Do illness perceptions predict health outcomes in adults with Long COVID?

Abstract

Background: The cognitive and emotional responses to an illness, known as illness perceptions, can contribute to psychological distress and impact self-management of health conditions. This research looks at the illness perceptions associated with Long COVID, the name given to symptoms which persist for more than 12 weeks after a COVID-19 infection.

Objectives: This study aims to identify the psychological characteristics of adults with Long COVID, investigate associations between illness perceptions and mental health, and explore whether illness perceptions and mental health are predictors of quality of life and functioning in adults with Long COVID.

Methods: 253 participants were recruited from a Long COVID assessment clinic within the National Health Service in England and completed outcome measures evaluating mental health, quality of life, functioning, and illness perceptions. These were completed face-to-face at baseline in the clinic. 61 participants completed quality of life and functioning outcome measurements again via post and online at least three months later at follow-up between November 2020 and March 2022. Hierarchical regression was used to investigate whether baseline measures of illness perceptions and mental health were significant predictors of health outcomes at follow-up.

Results: At baseline 59% reported clinically significant depression, 42% reported clinically significant anxiety, and 37% reported comorbid anxiety and depression. There was no difference in anxiety and depression scores between individuals who were hospitalised with acute COVID-19 and those who were not. The total Brief Illness Perception score was associated with poorer mental health at baseline. Mental health at baseline was a significant predictor of quality of life and functioning at follow-up, but illness perceptions were not.

Conclusion: Individuals with Long COVID presented with higher levels of anxiety and depression than the general population which had a negative impact on health outcomes.