Quantifying the Adverse Effects of Long COVID on Individuals' Health After Infection: A Propensity Score Matching Design Study

Yudong Miao; Ruizhe Ren; Zhanlei Shen; Yi Li; Wanliang Zhang; Junwen Bai; Dongfang Zhu; Jingbao Zhang; Dan Guo; Clifford Silver Tarimo; Rongmei Liu; Qiuping Zhao; Jianping Hu; Xue Zhou; Wenyong Dong

doi:10.2147/RMHP.S446321

Quantifying the Adverse Effects of Long COVID on Individuals' Health After Infection: A Propensity Score Matching Design Study

Risk Manag Healthc Policy. 2024 Mar 24:17:701-713. doi: 10.2147/RMHP.S446321. eCollection 2024.

Authors

Yudong Miao¹, Ruizhe Ren¹, Zhanlei Shen¹, Yi Li¹, Wanliang Zhang¹, Junwen Bai¹, Dongfang Zhu¹, Jingbao Zhang¹, Dan Guo^{1

2}, Clifford Silver Tarimo³, Rongmei Liu⁴, Qiuping Zhao⁴, Jianping Hu⁵, Xue Zhou⁶, Wenyong Dong⁷

Affiliations

¹ College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China.
² Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
³ Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania.
⁴ Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Zhengzhou, People's Republic of China.
⁵ Henan Medical Communication and Project Forward Center, Zhengzhou, People's Republic of China.
⁶ College of Health Management, Mudanjiang Medical University, Mudanjiang, People's Republic of China.
⁷ Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.

Abstract

Objective: To evaluate the prevalence and influencing factors of long COVID, and measure the difference in health status between long COVID and non-long COVID cases.

Methods: A cross-sectional survey was conducted from February 1 to 8, 2023, using a stratified random sampling method in four regions (eastern [Changzhou], central [Zhengzhou], western [Xining] and northeastern [Mudanjiang]) of China. The survey collected COVID-19 patients' socio-demographic characteristics and lifestyles information. The scores of lifestyles and health status range from 5 to 21 and 0 to 100 points, respectively. The criteria of "persistent health problems after 4 weeks of COVID-19 infection" issued by the US Centers for Disease Control and Prevention was used to assess long COVID. Multiple linear regression was used to analyze the influencing factors of the health. The bootstrap method was used to analyze the lifestyles' mediating effect. Propensity score matching (PSM) was used to evaluate the net difference in health scores between long COVID and non-long COVID cases.

Results: The study included 3165 COVID-19 patients, with 308 (9.73%) long COVID cases. The health score of the long COVID cases (74.79) was lower than that of the non-long COVID cases (81.06). After adjusting for potential confounding variables, we found that never focused on mental decompression was a common risk factor for the health of both groups. Lifestyles was the mediating factor on individuals' health. After PSM, the non-long COVID cases' health scores remained higher than that of long COVID cases.

Conclusion: The proportion of long COVID cases was low, but they were worse off in health. Given the positive moderating effect of healthy lifestyles on improving the health of long COVID cases, healthy lifestyles including mental decompression should be considered as the core strategy of primary prevention when the epidemic of COVID-19 is still at a low level.

Keywords: effect of mediation; lifestyles; long COVID; propensity score matching; self-reported health status.

Grants and funding

This work was supported by the Major Program of National Fund of Philosophy and Social Science of China [Grant No.21BGL222]; the Health Medical Collaborative Innovation Program of Zhengzhou [Grant No.20XTZX05015]; National Natural Science Foundation of China [Grant No.82270463].