OBJECTIVES: Long-COVID may be associated with poor mental health due to neuroinflammation and other psychosocial factors due to the impact of the COVID-19 pandemic. Examine the association of long-COVID with depression among adults(age>18 years) using near-real-time data from a recent(September,20–October 6,2023) nationally representative survey.

METHODS: A cross-sectional analysis of real-world data(N=60,308)on adults from the Census household survey, representing ~197.4 million adults. Adults with missing data in long-COVID, depression, and anxiety were excluded. Long-COVID was derived from an affirmative answer to a question about symptoms(for example: tiredness, difficulty breathing, pain, and heart palpitations) lasting longer than 3 months. Depression was derived from patient health questionnaire. Multivariable logistic regressions analyzed the association of long-covid with depression after adjusting for gender, age, race, ethnicity, social determinants of health–SDOH(education, poverty status, food sufficiency, health insurance, marital status, and region), and stress due to inflation.

RESULTS: Among US adults, 15.2% had long-COVID; 40.8% had acute COVID; 44% had no COVID; 22.5% reported depression. 83.2% had COVID vaccination. Among adults with COVID-19 vaccination, 15.4% had long-COVID. A higher percentage of adults with long-COVID reported depression(34.8% vs 22.8%,p < 0.001)compared to those without COVID. After adjustment for other covariates, adults with Long-COVID were more likely to report depression (aOR=1.78, 95%CI=1.57, 2.01) compared to those without COVID.

CONCLUSIONS: Approximately one in 5 adults reported depression even after the end of the COVID-19 pandemic. Long-COVID was associated with depression. Adults with long-COVID may need routine evaluation for major depression and possible mental health treatments.