Background <p>Psychological distress has been identified as a risk factor for long COVID in individuals infected with COVID-19. Little is known about the differences in long COVID symptom profiles between older adults with pre-existing depression and those without.</p> Methods <p>A population-based longitudinal prospective study was performed using the Survey of Health, Ageing and Retirement in Europe (SHARE) with participants aged 50 years and older. Depression was assessed by the EURO-D scale at the baseline. Long COVID symptoms were self-reported by participants during the 12-month follow-up. A hurdle negative binomial model was employed to assess the impact of pre-existing depression on the burden of long COVID. We compared the differences in symptoms between participants with pre-existing depression and those without with the Chi-squared test.</p> Results <p>Participants with pre-existing depression had an approximately 16% increased risk of experiencing additional persistent symptoms after COVID-19 infection. During the 12-month follow-up following COVID-19 infection, the prevalence of headaches (32.2% vs. 25.9%; <i>P</i> = 0.027), body aches or joint pain (38.5% vs. 29.4%; <i>P</i> &lt; 0.001), and confusion (10.6% vs. 7.6%; <i>P</i> &lt; 0.01) were significantly higher among participants with pre-existing depression than among those without.</p> Conclusion <p>Older adults with pre-existing depression had a higher burden of long COVID following COVID-19 infection and they were more likely to suffer from persistent physical pain and confusion compared to those without a history of depression.</p>