Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom.
Journal of the Royal Society of Medicine 2023
Shabnam S, Razieh C, Dambha-Miller H, Yates T, Gillies C, Chudasama YV, Pareek M, Banerjee A, Kawachi I, Lacey B, Morris EJ, White M, Zaccardi F, Khunti K, Islam N
DOI : 10.1177/01410768231168377
PubMed ID : 37164035
PMCID :
URL : https://journals.sagepub.com/doi/10.1177/01410768231168377
Abstract
To estimate the risk of Long COVID by socioeconomic deprivation and to further examine the inequality by sex and occupation.
We conducted a retrospective population-based cohort study using data from the ONS COVID-19 Infection Survey between 26 April 2020 and 31 January 2022. This is the largest nationally representative survey of COVID-19 in the UK with longitudinal data on occupation, COVID-19 exposure and Long COVID.
Community-based survey in the UK.
A total of 201,799 participants aged 16 to 64 years and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
The risk of Long COVID at least 4 weeks after SARS-CoV-2 infection by index of multiple deprivation (IMD) and the modifying effects of socioeconomic deprivation by sex and occupation.
Nearly 10% ( = 19,315) of participants reported having Long COVID. Multivariable logistic regression models, adjusted for a range of variables (demographic, co-morbidity and time), showed that participants in the most deprived decile had a higher risk of Long COVID (11.4% vs. 8.2%; adjusted odds ratio (aOR): 1.46; 95% confidence interval (CI): 1.34, 1.59) compared to the least deprived decile. Significantly higher inequalities (most vs. least deprived decile) in Long COVID existed in healthcare and patient-facing roles (aOR: 1.76; 95% CI: 1.27, 2.44), in the education sector (aOR: 1.68; 95% CI: 1.31, 2.16) and in women (aOR: 1.56; 95% CI: 1.40, 1.73) than men (aOR: 1.32; 95% CI: 1.15, 1.51).
This study provides insights into the heterogeneous degree of inequality in Long COVID by deprivation, sex and occupation. These findings will help inform public health policies and interventions in incorporating a social justice and health inequality lens.