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Predictors for Anxiety and Stress in Long COVID: A Study in the Brazilian Population

Daniel de Macêdo Rocha (), Andrey Oeiras Pedroso, Laelson Rochelle Milanês Sousa, Elucir Gir and Renata Karina Reis
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Daniel de Macêdo Rocha: Department of Nursing, Federal University of Mato Grosso do Sul, Coxim 79400-000, Brazil
Andrey Oeiras Pedroso: Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Laelson Rochelle Milanês Sousa: Nursing Course, State University of Maranhão, Coroatá 65665-000, Brazil
Elucir Gir: Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Renata Karina Reis: Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil

IJERPH, 2025, vol. 22, issue 2, 1-12

Abstract: Anxiety and stress are major challenges for public health and represent significant symptoms in long COVID. Despite the repercussions on quality of life and mental health, their impacts have not been systematically consolidated in the Brazilian population. Our objective was to analyze the indicators and predictors of anxiety and perceived stress in people who have experienced long COVID in different regional contexts in Brazil. This cross-sectional survey was carried out in the five regions of Brazil and included 4239 adult individuals who had at least one diagnosis of COVID-19. Participants responded to questions on the Depression, Anxiety, and Stress Scale (DASS-21). The GAMLSS class of regression models estimated the predictors associated with the outcomes investigated. The results showed a predominance of participants with a single diagnosis of COVID-19 (65.4%), mild clinical conditions (89.5%), and high adherence to immunization strategies (98.4%). Overall, 48.5% of participants had residual symptoms that started between 4 and 12 weeks after the acute phase of COVID-19 infection. Positive screening for anxiety and perceived stress was associated with female gender, diagnosis of chronic diseases, presence of physical symptoms, moderate or severe clinical condition in the acute phase of the infection, and the need for hospitalization. Through this study, we confirmed that anxiety and stress, developed or exacerbated during the post-COVID-19 phase, represent significant challenges in the Brazilian population. Sociodemographic, clinical, and care conditions were predictors of the outcomes assessed. Knowing these repercussions can allow for personalizing mental health care and help structure evidence-based public policies.

Keywords: post-acute COVID-19 syndrome; anxiety; stress; risk factors (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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