Social Determinants of Health and Risk for Long COVID in the U.S. RECOVER-Adult Cohort

作者：Candace H. Feldman, L Santacroce, Ingrid V. Bassett, Tanayott Thaweethai, Radica Z. Alicic, Rachel Atchley, Alicia Chung, Mark P. Goldberg, Carol R. Horowitz, Karen B. Jacobson, J. Daniel Kelly, Stacey Knight, Karen Lutrick, Praveen C. Mudumbi, Sairam Parthasarathy, Heather M. Prendergast, Yuri Quintana, Nasser Sharareh, Judd E. Shellito, Zaki A. Sherif, Brittany D. Taylor, Emily Taylor, Joel Tsevat, Zanthia Wiley, Natasha Williams, Lynn M. Yee, Lisa Aponte‐Soto, Jhony Baissary, J.L. Berry, Alexander W. Charney, Maged M. Costantine, Alexandria M. Duven, Nathaniel Erdmann, Kacey C. Ernst, Elen Feuerriegel, Valerie J. Flaherman, Minjoung Go, Kellie L. Hawkins, Vanessa L. Jacoby, Janice John, Sara W. Kelly, Elijah Kindred, Adeyinka O. Laiyemo, Emily B. Levitan, Bruce D. Levy, Jennifer K. Logue, Jai Marathe, Jeffrey N. Martin, Grace A. McComsey, Torri D. Metz, Tony Minor, Aoyjai P. Montgomery, Janet Mullington, Igho Ofotokun, Megumi J. Okumura, Michael J. Peluso, Kristen Pogreba-Brown, Hengameh Raissy, Johana Rosas, Upinder Singh, Timothy M. VanWagoner, Cheryl R. Clark, Elizabeth W. Karlson · 发表于：Annals of Internal Medicine · 年份：2025 · DOI：10.7326/annals-24-01971 · 被引用次数：10 · 研究领域：Long-Term Effects of COVID-19、COVID-19 and Mental Health、COVID-19 Clinical Research Studies

BACKGROUND: Social determinants of health (SDoH) contribute to disparities in SARS-CoV-2 infection, but their associations with long COVID are unknown. OBJECTIVE: To determine associations between SDoH at the time of SARS-CoV-2 infection and risk for long COVID. DESIGN: Prospective observational cohort study. SETTING: 33 states plus Washington, DC, and Puerto Rico. PARTICIPANTS: Adults (aged ≥18 years) enrolled in RECOVER-Adult (Researching COVID to Enhance Recovery) between October 2021 and November 2023 who were within 30 days of SARS-CoV-2 infection; completed baseline SDoH, comorbidity, and pregnancy questionnaires; and were followed prospectively. MEASUREMENTS: Social risk factors from SDoH baseline questionnaires, ZIP code poverty and household crowding measures, and a weighted score of 11 or higher on the Long COVID Research Index 6 months after infection. RESULTS: Among 3787 participants, 418 (11%) developed long COVID. After adjustment for demographic characteristics, pregnancy, disability, comorbidities, SARS-CoV-2 severity, and vaccinations, financial hardship (adjusted marginal risk ratio [ARR], 2.36 [95% CI, 1.97 to 2.91]), food insecurity (ARR, 2.36 [CI, 1.83 to 2.98]), less than a college education (ARR, 1.60 [CI, 1.30 to 1.97]), experiences of medical discrimination (ARR, 2.37 [CI, 1.94 to 2.83]), skipped medical care due to cost (ARR, 2.87 [CI, 2.22 to 3.70]), and lack of social support (ARR, 1.79 [CI, 1.50 to 2.17]) were associated with increased risk for lo...