Social determinants of health associated with developing long COVID in the US Veteran population

Abstract: Aim: Acute COVID-19 infection, morbidity, and mortality are strongly associated with many social determinants of health (SDoH). These trends are similar within the US veteran population. This study seeks to examine whether social determinants of health and demographic factors are similarly linked to long COVID. Subject and methods: This study surveyed 658 US veterans who had a confirmed COVID-19 case between 2020 and 2021. Logistic regression was used to understand how SDoH were associated with a person's risk of developing long COVID. This survey asked veterans questions regarding demographic factors, social determinants of health, and their experience with COVID-19. Specifically, this survey asked which symptoms related to COVID-19 each person experienced and the severity of those symptoms. Results: The only factors associated with experiencing any long COVID were age and gender. On average, for every additional year of age, a person was 2% more likely (p < 0.01) to contract long COVID. Our logistic regression found that women were 84% more likely (p = 0.043) to contract long COVID than men; however, the 95% confidence interval was between 1.4 and 3.3. Rurality, race, income, and employment status had no statistically significant relationship with whether or not someone would contract long COVID. These same factors plus gender and age were not statistically associated with experiencing severe long COVID. Conclusion: The risk of developing long COVID and severe long COVID seem to be related to specific demographic and social factors in a manner different from other diseases, specifically acute COVID-19.

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