A new study from researchers at King's College London suggests that those from disadvantaged backgrounds, including lower-income households, are more likely to report persistent COVID-19 symptoms, or long COVID. The research was published last week in BMJ Public Health.
The study showed that lingering symptoms could not be explained by pre-existing health conditions, but instead linked to social disadvantages including low education levels, low-income housing, and sex, with women more likely to report persistent COVID symptoms than men.
The study also suggests that in addition to experiencing more severe illness in the acute state, disadvantaged people may also take longer to recover from infections.
Nathan Cheetham, PhD, first author of the paper, said in a press releasefrom King's College, "Inequalities in health between people who are more or less advantaged within society aren’t new, but this study is the first to look at the association between multiple socio-demographic factors and recovery from COVID-19."
Overall recovery rate 69% to 81%
The studywas based on 3,882 participants in two UK cohorts: the COVID Symptom Study Biobank and TwinsUK. Participants were given questionnaires that asked if they still had symptoms after having COVID-19.
Across a series of questionnaires, participants were asked: "Thinking about the last or only episode of COVID-19 you have had, have you now recovered and are back to normal?" They could choose the following response options: "Yes, I am back to normal," or "No, I still have some or all my symptoms."
Overall, recovery rates were 81% in the TwinsUK cohort, and 69% in the COVID Symptom Study Biobank cohort. They ranged from 74% to 90% and from 55% to 80% in the two cohorts, respectively.
For both cohorts the median age group was 50 to 59 years old, most individuals were female, White, and were employed immediately before the COVID-19 pandemic.
"General health was self-rated prior to the COVID-19 pandemic as 'excellent' or 'very good' by just over half in both cohorts," the authors wrote. "At the time of reporting COVID-19 recovery status, most individuals were over a year, and a large proportion over 2 years, since the start of their COVID-19 infection."
Most-deprived women hit hardest
The predicted probability of recovery was lowest in females who had the lowest education and highest deprivation level in both studies. In the COVID Symptom Study Biobank the probability was 55.1% (95% confidence interval [CI], 44.0% to 65.1%). In the TwinsUK cohort, the probability was 73.9% (95% CI, 61.1% to 83.0%).
Such results suggest that social factors likely play a significant role in recovery from illness in general, not only in the case of COVID-19.
Educated men from the lowest deprivation level had the highest chances of full recovery, at 79.1% in the COVID Symptom Study Biobank (95% CI, 71.8% to 85.1%), and 89.7% in the TwinsUK cohort (95% CI, 82.5% to 94.1%).
"To put our results into context of other illnesses, sociodemographic factors including income, isolation, social support, race/ethnicity, education and local area deprivation have also been found to be social determinants of recovery from mental illness, poor general physical health, and following hospitalisation in critical care," the authors concluded.
"Such results suggest that social factors likely play a significant role in recovery from illness in general, not only in the case of COVID-19."