Older women who have a history of both depression and anxiety had a 78% higher risk of developing long COVID after a SARS-CoV-2 infection, report University of California San Diego researchers in the Jan. 27, 2026 online edition of the journal Menopause.
"Some people have only anxiety. Some have only depression. When these conditions occur together, they usually indicate more severe mental illness," said senior author Wael Al-Delaimy, MD, PhD , professor at the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego.
"In this study, we measured the health of women over 20 years by analyzing data from the Women's Health Initiative. We found that older women with a combined history of both depression and anxiety, before the COVID-19 pandemic, were at the highest risk of long COVID complications."
Long COVID is a chronic condition in which people experience persistent symptoms that last three months or more after the initial infection.
What the study found
- While women with both long‑term depression and anxiety faced a 78 % greater risk of long COVID, their SARS-CoV-2 infection rates were not higher; only their risk of complications increased.
- Higher anxiety scores increased the likelihood of long COVID symptoms such as fatigue, brain fog and shortness of breath.
- Elevated stress levels also raised the odds of long COVID.
- Mental health history affected safety habits: Women with long‑term depression, or both depression and anxiety, were less likely to wear masks, wash hands or keep social distance. Women who felt anxious during the early pandemic were slightly more likely to follow those rules.
Why it matters
People experiencing mental health illnesses are vulnerable to other diseases and may have trouble following public health guidelines.
"We hope that by characterizing these mental health risk factors public health officials and policymakers can target preventative measures to those with the greatest need," said co-author William Bruno, MD, MPH , associate physician in the Department of Emergency Medicine at the UC San Diego School of Medicine .
In addition, the community should stay vigilant and care for people who may be dealing with loneliness, isolation or existing mental illness should another pandemic or other isolating event occur, said Al-Delaimy.
The federally funded Women's Health Initiative is a long-term national study that began in the early 1990s, focusing on the health of postmenopausal women in the United States. The third extension of the study (2020-2027) included COVID-19 surveys. The average participant was 83 years old, and 414 participants met the criteria for long COVID.
Additional co-authors include: Aladdin H. Shadyab, UC San Diego; Nazmus Saquib, Sulaiman Alrajhi University; and Joseph S. Goveas, Medical College of Wisconsin.
The Women's Health Initiative program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health and United States Department of Health and Human Services (75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005).
Disclosures: The authors do not have any conflicts of interest to report.
DOI: 10.1097/GME.0000000000002727
