JMIR Publications

ABSTRACT

Background:

Long COVID is a post-infectious condition characterized by persistent multisystem symptoms lasting at least three months after SARS-CoV-2 infection. Beyond physical symptoms, long COVID substantially affects psychosocial well-being and daily functioning. Although these impacts are increasingly recognized, age-specific psychosocial challenges and support needs among younger people and adults remain insufficiently understood.

Objective:

The objective of this study was to identify age-specific psychosocial challenges and support needs among younger people and adults living with long COVID and to derive design considerations for age-responsive psychosocial support.

Methods:

This study comprised the pre-design phase of a co-design process using a sequential mixed-methods approach. Quantitative data were obtained through a retrospective analysis of the Dutch National Long COVID Panel Survey (December 2023), including 4,919 younger people (12–25 years) and 7,487 adults (≥26 years). Outcomes included mental health (MHI-5), loneliness, stress, support needs, and access to support. Group differences between participants with and without long COVID were analyzed separately for younger people and adults using chi-square tests (α=.05). Quantitative findings informed statements for a stakeholder session and age-specific focus groups with people living with long COVID. Qualitative data were analyzed using inductive reflexive thematic analysis.

Results:

Compared with peers without long COVID, both younger people and adults with long COVID more frequently reported symptoms indicative of anxiety or mood disorders, higher levels of social and emotional loneliness, greater psychosocial support needs across multiple life domains, and poorer access to appropriate support. In the qualitative phase both age groups shared needs for understanding and recognition, social connection, acceptance, and adaptive environments, but the underlying challenges differed. Younger people emphasized disrupted developmental milestones, including education, autonomy, and peer relationships, alongside the need for environmental adaptations that enable pacing and normalize help-seeking. Adults primarily described challenges related to changes in established identities, family roles, and work participation, as well as balancing responsibilities with limited energy, highlighting the importance of family involvement and workplace accommodations.

Conclusions:

Long COVID is associated with substantial psychosocial challenges that differ across life stages while extending beyond physical symptoms. Although younger people and adults share needs for recognition, social connection, and adaptive environments, their support needs differ according to developmental context. These findings highlight the importance of age-responsive psychosocial support and provide design considerations for the co-design and future development of tailored support interventions for people living with long COVID.