Childhood abuse predicts increased risk of post-COVID conditions, new research shows

A new study published in Brain, Behavior, and Immunity reveals a significant link between childhood abuse and a higher risk of developing post-COVID-19 conditions, also known as long COVID. The research found that those who experienced severe abuse as children had a 42 percent increased risk of post-COVID-19 conditions compared to those who did not experience abuse. The study highlights the importance of considering a person’s full history, including early life experiences, when assessing long-term health outcomes after COVID-19.

Since the beginning of the COVID-19 pandemic, many individuals who recovered from the virus have reported experiencing ongoing symptoms for weeks or even months after their initial infection. These lingering symptoms, which include fatigue, breathing difficulties, and cognitive issues, have been grouped under the term “long COVID.”

Researchers have been trying to identify the risk factors for long COVID, as understanding these risks may help develop better prevention and treatment strategies. However, one area that has been largely unexplored is the role that early life adversities, such as childhood abuse, may play in increasing susceptibility to long COVID.

Childhood abuse can have long-lasting effects on both mental and physical health. People who experienced abuse early in life are more likely to suffer from chronic health conditions, inflammation, and psychological issues later in life. These factors have also been linked to an increased risk of post-COVID conditions, leading the researchers to wonder whether childhood abuse might contribute to the development of long COVID.

“Childhood abuse—whether physical, emotional, or sexual—has been linked to a range of problems, including chronic illnesses and mental health issues, which affect overall well-being,” said study authors Chirag M. Vyas and Andrea L. Roberts, an instructor in psychiatry at Harvard Medical School and a principal research scientist at the Harvard T. H. Chan School of Public Health, respectively.

“Meanwhile, many people are experiencing persistent COVID-19 symptoms or “long COVID”, which is becoming a major public health concern. Although there is substantial research on childhood abuse and COVID-19 separately, we haven’t understood how childhood abuse relates to risk of long COVID.

“By investigating this connection, we can better understand how these issues intersect and identify the specific needs of individuals affected by both childhood trauma and long COVID. Ultimately, this research could help create more effective strategies for those at risk, improving health outcomes for vulnerable individuals dealing with the fallout from both experiences. It is about connecting the dots to help people lead healthier lives.”

The researchers analyzed data from three long-term health studies: the Nurses’ Health Study II, the Nurses’ Health Study 3, and the Growing Up Today Study. These studies, which have been ongoing for decades, provided a large pool of participants who had already shared information about their health history, including any experiences of childhood abuse.

In total, 2,851 participants were included in the final analysis. All of these individuals had tested positive for COVID-19 and provided data on both their experiences of childhood abuse and whether they experienced long-term COVID-19 symptoms. Childhood abuse was assessed using standardized questionnaires, which asked participants about both sexual and physical or emotional abuse they experienced before the age of 18. Based on their responses, the participants were categorized into different levels of abuse severity, ranging from no abuse to severe abuse.

To measure post-COVID conditions, participants were asked whether they had experienced any COVID-related symptoms lasting more than four weeks after their initial infection. If they reported ongoing symptoms, they were classified as having post-COVID conditions. The researchers then analyzed the data to determine whether there was a relationship between childhood abuse and post-COVID conditions, while also considering other factors like lifestyle, health conditions, and psychological well-being.

The study revealed a clear connection between childhood abuse and an increased risk of post-COVID conditions. Moreover, the study identified a dose-dependent relationship. Participants who reported severe childhood abuse were 42 percent more likely to develop post-COVID conditions compared to those who had not experienced abuse.

Interestingly, the study found that both physical and emotional abuse, as well as sexual abuse, were independently associated with post-COVID conditions. This means that any form of childhood abuse, whether physical, emotional, or sexual, could increase the risk of long-term COVID-19 symptoms.

“Our findings suggest that experiencing childhood abuse—whether sexual or physical/emotional—is linked to a greater likelihood of facing long COVID,” Vyas and Roberts told PsyPost. “We also found that the more severe the abuse, the higher the risk of reporting these conditions. In simpler terms, if someone experienced more intense or serious forms of abuse during childhood, they might be more likely to report long COVID symptoms. Ultimately, this research underscores the importance of considering a person’s full history—including experiences of abuse—when evaluating their health outcomes after COVID-19.”

This relationship remained strong even when the researchers took into account other factors, such as participants’ smoking habits, body weight, and history of chronic health conditions like diabetes or asthma. In fact, the researchers found that while these lifestyle and health-related factors did explain part of the connection between childhood abuse and post-COVID conditions, they did not account for all of it. The biological and psychological effects of abuse, such as immune system dysfunction and chronic inflammation, may play a larger role.

“We also looked into whether lifestyle and health-related factors—like smoking and medical comorbidities—play a role in this relationship,” the researchers explained. “However, we found that these factors only explained about 25% of the connection. This suggests that there are likely other important factors at play that we haven’t fully understood yet.”

Despite the important insights this study provides, there are some limitations that should be considered. First, the sample was predominantly composed of white women, most of whom were healthcare professionals. This raises questions about whether the findings would apply to more diverse populations, including men or individuals from different racial or socioeconomic backgrounds. The researchers noted that future studies should aim to include more diverse groups to better understand how childhood abuse might affect different segments of the population.

Additionally, because the study relied on participants’ self-reports of both their abuse experiences and their COVID-19 symptoms, there is a possibility of recall bias.

“We gathered data about childhood abuse and long COVID based on what participants reported in study questionnaires,” Vyas and Roberts noted. “This means that people shared their experiences rather than us measuring or assessing them directly. Self-reporting can provide valuable insights, but it also has some limitations.”

“For example, participants might remember their experiences differently or may not feel comfortable sharing certain details. Because of this, it is important to interpret the results carefully, understanding that they reflect individuals’ perspectives and experiences.”

Looking ahead, the researchers plan to investigate these biological mechanisms in more detail. Additionally, they suggest that future studies could examine whether interventions aimed at reducing the long-term effects of childhood abuse might help lower the risk of long COVID in this vulnerable population.

“The long-term goals of this research are twofold,” the researchers said. “The first goal is to explore the biological mechanisms that connect childhood abuse to long COVID. The focus is on understanding how experiences of abuse might affect the body and brain in ways that could increase risk of post-COVID-19 conditions. This could involve examining factors like stress responses, inflammation, or other physical changes that might occur due to childhood abuse.”

“The second goal is to develop effective strategies for individuals who have experienced both childhood abuse and COVID-19. The intention is to identify ways to improve long-term health and well-being for these individuals. This could include creating targeted therapies, support programs, or health interventions that address their unique needs.”

The study, “Association between childhood abuse and risk of post-COVID-19 conditions: Results from three large prospective cohort studies,” was authored by Chirag M. Vyas, Siwen Wang, Anthony M. Menor, Laura D. Kubzansky, Natalie Slopen, Janet Rich-Edwards, Jorge E. Chavarro, Jae H. Kang, and Andrea L. Roberts.