Risk of Long COVID Greater for Individuals With Social Risk Factors

THURSDAY, July 31, 2025 (HealthDay News) — Individuals with social risk factors at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have increased risk for subsequent long COVID, according to a study published online July 29 in the Annals of Internal Medicine.

Candace H. Feldman, M.D., M.P.H., Sc.D., from Brigham and Women”s Hospital in Boston, and colleagues conducted a prospective observational cohort study in 33 states plus Washington, D.C., and Puerto Rico to examine associations between social determinants of health (SDoH) at the time of SARS-CoV-2 infection and risk for long COVID. Adults enrolled in the Researching COVID to Enhance Recovery study and who were within 30 days of SARS-CoV-2 infection were included.

Overall, 418 (11 percent) of the 3,787 participants developed long COVID. The researchers found that the risk of long COVID was increased in association with financial hardship (adjusted marginal risk ratio [ARR], 2.36), food insecurity (ARR 2.36), less than a college education (ARR, 1.60), experiences of medical discrimination (ARR, 2.37), skipped medical care due to cost (ARR, 2.87), and lack of social support (ARR, 1.79), after adjustment for demographic characteristics, pregnancy, disability, comorbidities, SARS-CoV-2 severity, and vaccinations. Greater risk was also seen in association with living in ZIP codes with the highest versus the lowest household crowding (ARR, 1.36).

“Efforts are urgently needed to build infrastructure to address current inequities in social risk factor distribution and to ensure access to high-quality, multidisciplinary long COVID care for persons with the greatest burden,” the authors write.

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