Long COVID and Its Impact on Daily Functioning: Findings from the Si-Panda Behavioural Insights Survey in Slovenia

Helena Jeriček Klanšček; Maruša Rehberger; Andreja Belščak Čolaković; Marina Šinko; Darja Lavtar; Ada Hočevar Grom

doi:10.2478/sjph-2026-0013

.blurhash-client-img { display: none !important; }

Long COVID and Its Impact on Daily Functioning: Findings from the Si-Panda Behavioural Insights Survey in Slovenia

Slovenian Journal of Public Health

Volume 65 (2026): Issue 2 (June 2026)

By: Helena Jeriček Klanšček , Maruša Rehberger, Andreja Belščak Čolaković , Marina Šinko , Darja Lavtar and Ada Hočevar Grom

Open Access

|Jun 2026

Abstract

Introduction

Research on the long-term consequences of COVID-19 has initially focused on the symptoms and prevalence of long COVID. However, few studies have fully incorporated the World Health Organization definition or explored its diverse predictors, including mental health factors. This study aims to deepen the understanding of long-term outcomes of COVID-19 and their associated factors.

Methods

Data were drawn from the SI-PANDA Behavioural Insights survey on COVID-19, an online questionnaire administered to a selected sample of participants from an online access panel in Slovenia. The study included 5,961 participants aged 18 to 74. A multivariate logistic regression model was used to identify factors associated with reporting long COVID.

Results

Among the 5,961 respondents, 3,234 reported having been infected with SARS-CoV-2 at least once. Of those, 38% reported persistent fatigue and lack of energy. Long COVID developed in 16.1% (n = 520) of respondents who had been infected. The factor most strongly associated with long COVID was experiencing at least one severe episode of COVID-19, which was associated with a fourfold increase in the odds (OR = 3.99; 95% CI: 3.25–4.91). Other significant associations were observed for risk of a depressive disorder (OR = 2.50; 95% CI: 1.79–3.44), three or more SARS-CoV-2 infections (OR = 2.30; 95% CI: 1.45–3.64), risky stress behaviour (OR = 2.10; 95% CI: 1.38–3.30), and the presence of at least one chronic disease (OR = 1.50; 95% CI: 1.24–1.91).

Conclusions

Understanding and effectively addressing infectious diseases like COVID-19 requires not only insight into the virus’s biology and evolution but also recognition of the important role of mental health and psychological factors.

