AUTHOR=Saito Ayaka , Otake Shiro , Ohgino Keiko , Bun Shogyoku , Mimura Yu , Ito Daisuke , Miyazaki Naoki , Nagashima Kengo , Terai Hideki , Chubachi Shotaro , Masaki Katsunori , Miyata Jun , Kawada Ichiro , Namkoong Ho , Hashiguchi Mizuha , Kagyo Junko , Shiomi Tetsuya , Masuzawa Keita , Asakura Takanori , Nakayama Sohei , Suzuki Yusuke , Minematsu Naoto , Manabe Tadashi , Fukui Takahiro , Funatsu Yohei , Koh Hidefumi , Fukunaga Koichi 

TITLE=Anxiety, depression, and fear after coronavirus disease 2019 infection and their association with long coronavirus disease symptoms

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1672447

DOI=10.3389/fpsyt.2025.1672447

ISSN=1664-0640

ABSTRACT=IntroductionThe 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.MethodsThis 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.ResultsThree 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.ConclusionsThis 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.