Factors Associated With Long COVID: Insights From Two Nationwide Surveys

Yixuan Wu; Mitsuaki Sawano; Yilun Wu; Rishi M Shah; Pamela Bishop; Akiko Iwasaki; Harlan M Krumholz

doi:10.1016/j.amjmed.2024.02.032

Factors Associated With Long COVID: Insights From Two Nationwide Surveys

Am J Med. 2024 Mar 14:S0002-9343(24)00142-6. doi: 10.1016/j.amjmed.2024.02.032. Online ahead of print.

Authors

Yixuan Wu¹, Mitsuaki Sawano², Yilun Wu¹, Rishi M Shah³, Pamela Bishop⁴, Akiko Iwasaki⁵, Harlan M Krumholz⁶

Affiliations

¹ Department of Biostatistics, Yale School of Public Health, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT.
² Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
³ Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT; Department of Applied Mathematics, Yale College, New Haven, CT.
⁴ Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT.
⁵ Center for Infection and Immunity, Yale School of Medicine, New Haven, CT; Department of Immunobiology, Yale School of Medicine, New Haven, CT; Howard Hughes Medical Institute, Chevy Chase, MD.
⁶ Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT; Center for Infection and Immunity, Yale School of Medicine, New Haven, CT; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT. Electronic address: harlan.krumholz@yale.edu.

PMID: 38490304
DOI: 10.1016/j.amjmed.2024.02.032

Abstract

Background: Long COVID is a multisystemic condition that affects the lives of millions of people globally, yet factors associated with it are poorly defined. Our purpose in this study was to identify factors associated with long COVID.

Methods: This cross-sectional study used data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) and the 2022 National Health Interview Survey (NHIS). We restricted the sample to individuals aged 18 and older who reported a positive COVID-19 test or doctor's diagnosis. Individuals who reported symptoms of at least 3 months were assumed to have long COVID. We identified demographic and clinical characteristics associated with long COVID, in unadjusted and adjusted analyses.

Results: The study included 124,313 individuals in the BRFSS cohort and 10,131 in the NHIS cohort who reported a COVID-19 infection, with 26,783 (21.5%) and 1797 (17.7%) reporting long COVID, respectively. We found middle age, female sex, lack of a college degree, and severity of acute COVID-19 infection to be associated with long COVID. In contrast, non-Hispanic Asian and Black Americans were less likely to report long COVID compared with non-Hispanic White individuals. These findings were consistent across datasets.

Conclusions: Several demographic features were associated with long COVID, which may be the result of social, clinical, or biological influences.

Keywords: COVID-19; Long COVID; Risk factors; Survey.