The Effects of Messaging on Long COVID Expectations: An Online Experiment

Objective: We examined whether varying information about long COVID would affect expectations about the illness. Method: In October 2021, we conducted a 2 (Illness Description: long COVID vs. ongoing COVID-19 recovery) × 2 (Symptom Uncertainty: uncertainty emphasized vs. not emphasized) × 2 (Efficacy of Support: enhanced vs. basic support) between-subjects randomized online experimental study. Participants (N = 1,110) were presented with a scenario describing a positive COVID-19 test result, followed by one of eight scenarios describing a long COVID diagnosis and then completed outcome measures of illness expectations including: symptom severity, symptom duration, quality of life, personal control, treatment control, and illness coherence. Results: We ran a series of 2 × 2 × 2 ANOVAs on the outcome variables. We found a main effect of illness description: individuals reported longer symptom duration and less illness coherence when the illness was described as long COVID (compared to ongoing COVID-19 recovery). There was a main effect of symptom uncertainty: when uncertainty was emphasized, participants reported longer expected symptom duration (p <.001), less treatment control (p =.031), and less illness coherence (p<.001) than when uncertainty was not emphasized. There was a main effect of efficacy of support: participants reported higher personal control (p =.004) and higher treatment control (p =.037) when support was enhanced (compared to basic support).