Long COVID affects 8.4% of U.S. adults, with income and geography influencing it

Long COVID affects 8.4% of U.S. adults, with income and geography influencing it

Millions of Americans have long struggled with COVID as new data shows how income, geography and gender compound its debilitating effects.

In a recent study published inJAMA network openedResearchers at the Centers for Disease Control and Prevention examined the prevalence and impact of post-coronavirus disease 2019 (COVID-19) condition (PCC), commonly known as long-coronavirus disease (long-COVID), in adults in the United States (US). . Using current survey data, they examined how long-term symptoms after COVID-19 affect daily performance.

background

The post-COVID-19 condition or long-COVID refers to persistent symptoms lasting three months or longer after a first severe infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These symptoms can include fatigue, difficulty concentrating, and breathing problems, which can interfere with everyday activities.

While initial studies have highlighted the widespread prevalence of this disease, detailed knowledge of its overall prevalence and the degree of associated activity limitations remains lacking. Emerging data suggests that factors such as age, gender, socioeconomic status, and geographic location may influence the likelihood and severity of PCC, but these associations have yet to be fully quantified at the national level.

Additionally, the study acknowledges that PCC estimates are based on self-reported symptoms that have not been clinically validated. This reliance on self-reporting is a key limitation. Differences in reporting methods and definitions have resulted in inconsistencies in prevalence estimates. These gaps highlight the need for comprehensive, standardized data to better understand the burden of PCC in diverse populations. Addressing these issues is also crucial for adapting health policy and resource allocation to mitigate long-term impacts.

About the study

Bisexual adults reported the highest prevalence of long COVID (14%) and activity-limiting symptoms (5.7%), significantly higher than other sexual orientation groups.

In this cross-sectional study, researchers used data from the 2023 National Health Interview Survey (NHIS), a nationally representative survey of U.S. households conducted by the National Center for Health Statistics. The survey regularly collects health information from non-institutional civilians, randomly selecting one adult per household to answer detailed health-related questions.

Data collection began by asking participants about their history of COVID-19. Individuals with a history of infection were questioned for the presence of symptoms that lasted three months or longer and did not occur before their COVID-19 diagnosis.

Respondents with such symptoms were also asked whether they were currently experiencing these symptoms and, if so, to what extent these symptoms affected their ability to carry out daily activities compared to their pre-COVID-19 condition. Responses were categorized as “not at all,” “a little,” or “severe” activity limitation, with any reported limitation classified as activity-limiting PCC.

The researchers analyzed the survey responses using statistical software designed for complex sample surveys. Results were tested for statistical significance, including linear and trend analyzes for specific demographic factors. The analysis considered demographic variables such as gender, age, race, ethnicity, sexual orientation, family income, and urbanization. In addition, estimates were weighted to ensure national representation and statistical significance was assessed. The study ensured that Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed to ensure clarity and reproducibility.

Overall, the survey design, inclusion of demographic diversity, and use of imputed income data for missing values ​​enabled an informed assessment of PCC prevalence and its functional impact. The researchers interpreted the results in the context of the broader population to inform health policy and interventions targeting long-term effects of COVID-19.

Results

Long COVID prevalence is higher in non-urban areas (10%) than in large metropolitan areas (8%).

The study found that 8.4% of U.S. adults reported having PCC, while 3.6% were currently experiencing symptoms consistent with PCC. Of these people, 2.3% reported symptoms severe enough to limit their daily activities. Women, bisexual individuals, and adults aged 35 to 64 years had the highest reported rates of PCC and activity-limiting PCC.

Economic status has also been observed to influence prevalence, with higher rates of PCC observed among those with lower family income. Rural residents also reported higher rates of both PCC and activity-limiting PCC compared to urban residents.

Additionally, results showed significant racial and ethnic disparities, with Hispanic adults and non-Hispanic American Indians and Alaska Natives having higher rates than other groups. In contrast, non-Hispanic Asian adults reported the lowest prevalence.

Nearly 65% ​​of those with current PCC reported that their symptoms limited their daily activities and affected their ability to function “a little” or “a lot.” The prevalence of PCC and activity limitations showed clear trends due to urbanization, with rural populations consistently more affected.

These results highlighted significant demographic and socioeconomic differences in PCC burden, suggesting that specific populations may require targeted interventions to manage the long-term impacts of COVID-19.

Conclusions

In summary, the study demonstrated the significant and uneven burden of PCC among US adults and highlighted significant activity limitations for many affected individuals. The results revealed differences based on gender, age, income and geographic location, providing valuable insights for public health strategies.

However, the authors caution that the results are based on self-reported symptoms, which may introduce reporting bias. The researchers stated that addressing these disparities will be critical to mitigating the impact of PCC and inform health planning, resource allocation, and support systems tailored to the needs of affected populations.

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