References

COVID-19 National Preparedness Collaborators. Pandemic preparedness and COVID-19: An exploratory analysis of infection and fatality rates, and contextual factors associated with preparedness in 177 countries, from Jan 1, 2020, to Sept 30, 2021. Lancet. 2022;399(10334):1489–1512. doi: 10.1016/S0140-6736(22)00172-6.
Open DOI Search in Google Scholar Back to article
Castanares-Zapatero D, Chalon P, Kohn L, Dauvrin M, Detollenaere J, Maertens De Noordhout C, et al. Pathophysiology and mechanism of long COVID: A comprehensive review. Ann Med. 2022 Dec 31;54(1):1473–1487. doi: 10.1080/07853890.2022.2076901.
Open DOI Search in Google Scholar Back to article
Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: Major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023 Mar;21(3):133–146. doi: 10.1038/s41579-022-00846-2.
Open DOI Search in Google Scholar Back to article
Markov PV, Ghafari M, Beer M, Lythgoe K, Simmonds P, Stilianakis NI, et al. The evolution of SARS-CoV-2. Nat Rev Microbiol. 2023 Jun;21(6):361–379. doi: 10.1038/s41579-023-00878-2.
Open DOI Search in Google Scholar Back to article
Peters EMJ, Schedlowski M, Watzl C, Gimsa U. To stress or not to stress: Brain-behavior-immune interaction may weaken or promote the immune response to SARS-CoV-2. Neurobiol Stress. 2021;14. doi: 10.1016/j.ynstr.2021.100296.
Open DOI Search in Google Scholar Back to article
Bower JE, Radin A, Kuhlman KR. Psychoneuroimmunology in the time of COVID-19: Why neuro-immune interactions matter for mental and physical health. Behav Res Ther. 2022;104104154. doi: 10.1016/j.brat.2022.104104.
Open DOI Search in Google Scholar Back to article
Lemogne C, Gouraud C, Pitron V, Ranque B. Why the hypothesis of psychological mechanisms in long COVID is worth considering. J Psychosom Res. 2023 Feb;165:111135. doi: 10.1016/j.jpsychores.2022.111135.
Open DOI Search in Google Scholar Back to article
Alqahtani Js, Almamary As, Alghamdi Sm, Komies S, Althobiani M, Aldhahir Am, et al. Effect of the COVID-19 pandemic on psychological aspects. In: COVID-19 and the sustainable development goals [Internet]. 2022. p. 235–258. Available at: https://doi:10.1016/B978-0-323-91307-2.00007-9
Search in Google Scholar Back to article
Baranova A, Fu L, Song Y, Cao H, Zhang F. Causal associations between posttraumatic stress disorder and COVID-19. J Integr Neurosci. 2024 Apr 1;23(4):68. doi: 10.31083/j.jin2304068.
Open DOI Search in Google Scholar Back to article
Burton A, Aughterson H, Fancourt D, Philip KEJ. Factors shaping the mental health and well-being of people experiencing persistent COVID-19 symptoms or ‘long COVID’: Qualitative study. BJPsych open. 2022 Mar;8(2):e72. doi: 10.1192/bjo.2022.38.
Open DOI Search in Google Scholar Back to article
Bavel JJV, Baicker K, Boggio PS, Capraro V, Cichocka A, Cikara M, et al. Using social and behavioural science to support COVID-19 pandemic response. Nat Hum Behav. 2020;4(5):460–471. doi: 10.1038/s41562-020-0884-z.
Open DOI Search in Google Scholar Back to article
Houben-Wilke S, Goërtz YM, Delbressine JM, Vaes AW, Meys R, Machado FV, et al. The impact of long COVID-19 on mental health: Observational 6-month follow-up study. JMIR Ment Health. 2022 Feb 24;9(2):e33704. doi: 10.2196/33704.
Open DOI Search in Google Scholar Back to article
Blomberg B, Cox RJ, Langeland N. Long-COVID: A growing problem in need of intervention. Cell Rep Med. 2022;3(3):100552. doi: 10.1016/j.xcrm.2022.100552.
Open DOI Search in Google Scholar Back to article
World Health Organization. Post COVID-19 condition (long COVID) [Internet]. 2022. [cited 2025 Jan 28]. Available at: Available at: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition
Search in Google Scholar Back to article
Vranić L, Biloglav Z, Medaković P, Talapko J, Škrlec I. The effects of a pulmonary rehabilitation programme on functional capacity and strength of respiratory muscles in patients with post-COVID syndrome. Zdr Varst. 2024 Sep 1;63(3):123–131. doi: 10.2478/sjph-2024-0017.
Open DOI Search in Google Scholar Back to article
Robineau O, Zins M, Touvier M, Wiernik E, Lemogne C, De Lamballerie X, et al. Long-lasting symptoms after an acute COVID-19 infection and factors associated with their resolution. JAMA Netw Open. 2022 Nov 9;5(11):e2240985. doi: 10.1001/jamanetworkopen.2022.40985.
Open DOI Search in Google Scholar Back to article
Woodrow M, Carey C, Ziauddeen N, Thomas R, Akrami A, Lutje V, et al. Systematic review of the prevalence of long COVID. Open Forum Infect Dis. 2023;10(7):ofad233. doi: 10.1093/ofid/ofad233.
Open DOI Search in Google Scholar Back to article
