approach to patient care, including addressing psychosocial issues, may aid in recovery from post-acute sequelae of COVID-19.”