# Confirmation of COVID-19 infection status and reporting of Long COVID symptoms in a population-based birth cohort: No evidence of a nocebo effect

## TL;DR

This study found no evidence that knowing you had COVID-19 leads to more Long COVID symptoms, suggesting a nocebo effect is not at play.

## Contribution

The study provides new evidence against the nocebo effect in Long COVID symptom reporting.

## Key findings

- No strong association found between confirmed infection and Long COVID symptoms.
- No evidence of moderation by sex or anxiety.
- Suggests psychological mechanisms like nocebo do not drive Long COVID symptoms.

## Abstract

Some patients with COVID-19 develop symptoms after the acute infection, known as ‘Long COVID’. We examined whether or not confirmation of COVID-19 infection status could act as a nocebo, using data from questionnaires distributed to the Avon Longitudinal Study of Parents and Children cohort. We examined associations between confirmation of COVID-19 infection status (confirmed by a positive test vs unconfirmed) and reporting of Long COVID symptoms. We explored the roles of sex and anxiety as potential moderators. There was no clear evidence of a strong association between confirmation of COVID-19 infection status and the Long COVID composite score, physical or psychological symptoms or duration of symptoms. There was no clear evidence of moderation by sex or anxiety. We therefore found no evidence of a nocebo effect. Our data suggest that this psychological mechanism does not play a role in the medical symptomatology experienced by patients with Long COVID.