Long COVID & Mental Health – Q&A with Saleena Subaiya and People Science

Dr. Saleena Subaiya, board-certified emergency medicine doctor and clinical researcher at New York State Psychiatric Institute and Columbia University, shares her insights as a Long COVID researcher. 

PS: What is long COVID?

SS: Long COVID, also known as post-acute sequelae of COVID (PASC), involves new or returning symptoms 4 weeks after a COVID infection. It’s estimated to affect between 10-30% of all COVID-19 survivors.  The most common symptoms include fatigue, cognitive and attention deficits (known as ‘brain fog’), shortness of breath, and the worsening of symptoms following physical or mental exertion (1).  Patients with long COVID also report changes in mental health including new-onset depression, anxiety, and even suicidal behavior. 

PS: You’ve previously described long COVID as a “road walked alone,” how so?

SS: There is currently no pharmacologic treatment for long COVID, with patients reporting symptoms up to 2 years post-infection.  After my own diagnosis with long COVID, I’ve been on and off eight different medications, changed my lifestyle and diet, and I am still recovering.  During this period I relapsed, which meant 6 weeks at home confined to my bed, feeling so exhausted I was unable to carry a 30-minute conversation.

This pattern of  relapsing-remitting, common among those with long COVID, has been challenging to navigate.  The majority of people who see me do so when I’m well enough to leave my home.  They are unable to see the tremendous effort I have to put forth to appear as normal as possible, and this comes at a cost.  It is exhausting.  

PS: How does long COVID impact mental health?

SS: Ongoing research has shown that there are likely different types of long COVID with the most common being a neurological type consisting of ‘brain fog,’ impaired memory, attention deficits, and sleep disturbances (2) (3).  Rates of depression among individuals with long COVID range from 11- 28% (4), nearly two to three times higher than the general population.   Managing mental health symptoms is a crucial part of helping patients function better in life and at work. 

For readers suffering from long COVID, I suggest checking out Body Politic (www.wearebodypolitic.com) for resources or considering participating in clinical research.

References:

1. Organization, W.H., A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. 2021.
2. Premraj, L., et al., Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis. J Neurol Sci, 2022. 434: p. 120162.
3. Taquet, M., et al., 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry, 2021. 8(5): p. 416-427.
4. Renaud-Charest, O., et al., Onset and frequency of depression in post-COVID-19 syndrome: A systematic review. Journal of Psychiatric Research, 2021. 144: p. 129-137.