Researchers highlight anxiety and depression in long COVID
Long COVID refers to symptoms that continue or develop more than three months after a COVID-19 infection. Anxiety and depression are common in people with long COVID. Prior studies estimate prevalence of 16 to 37 percent for anxiety, and 15 to 32 percent for depression.
In an editorial in the April 2026 issue of American Family Physician, UW Medicine researchers describe how the mental health consequences of long COVID are shaped by biological, social, and psychological factors. Screening, assessment, and treatment should take these overlapping factors into account.
The editorial was written by Assistant Professor Lindsey M. Knowles, PhD; Acting Assistant Professor Kristen M. O'Loughlin, PhD; Adjunct Assistant Professor Nicole Gentile, MD, PhD; and Assistant Professor Tracy Herring, PhD.
The authors note that people with long COVID report higher rates of depression and slower improvement in anxiety than those who fully recovered from COVID-19. These symptoms are shaped by a mix of factors including:
- Biological factors, such as inflammation or changes in brain chemistry
- Social factors, such as isolation or difficulty accessing medical care
- Psychological factors, including a history of mental health conditions.
Because of these complex factors, the authors recommend a trauma-informed, biopsychosocial approach to care that treats physical and mental health together. Trauma-informed care focuses on building trust, supporting patient safety, and recognizing the impact of past experiences on health.
Many patients with long COVID report that their symptoms were dismissed or attributed to psychological rather than physical causes. This can add stress and make it difficult to seek care. Healthcare professionals can support their patients by validating their experiences and working with them to manage the physical and mental symptoms of long COVID.
The editorial outlines several ways doctors can support patients, including:
- Screen regularly for anxiety and depression using brief questionnaires
- Prescribe appropriate medications while avoiding those that may worsen long COVID symptoms like fatigue
- Teach practical skills for managing symptoms, including diaphragmatic breathing and activity pacing with clear, achievable goals
- Provide access to virtual care, including video-based therapy.
Cognitive behavioral therapy and mindfulness- and acceptance-based treatments can help patients manage fatigue, stress, and changes in daily life. A variety of apps and other tools can support these approaches.
The authors conclude that primary care physicians play an important role in supporting patients with long COVID.
Learn more
A UW Medicine Q&A with Dr. Lindsey Knowles explains how patients and care teams can work together to address both physical and mental health needs: