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. 2025 Jul 24:13:1562894.
doi: 10.3389/fpubh.2025.1562894. eCollection 2025.

Anxiety and perceived social support as moderators of cognitive and emotional well-being in populations affected by COVID-19

Jonathan Zegarra-Valdivia  1 , Brenda Chino-Vilca  2   3 , Leandro Pérez-Fernández  1 , Milagros Casimiro-Arana  1 , Harold Arana-Nombera  1 , Viviana Nayelli Gallegos-Manayay  1 , María Del Rosario Oliva-Piscoya  1 , Reyna Alamo-Medina  1 , Eduardo Abanto-Saldaña  1 , Nobuko Vásquez-Zuñe  1 , Lisseth Detquizan Pérez  1 , Diana Gutierrez-Flores  1 , Leslie Lozada Tantarico  1 , Naydelin Hernández  1 , María Celinda Cruz-Ordinola  1 , Carmen Paredes-Manrique  4
Affiliations

Anxiety and perceived social support as moderators of cognitive and emotional well-being in populations affected by COVID-19

Jonathan Zegarra-Valdivia et al. Front Public Health. .

Abstract

Introduction: The COVID-19 pandemic has raised significant concerns about its long-term impact on cognitive and emotional functioning. This study explores the role of anxiety and social variables in shaping cognitive performance among individuals with a history of COVID-19 infection.

Methods: This retrospective cross-sectional study included 227 Peruvian adults, classified into control, acute phase, and hyperinflammatory phase groups based on COVID-19 symptomatology. Cognitive performance was assessed using the Addenbrooke's Cognitive Examination (ACE), focusing on global cognition. Anxiety levels, social cognition, and perceived social support were also measured. Moderation analyses were conducted to explore whether anxiety moderated the relationship between social cognition and perceived support, and whether support moderated the relationship between age and cognition.

Results: Individuals with a history of COVID-19, particularly those in the acute and hyperinflammatory phases, showed significantly lower ACE scores than controls. Anxiety moderated the relationship between social cognition and perceived social support, with stronger associations at higher anxiety levels. Additionally, perceived support moderated the effect of age on cognitive performance, especially in individuals with low to moderate support.

Discussion: These findings highlight the complex interplay between psychological and social factors in cognitive functioning following COVID-19. Understanding these relationships is crucial for developing integrated interventions that address cognitive and psychosocial recovery in affected populations.

Keywords: COVID-19; anxiety; cognitive performance; perceived social support; social cognition.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A conceptual model for social and cognitive outcomes in COVID-19. The diagram illustrates the conceptual model and the variance for cognitive performance explained in the second model. Blue arrows represent direct effects. The red dashed outline emphasizes that the moderation effect appears only in the AP group. Perceived social support moderates the relationship between age and cognitive performance, with this relationship being significant only in people who have suffered from COVID in the acute phase.
Figure 2
Figure 2
Interaction effects of anxiety and perceived social support on social and cognitive outcomes. The plots display the interaction effects analyzed in the regression models. Solid red lines represent the point estimates, while dashed red lines denote the 95% confidence intervals (CI). The blue-shaded area in the plots marks the moderator values where the interaction effect becomes statistically significant.
See this image and copyright information in PMC

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