Is there a correlation between stress and long COVID?

We have spoken a length about the pandemic’s impact on mental health. But, what about vice versa? Does stress play a role in how our bodies recover from COVID-19? Could it be correlated to long COVID-19?

The relationship between stress and illness is complex

According a study conducted back in October 2008, “Not all stress has negative effect. Studies have shown that short-term stress boosted the immune system, but chronic stress has a significant effect on the immune system that ultimately manifest an illness. The correlation between stressful life events and psychiatric illness is stronger than the correlation with medical or physical illness.” 

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Prolonged bad stress (or distress)  has been tied to mental illness such as depression and anxiety. But, over the long term, it can increase our risk of heart disease, stroke, type 2 diabetes, dementia and even cancer.

Does the same conclusion apply to COVID-19 as well? 

A Harvard University study published in September 2022 found that people suffering psychological distress in the lead-up to their COVID-19 infection had a greater chance of experiencing long COVID.

The researchers found those with two or more types of distress (including symptoms of depression, symptoms of anxiety, worry about COVID-19, loneliness, and perceived stress) had an almost 50% greater risk of long COVID than other participants.

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As quoted in the study “Participants with vs without distress at baseline developed on average one additional long-term symptom. All types of distress except loneliness were associated with risk of daily life impairment related to post–COVID-19 conditions.”

As summarised by an article in The Conversation, “Distress can also affect our ability to fully recover from COVID. Ongoing symptoms for a month or more is referred to as long COVID. Those affected can experience fatigue, brain fog, shortness of breath, loss of taste and smell, difficulty sleeping, anxiety and/or depression. For some, these symptoms can last for many months or even years, making it impossible to return to pre-COVID life.”

The results of this study should not be misinterpreted as supporting a hypothesis that post–COVID-19 conditions are psychosomatic.

How does distress impede the body’s ability to fight COVID-19 infection?

When the body’s immune system is under attack, by either infection or injury, it defends itself to neutralise the infected cells. This is called the inflammatory response.  

Pain, swelling, redness, and heat are the external signs of this process. Pain warns us to take care and notifies us of the injury/infection; an area may become swollen as fluids are moved to the injury; heat and redness follow as increased blood flow brings cells to start the healing process; and hormone-like messaging systems can order the blood to clot to close a wound.

When pathogens like bacteria or viruses are present, the immune response involves dispatching white blood cells to fight off and kill the infection. If all goes well, inflammation will subside and our bodies will return to normal as the damage is healed or the pathogen is destroyed.

When experienced over an extended period of time, distress itself can cause low-grade inflammation. Chronic distress and related mental health conditions such as anxiety and depression are all associated with high levels of inflammatory markers. 

When inflammation is ongoing, the immune system’s response changes. In layman’s terms, it goes into “low surveillance mode”. Due to this, the body’s response to infection or injury may become slower and less effective. The process of recovery can also take longer. 

For a virus like COVID-19, it’s possible that prior exposure to distress may similarly impair the body’s ability to fight the infection and increase the risk of long COVID.

There is still much to learn about how COVID-19 and long COVID-19 affect the body and how psychological factors can impact us in the short and long term. 

In the meantime, vaccines work by helping to train the immune system to find the target sooner, giving the immune system the advantage. 

Heathershaw’s offers Bivalent Moderna Booster vaccine appointments. If you are eligible and haven’t received your booster yet, you can book one for yourself online: https://heathershawscompounding.com.au/covid-vaccination/   

Information sources:

1. Salleh, M. R. (2008). Life Event, Stress and Illness. The Malaysian Journal of Medical Sciences : MJMS, 15(4), 9-18. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341916/ 
2. https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649?utm_source=twitter&utm_medium=bylinetwitterbutton 
3. https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html 
4. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097 
5. Devine  J. The dubious origins of long Covid. Wall Street Journal. Published March 22, 2021. Accessed December 20, 2021. https://www.wsj.com/articles/the-dubious-origins-of-long-covid-11616452583

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