Antony B, Blau H, Casiraghi E, Loomba JJ, Callahan TJ, Laraway BJ, et al. Predictive models of long COVID. eBioMedicine. 2023;96:104777. doi: 10.1016/j.ebiom.2023.104777.
Open DOI Search in Google Scholar Back to article
Fernández-de-las-Peñas C, Martín-Guerrero JD, Pellicer-Valero ÓJ, Navarro-Pardo E, Gómez-Mayordomo V, Cuadrado ML, et al. Female sex is a risk factor associated with long-term post-COVID related-symptoms but not with COVID-19 symptoms: The LONG-COVID-EXP-CM multicenter study. J Clin Med. 2022 Jan 14;11(2):413. doi: 10.3390/jcm11020413.
Open DOI Search in Google Scholar Back to article
Jacobs ET, Catalfamo CJ, Colombo PM, Khan SM, Austhof E, Cordova-Marks F, et al. Pre-existing conditions associated with post-acute sequelae of COVID-19. J Autoimmun. 2023 Feb;135:102991. doi: 10.1016/j.jaut.2022.102991.
Open DOI Search in Google Scholar Back to article
Subramanian A, Nirantharakumar K, Hughes S, Myles P, Williams T, Gokhale KM, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022 Aug;28(8):1706–1714. doi: 10.1038/s41591-022-01909-w.
Open DOI Search in Google Scholar Back to article
Heald A, Williams R, Khan Z, Mudaliar R, Khan A, Naseem A, et al. The predisposing factors to having a coded diagnosis of long COVID. Public Health. 2025 Sep;246:105826. doi: 10.1016/j.puhe.2025.105826.
Open DOI Search in Google Scholar Back to article
Tsampasian V, Elghazaly H, Chattopadhyay R, Debski M, Naing TKP, Garg P, et al. Risk factors associated with post−COVID-19 condition: A systematic review and meta-analysis. JAMA Internal Medicine. 2023;183(6):566–580. doi: 10.1001/jamainternmed.2023.0750.
Open DOI Search in Google Scholar Back to article
Jeriček Klanšček H, Rehberger M, Belščak Čolaković A, Šinko M, Lavtar D, Hočevar Grom A. Dataset for the article “Long COVID and Its impact on daily functioning: findings from the SI-PANDA behavioural insights survey in Slovenia” [Internet]. Geneva: Zenodo; 2026 [cited 2026 Apr 9]. Available at: https://zenodo.org/doi/10.5281/zenodo.18479765
Search in Google Scholar Back to article
Prättälä R, Helakorpi S, Sipilä N, Sippola R, Sääksjaärvi K, et al. Social determinants of health behaviours. Finbalt Health Monitor 1998 – 2008. Report. [Internet]. Tampere: National Institute for Health and Welfare. 2011 [cited 2026 Apr 9]. Available at: https://www.spkc.gov.lv/lv/veselibu-ietekmejoso-paradumu-petijumi/social-determinants-of-health-behaviours.-finbalt-health-monitor-1998-2008_0.pdf/social-determinants-of-health-behaviours.-finbalt-health-monitor-1998-2008_0.pdf
Search in Google Scholar Back to article
Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-Arimi S. Physical and mental health complications post-COVID-19: Scoping review. J Psychosom Res. 2021;147:110525. doi: 10.1016/j.jpsychores.2021.110525.
Open DOI Search in Google Scholar Back to article
European Centre for Disease Prevention and Control. Prevalence of post COVID-19 condition symptoms: A systematic review and meta-analysis of cohort study data, stratified by recruitment setting [Internet]. [cited 2025 Jan 28]. Available at: Available at: https://www.ecdc.europa.eu/en/publications-data/prevalence-post-covid-19-condition-symptoms-systematic-review-and-meta-analysis
Search in Google Scholar Back to article
Krishna B, Wills M, Sithole N. Long COVID: What is known and what gaps need to be addressed. Br Med Bull. 2023;147(1):6–19. doi: 10.1093/bmb/ldad016.
Open DOI Search in Google Scholar Back to article
O’Mahoney LL, Routen A, Gillies C, Ekezie W, Welford A, Zhang A, et al. The prevalence and long-term health effects of long COVID among hospitalised and non-hospitalised populations: A systematic review and meta-analysis. eClinicalMedicine. 2023;55:101762. doi: 10.1016/j.eclinm.2022.101762.
Open DOI Search in Google Scholar Back to article
Hermans L, Van den Broucke S, Gisle L, Demarest S, Charafeddine R. Mental health, compliance with measures and health prospects during the COVID-19 epidemic: The role of health literacy. BMC Public Health. 2021;21(1):1365. doi: 10.1186/s12889-021-11437-w.
Open DOI Search in Google Scholar Back to article
Velikonja NK, Erjavec K, Verdenik I, Hussein M, Velikonja VG. Association between preventive behaviour and anxiety at the start of the COVID-19 pandemic in Slovenia. Zdr Varst. 2020 Dec 31;60(1):17–24. doi: 10.2478/sjph-2021-0004.
Open DOI Search in Google Scholar Back to article
Arjun MC, Kumar Singh A, Pal D, Das K, Alekhya G, Venkateshan M. Characteristics and predictors of Long COVID among diagnosed cases of COVID-19. PLoS One. 2022;17(12):e0278825. doi: 10.1371/journal.pone.0278825.
Open DOI Search in Google Scholar Back to article
