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Psychological distress after COVID-19 recovery and subsequent prolonged post-acute COVID-19 syndrome: A longitudinal study with one-year follow-up in Japan.

Megumi Hazumi,M. Kataoka,Zui C. Narita,Kentaro Usuda,Emi Okazaki,Daisuke Nishi

Published 2025 in Journal of Psychosomatic Research

ABSTRACT

OBJECTIVE This study investigated the longitudinal association between psychological distress in the post-acute phase and the subsequent prolonged post-acute COVID-19 syndrome (PACS) symptoms among individuals with PACS symptoms. METHODS An online longitudinal survey was conducted from July to September 2021 (Time 1, T1) and from July to September 2022 (Time 2, T2). Individuals who were 20 years or older had a positive polymerase chain reaction test, were one-month post-infection, and did not select "Nothing" to a question about PACS symptoms were included. The primary outcome was any PACS symptoms at T2. General and respiratory symptoms at T2 were also examined among participants with those symptoms at T1. Exposure was psychological distress, defined as Kessler Distress Scale ≥13 at T1. Logistic regression analyses were conducted to examine associations between psychological distress and PACS symptoms, general and respiratory symptoms among participants with relevant symptoms at T1. RESULTS Of 1674 participants, 671 completed T2, and 109 of them reported psychological distress. Psychological distress was associated with higher odds of any PACS (odds ratio [OR] = 1.79, 95 % confidence interval [CI] = 1.07-2.98, p = 0.03), general symptoms (OR = 1.92, 95 % CI = 1.01-3.67, p = 0.046), and respiratory symptoms (OR = 2.73, 95 % CI = 1.02-6.44, p = 0.02) at T2. CONCLUSION Psychological distress in the post-acute phase may contribute to the persistence of PACS symptoms, mainly general and respiratory symptoms, at the one-year follow-up in individuals with PACS symptoms.

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