City-wide study of laboratory-confirmed COVID-19 cases in San Antonio: An investigation of stressful events accompanying infection and their relation to psychosocial functioning

Little is known about how Coronavirus Disease-2019 (COVID-19) infection is associated with stressful events (SEs) and stress-related psychological symptoms. This study examined the prevalence of SEs and incidence of stress-related symptoms accompanying COVID-19 infection. The association between these stress-related symptoms and psychosocial functioning were also examined. A city-wide sample of 3,595 adults with lab -informed cases of COVID-19 infection in San Antonio, Texas completed an online assessment of their psycho-logical health and well-being after completing contact tracing activities in 2021-2022. A total 88.3% of par-ticipants reported exposure to SEs related to COVID-19 infection and their "worst" SEs were related to physical symptoms, fear of infecting others, financial problems, being isolated/quarantined, and loss of a loved one. Based on these SEs, 14.8% of the sample screened positive for substantial stress-related psychological problems related to COVID-19 infection. These psychological symptoms were strongly associated with worse psychosocial func-tioning. Together, these findings suggest SEs were commonly experienced by adults infected with COVID-19. Only a relatively small proportion reported substantial psychological symptoms related to their infection, but those who did had a high likelihood of impaired psychosocial functioning. Targeted support for individuals at high-risk of psychological symptoms following COVID-19 infection may help mitigate long-term psychological effects.