Slurink IAL, Sophie C M van den Houdt, Mertens G. Who develops long COVID? Longitudinal pre-pandemic predictors of long COVID and symptom clusters in a representative Dutch population. Int J Infect Dis. 2024;144:107048. doi: 10.1016/j.ijid.2024.107048.
Open DOI Search in Google Scholar Back to article
Bowe B, Xie Y, Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med. 2022;28(11):2398–2405. doi: 10.1038/s41591-022-02051-3.
Open DOI Search in Google Scholar Back to article
Engelmann P, Reinke M, Stein C, Salzmann S, Löwe B, Toussaint A, et al. Psychological factors associated with Long COVID: A systematic review and meta-analysis. eClinicalMedicine. 2024;74:102756. doi: 10.1016/j.eclinm.2024.102756.
Open DOI Search in Google Scholar Back to article
Sirotiak Z, Thomas EBK, Brellenthin AG. Stress, anxiety, and depression severity among individuals with no history, previous history, or current history of long COVID. J Psychosom Res. 2023;175:111519. doi: 10.1016/j.jpsychores.2023.111519.
Open DOI Search in Google Scholar Back to article
Wang S, Quan L, Chavarro JE, Slopen N, Kubzansky LD, Koenen KC, et al. Associations of depression, anxiety, worry, perceived stress, and loneliness prior to infection with risk of post–COVID-19 conditions. JAMA Psychiatry. 2022 Nov 1;79(11):1081. doi: 10.1001/jamapsychiatry.2022.2640.
Open DOI Search in Google Scholar Back to article
Kostev K, Smith L, Koyanagi A, Jacob L. Prevalence of and factors associated with post-coronavirus disease 2019 (COVID-19) condition in the 12 months after the diagnosis of COVID-19 in adults followed in general practices in Germany. Open Forum Infect Dis. 2022;9(7):ofac333. doi: 10.1093/ofid/ofac333.
Open DOI Search in Google Scholar Back to article
Marra AR, Kobayashi T, Callado GY, Pardo I, Gutfreund MC, Hsieh MK, et al. The effectiveness of COVID-19 vaccine in the prevention of post-COVID conditions: A systematic literature review and meta-analysis of the latest research. Antimicrob Steward Healthc Epidemiol. 2023;3(1):e168. doi: 10.1017/ash.2023.447.
Open DOI Search in Google Scholar Back to article
Man MA, Rosca D, Bratosin F, Fira-Mladinescu O, Ilie AC, Burtic SR, et al. Impact of pre-infection COVID-19 vaccination on the incidence and severity of post-COVID syndrome: A systematic review and meta-analysis. Vaccines. 2024 Feb 12;12(2):189. doi: 10.3390/vaccines12020189.
Open DOI Search in Google Scholar Back to article
Ayoubkhani D, Bermingham C, Pouwels KB, Glickman M, Nafilyan V, Zaccardi F, et al. Trajectory of long covid symptoms after COVID-19 vaccination: Community based cohort study. BMJ. 2022 May 18;e069676. doi: 10.1136/bmj-2021-069676.
Open DOI Search in Google Scholar Back to article
Byambasuren O, Stehlik P, Clark J, Alcorn K, Glasziou P. Effect of COVID-19 vaccination on long COVID: Systematic review. BMJ Med. 2023 Feb;2(1):e000385. doi: 10.1136/bmjmed-2022-000385.
Open DOI Search in Google Scholar Back to article
Tana C, Giamberardino MA, Martelletti P. Long COVID and especially headache syndromes. Curr Opin Neurol. 2023 Jun;36(3):168–174. doi: 10.1097/WCO.0000000000001153.
Open DOI Search in Google Scholar Back to article
Tana C, Bentivegna E, Cho SJ, Harriott AM, García-Azorín D, Labastida-Ramirez A, et al. Long COVID headache. J Headache Pain. 2022 Dec;23(1):93. doi: 10.1186/s10194-022-01450-8.
Open DOI Search in Google Scholar Back to article
Mutiawati E, Syahrul S, Fahriani M, Fajar JK, Mamada SS, Maliga HA, et al. Global prevalence and pathogenesis of headache in COVID-19: A systematic review and meta-analysis. F1000Res. 2021 Mar 10;9:1316. doi: 10.12688/f1000research.27334.2.
Open DOI Search in Google Scholar Back to article
Al-Hashel JY, Abokalawa F, Alenzi M, Alroughani R, Ahmed SF, et al. Coronavirus disease-19 and headache; impact on pre-existing and characteristics of de novo: A cross-sectional study. J Headache Pain. 2021;22(1):97. doi: 10.1186/s10194-021-01314-7.
Open DOI Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.2478/sjph-2026-0013 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026

Journal RSS Feed

Language: English

Page range: 104 - 113

Submitted on: Jan 22, 2026

Accepted on: Apr 14, 2026

Published on: Jun 1, 2026

Published by: National Institute of Public Health, Slovenia

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

SARS-CoV-2 virus,

Consequences,

Long COVID,

Number of infections,

Risk of a depressive disorder

Related subjects:

Medicine,

Clinical medicine,

Hygiene and environmental medicine

© 2026 Helena Jeriček Klanšček, Maruša Rehberger, Andreja Belščak Čolaković, Marina Šinko, Darja Lavtar, Ada Hočevar Grom, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 65 (2026): Issue 2 (June 2026)