Predictors of Anxiety, Depression, and Stress in Long COVID: Systematic Review of Prevalence

Daniel de Macêdo Rocha (), Andrey Oeiras Pedroso, Mayra Gonçalves Menegueti, Renata Cristina de Campos Pereira Silveira, 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
Mayra Gonçalves Menegueti: Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Renata Cristina de Campos Pereira Silveira: 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 6, 1-14

Abstract: Anxiety, depression, and stress are prevalent psychosocial manifestations in Long COVID, and understanding their global impact can guide safe, effective, and evidence-based interventions. This study reviewed the literature to analyze the prevalence indicators and predictors of anxiety, depression, or stress experienced by adults and older adults with Long COVID. This systematic prevalence review was conducted using the databases MEDLINE via PubMed ® , CINAHL-EBSCO, Web of Science, Scopus, EMBASE, LILACS, and BDENF. Observational studies that assessed anxiety, depression, or perceived stress in adults and older adults with Long COVID were included, with no restrictions on time or language. Two reviewers independently conducted the selection process. Full texts were analyzed for their eligibility potential. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Studies. Ten observational studies with moderate methodological quality were included. Anxiety and depression were the most prevalent psychosocial symptoms in Long COVID, reported in mild, moderate, and severe cases of COVID-19 infection. Prevalence rates reached up to 47.8% for anxiety, 37.3% for depression, and 23% for stress. The combined analysis revealed a pooled prevalence of 15.3% (95% CI: 10.8% to 20.2%). Being female, having pre-existing mental disorders or associated clinical comorbidities, experiencing severe infection in the acute phase, and receiving intensive care were predictors of greater mental burden. The experience of anxiety, depression, and stress in prolonged COVID-19 was reported in countries with different income levels and was disproportionately experienced, especially by women and individuals with associated clinical conditions or psychopathological comorbidities.

Keywords: acute post-COVID-19 syndrome; anxiety; depression; stress; prevalence; risk factor (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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