Abstract
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has had widespread physical and psychological repercussions. Additionally, long COVID symptoms such as fatigue, dyspnea, and cognitive impairment have been well-documented; however, their associations with mental health symptoms remain unclear. This study investigated the relationships between long COVID and symptoms of anxiety, depression, and COVID-19-related fear using validated psychological assessment tools. METHODS: This nationwide, prospective cohort study enrolled 1,066 individuals who recovered from COVID-19. The participants completed self-report questionnaires at 3, 6, and 12 months after diagnosis. Long COVID symptoms and psychological status were assessed using the Hospital Anxiety and Depression Scale (HADS) and Fear of COVID-19 Scale (FCV-19S). Statistical analyses were used to examine associations between long COVID symptoms and psychological scores while accounting for clinicodemographic factors. RESULTS: Three months after diagnosis, 20.1% of the participants exhibited high anxiety (HADS-Anxiety [A] score ≥ 8), 23.6% had high depression (HADS-Depression [D] score ≥ 8), and 35.3% reported high levels of COVID-19-related fear (FCV-19S score ≥ 21). High HADS-A and HADS-D scores were significantly associated with younger age, female sex, and mild initial illness severity. Individuals with high HADS scores reported significantly greater long COVID symptoms; headaches and fatigue were associated with high anxiety scores and impaired concentration was associated with high depression scores. CONCLUSIONS: This study highlighted the significant associations between mental health symptoms and long COVID, emphasizing the need for integrated psychological support in post-COVID care. Addressing anxiety, depression, and fear-related concerns may contribute to improved management of long COVID symptoms and enhance overall patient well-being.