Chronic stress as a risk factor for long COVID

The disease caused by the pathogen SARS-CoV-2 is known as coronavirus disease with the acronym COVID-19. The acute phase of this condition typically lasts one to two weeks and usually results in a full recovery. However, in about 10-30% of those affected, the symptoms persist for more than four weeks after the onset of the disease. In this case, there is an ongoing COVID-19 illness known as long COVID. Long COVID can persist for many months and cause significant distress and limitations to those affected due to the long-term health consequences. The causes of long COVID are still unclear and, accordingly, therapeutic measures are still insufficiently developed. It is assumed that long COVID can in principle affect anyone. Possible risk factors for long COVID include age, gender, obesity and the number of symptoms during an acute COVID-19 illness. Another potential risk factor for developing long COVID could be chronic stress, which demonstrably burdens the immune system. It is known from infections with other coronaviruses and other viral respiratory diseases that chronic stress can lead to prolonged illness and limited recovery. The aim of this study is to systematically examine chronic stress, as it existed before infection with the coronavirus, as a possible risk factor for long COVID. For this purpose, 600 people with proven SARS-CoV-2 infection and COVID-19 symptoms will be recruited for this study. The burden of chronic stress is examined psychologically using questionnaires and physiologically. By measuring the concentration of the stress hormone cortisol in the hair, the physiological stress level of the organism before infection can be analyzed. The course of the disease will be observed over 6 months. This enables to determine whether those individuals who have a higher burden of chronic stress before infection are also more likely to develop ongoing COVID-19 disease or Long COVID. In addition, in the subgroup of people with long COVID, the metabolic processes in the blood associated with the stress response of the body are examined in more detail and these results are compared with those of a control group without long COVID. Study results will help assess the influence of chronic stress on the occurrence of long-term health consequences after the acute phase of COVID-19 at multiple levels. Subsequently, based on these results, persons at risk for long-COVID could possibly be identified at an early stage and secondary preventive measures and targeted therapy approaches for long COVID could be developed.