Long COVID and psychological distress in young adults: Potential protective effect of a prior mental health diagnosis

Although young adulthood is a period characterized by marked psychological vulnerability, young adults are typically considered to be in good physical health and are therefore understudied with respect to the effects of COVID-19 infection and long COVID. The present study examined associations between post-acute sequelae of COVID-19 (PASC) and serious psychological distress during young adulthood, and tested whether prior mental health diagnosis moderated this association. Participants were 44,652 young adults who completed the Spring 2022 administration of the American College Health Association-National College Health Assessment III (ACHA-NCHA). Blockwise logistic regressions tested the odds of meeting the clinical threshold for serious psychological distress. PASC was associated with 53 % increased likelihood of meeting the clinical threshold for serious psychological distress. Among young adults with a prior mental health diagnosis, PASC predicted 36 % increased odds of serious psychological distress; among those without a diagnosis, PASC predicted 81 % increased odds. PASC was assessed using a single self-report item rather than a clinical diagnosis of specific symptomatology. The analyses were cross-sectional and relied on concurrent reports of PASC and psychological distress which precluded us from making claims regarding directionality of the associations. The outcome of generalized psychological distress limited us from generating targeted treatment recommendations. PASC may confer elevated psychological distress among young adults. The association of PASC to serious psychological distress was stronger in young adults without a mental health diagnosis than those with a diagnosis. Prior experience with mental illness may mitigate the psychological burden of long-term symptomatology. •Young adults with acute COVID-19 had lower odds of serious psychological distress.•Young adults with long COVID had greater odds of serious psychological distress.•A prior mental health diagnosis significantly moderated the association.•Those without diagnosis had greater odds of distress due to COVID, than those with.