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Incidence of long COVID and associated psychosocial characteristics in a large U.S. city

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Abstract

Purpose

Persistent residual effects from Coronavirus Disease-2019 (COVID-19) have been observed with varying definitions of “Long COVID” and little comprehensive examination. This study examined the incidence and psychosocial correlates of Long COVID using different definitions.

Methods

Data were analyzed from a citywide sample of 3595 adults with lab-confirmed cases of COVID-19 that were surveyed over 3 months. Rates of Long COVID were examined in terms of Post-Acute COVID (PAC), defined as at least one symptom lasting for 4 weeks, and three levels of Post-COVID Syndrome (PCS) that included experiencing at least one symptom for 3 months (PCS-1), experiencing three or more symptoms for 3 months (PCS-2), or experiencing at least one of the same symptoms for 3 months (PCS-3).

Results

Among the 686 participants who completed baseline, 1-month, and 3-month follow-up assessments, 75.7% had PAC, 55.0% had PSC-1, 26.5% had PSC-2, and 19.0% had PSC-3. Comparing participants with PAC and PSC-3 in the total sample with inverse probability weighting, multivariable analyses revealed being female, Asian or Native American, greater reported longlines, and less social support were predictive of PCS-3.

Conclusion

Residual effects of COVID-19 are very common and nearly one-fifth of our sample met the most restrictive definition of Long COVID warranting concern as a public health issue. Some demographic and social factors may predispose some adults to Long COVID, which should be considered for prevention and population health.

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Data availability

Data are available upon request from the first author and with proper approval from appropriate institutional review boards.

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Acknowledgements

Special thanks to the UTHealth COVID-19 contact tracing team for their assistance.

Funding

This study was funded by internal university funds, and supported by the City of San Antonio’s Metropolitan Health District.

Author information

Authors and Affiliations

  1. School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St., Houston, TX, 77098, USA

    Jack Tsai & Abigail Grace

  2. Department of Psychiatry, Yale University School of Medicine, New Haven, USA

    Jack Tsai

  3. Metropolitan Health District, City of San Antonio, USA

    Rita Espinoza & Anita Kurian

Authors
  1. Jack Tsai
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  2. Abigail Grace
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  3. Rita Espinoza
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  4. Anita Kurian
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Contributions

J. Tsai conceptualized and designed the study, and wrote the paper. A. Grace helped with data collection and data analysis. R. Espinoza and A. Kurian provided administrative support for the study, assisted with data collection, and provided edits on the paper.

Corresponding author

Correspondence to Jack Tsai.

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Conflict of interest

The authors declare that they have no conflict of interest. Financial interests: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. Non-financial interests: None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Committee for the Protection of Human Subjects at the University of Texas Health Science Center School of Public Health at Houston (HSC-SPH-20–0931).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary Information

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Supplementary file1 (DOCX 13 KB)

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Tsai, J., Grace, A., Espinoza, R. et al. Incidence of long COVID and associated psychosocial characteristics in a large U.S. city. Soc Psychiatry Psychiatr Epidemiol 59, 611–619 (2024). https://doi.org/10.1007/s00127-023-02548-3

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  • DOI: https://doi.org/10.1007/s00127-023-02548-3

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