Trajectories of Post-Traumatic Stress Disorder Symptoms and Subsequent Risk of Long COVID in the World Trade Center Health Registry

Details

• Journal Article:
  Journal of Affective Disorders
• Personal Author:
  Sisti, Julia S. ; Packard, Samuel E. ; Yung, Janette ; Metzler, Janna
• Description:
  Objective: Though the etiology of long COVID is not well-understood, pre-existing mental health conditions have been identified as risk factors. We examined associations between post-traumatic stress disorder symptoms (PTSS) and long COVID among individuals exposed to the World Trade Center disaster. Methods: We used group-based trajectory modeling to identify five PTSS trajectories (resilient, low-stable, remitted, delayed onset, chronic-high) among enrollees in the World Trade Center Health Registry (2003-04 to 2020-2021). Among 5361 enrollees who reported a COVID-19 infection, we used modified Poisson regression to estimate risk ratios (RRs) and 95% confidence intervals (95% CI) for associations of PTSS trajectories with self-reported long COVID symptoms. Results: In 2022-23, 41% of enrollees reported long COVID symptoms. In models adjusted for sociodemographic characteristics and self-reported diagnosed physical health conditions and depression, associations with long COVID were observed for all trajectories compared to the resilient trajectory, which was characterized by very low PTSS at all points. RRs were similar among trajectory groups characterized by a high lifetime prevalence of probable PTSD (RRremitted = 1.83, 95% CI = 1.64, 2.04; RRdelayed = 1.86, 95% CI = 1.67, 2.06; RRchronic = 1.80, 95% CI = 1.59, 2.03). Risk of long COVID was also elevated among individuals in the low-stable trajectory group, who had a lower lifetime prevalence of probable PTSD (RR = 1.46, 95% CI = 1.35, 1.58). Conclusion: Risk of long COVID is elevated among individuals with a history of PTSS, including among those whose symptoms have improved. Populations at high risk of PTSD, including those exposed to traumatic events, may benefit from targeted screening to identify those with long COVID.
• Subjects:
  COVID-19 Mental Health Occupational Health Post-Acute COVID-19 Syndrome Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: Long COVID; Post-traumatic Stress Disorder; Mental Health; COVID-19; Cohort Studies Mental Health; Post-traumatic Stress Disorder; PTSD; WTC; World Trade Center; Traumatic Incident Stress; Long COVID; COVID-19; Cohort Studies;
• Source:
  J Affect Disord 2025 Dec; 390:119814
• ISSN:
  0165-0327
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  11 pdf pages
• Volume:
  390
• NIOSHTIC Number:
  nn:20071499
• Contact Point Address:
  Julia S. Sisti, New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 30-30 47th Avenue, Long Island City, NY 11101, USA
• Email:
  jsisti@health.nyc.gov
• Federal Fiscal Year:
  2026
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b36463bd5d48f4ed91238d4b12707139ef62b795bc7ef719ca5abf9e10dc3c21cd8d22f5eac0425e82c5eba85fcfd6f151754cd19c27fecd05cf58a284625115
• Download URL:
  https://stacks.cdc.gov/view/cdc/259096/cdc_259096_DS1.pdf
• File Type:
  [PDF - 2.09 MB ]