Socioeconomic Challenges of Long COVID

Abstract

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection or PASC, is a condition resulting from a SARS-CoV-2 infection characterized by continuing or novel symptoms across multiple organ systems occurring at least four weeks after infection. Symptoms of Long COVID can include cognitive impairment, memory loss, and fatigue. Although associations between COVID-19 and social determinants of health have been studied, noting that disadvantaged socioeconomic or racial groups have higher incidence and mortality rates from COVID-19, the associations between Long COVID and social determinants of health have not been robustly examined. Using data from the Household Pulse Survey in Summer 2022 and Winter 2022, we explored differences and odds in demographics and social determinants of health between those reporting Long COVID and those without Long COVID through descriptive statistics and comparisons, as well as multivariable logistic regression. The odds of Long COVID were further compared between the two survey periods to determine any change in odds over time across demographics and social determinants of health. We found increased odds of Long COVID in participants who were female, of lower educational attainment, of lower income, had experienced a recent loss of work, had recent difficulty with household expenses, had trouble with energy bills within the year, or had recent household food insufficiency. We found no major differences in the odds of Long COVID over time. However, after controlling for other factors, we found that Black or African American participants had lower odds of reporting Long COVID than White participants, in contrast to existing literature. Our study merits further investigation into Long COVID in at-risk populations to thoroughly examine associations between social determinants of health and Long COVID.