Evidence map›Paper›PMID 41231196›Full record

ArticleAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2025

Daily stress and worry are additional triggers of symptom fluctuations in individuals living with Long COVID: results from an intensive longitudinal cohort study.

Daryl B O'Connor, Darren C Greenwood, Maedeh Mansoubi, Nawar D Bakerly, Aishwarya Bhatia, Johnny Collett, Helen E Davies, Joanna Dawes, Brendan C Delaney, Leisle Ezekiel and 12 more

Abstract read
In one paragraph

Article in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Daryl B O'ConnorSchool of Psychology, University of Leeds, Leeds, LS2 9JT, United Kingdom.
Darren C GreenwoodSchool of Medicine and Leeds Institute for Data Analytics, University of Leeds, Leeds, LS2 9JT, United Kingdom.ORCID 0000-0001-7035-3096
Maedeh MansoubiMedical School, University of Exeter, Exeter, EX1 2HZ, United Kingdom.
Nawar D BakerlyNorthern Care Alliance, Salford, M6 8HD, United Kingdom.
Aishwarya BhatiaMedical School, University of Exeter, Exeter, EX1 2HZ, United Kingdom.
Johnny CollettDepartment of Sport, Health and Social Work, Oxford Brookes University, Oxford, OX3 0BP, United Kingdom.
Helen E DaviesCardiff and Vale University Health Board, Cardiff, CF14 4TT, United Kingdom.
Joanna DawesMedical School, University of Exeter, Exeter, EX1 2HZ, United Kingdom.
Brendan C DelaneyDepartment of Surgery & Cancer, Imperial College London, London, W12 0NN, United Kingdom.
Leisle EzekielSchool of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
Phaedra LeveridgeMedical School, University of Exeter, Exeter, EX1 2HZ, United Kingdom.
Ghazala MirLeeds Institute for Health Sciences, University of Leeds, Leeds, LS2 9JT, United Kingdom.
Willie MuehlhausenSAFIRA Clinical Research Limited, Tipperary, E53 VW10, Ireland.
Clare RaynerPatient Advisory Group (PAG).ORCID 0000-0002-5167-6903
Janet T ScottCOVID Recovery Service, NHS Highlands, Raigmore Hospital, Inverness, IV2 3BW, United Kingdom.
Manoj SivanAcademic Department of Rehabilitation Medicine, University of Leeds, Leeds, LS2 9JT, United Kingdom.
Ian Tucker-BellPatient Advisory Group (PAG).
Himanshu VashishtSAFIRA Clinical Research Limited, Tipperary, E53 VW10, Ireland.
Tomás WardInsight SFI Research Centre for Data Analytics, Dublin City University, Dublin, D04 V1W8, Ireland.
Darren WinchPatient Advisory Group (PAG).
Helen DawesMedical School, University of Exeter, Exeter, EX1 2HZ, United Kingdom.
LOCOMOTION Consortium

Funding

National Institute for Health and Care Research
6 · The paper itself

Abstract

backgroundRecent research has shown that exertion in physical, cognitive, social, and self-care activities triggers symptom severity in individuals with Long COVID. PURPOSE: The current study aimed to investigate whether daily emotional exertions (stress, worry, rumination) were associated with symptom exacerbation, over and above influences of effortful daily activities, in individuals with Long COVID.

methodsIn total, 376 participants were recruited from UK Long COVID clinics and community settings and completed daily assessments of activity and severity of 8 core symptoms every 3 hours for up to 24 days; 155 participants completed daily assessments of stress, worry, and rumination for at least 7 consecutive days.

resultsDays with higher stress scores were associated with increased severity of all symptoms on the same day, after adjusting for activities, demographic and medical factors (P-values ≤ .007). Days with higher stress scores also predicted more severe anxiety and depression symptoms 1 day later (P < .001) and more severe anxiety (P < .001) and dizziness symptoms (P = .003) 2 days later. Days with higher worry scores were associated with increased fatigue (P < .001), anxiety (P < .001), depression (P < .001), and cognitive dysfunction (P = .002) on the same day, but decreased anxiety (P = .003) and depression (P = .002) symptoms 1 day later and less severe pain (P = .002) symptoms 2 days later. Daily rumination was only associated with 2 symptoms.

conclusionsDaily stress and worry are distinct factors linked to fluctuations in same-day and next-day Long COVID symptoms, with daily stress showing the strongest association-consistent with patterns of postexertional symptom exacerbation. These findings highlight the importance of considering stress and worry as potential therapeutic targets and integrating their management into self-care programs.

Indexed as

AnxietyCOVID-19DepressionRumination, CognitiveStress, PsychologicalSymptom Flare UpAdultAgedDizzinessFatigueFemaleHumansLongitudinal StudiesMaleMiddle AgedPost-Acute COVID-19 Syndromeecological momentary assessmentmental exertionphysical exertionpost-COVID conditionstresssymptoms

Identifiers

PMID41231196
PMCPMC12613253

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.