Ecological momentary assessment of physical symptoms among patients with a history of COVID-19 infection: towards understanding long covid and the role of mental health symptoms

OBJECTIVE: This project used ecological momentary assessment (EMA) in adults with a previous COVID-19 infection to examine the association of long covid with physical symptoms and the association of contextual factors with physical symptoms among adults with long covid. METHOD: = 121) completed survey questions about COVID-19 history, long covid and mental and physical health followed by 7-days of EMA. During EMA, participants reported on physical symptoms and contextual factors five times across the day. RESULTS: Multilevel exploratory factor analyses found two within-subjects (i.e. aches/fatigue and respiratory symptoms) and one between-subjects physical symptom factor. Long covid was associated with more real-world aches/fatigue symptoms compared to those without long covid, and effects persisted after controlling for baseline mental health; long covid was unrelated to respiratory symptoms. Greater within-subjects aches/fatigue were concurrently associated with higher negative affect, higher interpersonal problems, and lower positive affect and prospectively associated with greater negative affect and lower positive affect. CONCLUSION: Findings show that long covid diagnosis predicts real-world ache/fatigue symptoms, and this effect is not explained by baseline mental health. Furthermore, real-world ache/fatigue symptoms are associated with poor momentary psychosocial functioning and predict acute affective disturbance.