METHODS: This study focused on participants who reported having had COVID in Spring 2023 (n = 656; 85% female, mean age = 55, 59% college). Participants were categorized into symptom-burden groups using Latent Profile Analysis of 19 Long-COVID symptoms. Measures included demographics; quality of life and well-being (QOL); and COVID-specific stressors. Bivariate and multivariate associations of symptom burden were examined.
RESULTS: A three-profile solution reflected low, medium, and high symptom burden, aligning with diagnosis confirmation and treatment by a healthcare provider. Higher symptom burden was associated with reporting more comorbidities; being unmarried, difficulty paying bills, being disabled from work, not having a college degree, younger age, higher body mass index, having had COVID multiple times, worse reported QOL, greater reported financial hardship and worry; maladaptive coping, and worse healthcare disruption, health/healthcare stress, racial-inequity stress, family-relationship problems, and social support. Multivariate modeling revealed that financial hardship, worry, risk-taking, comorbidities, health/healthcare stress, and younger age were risk factors for higher symptom burden, whereas social support and reducing substance use were protective factors.
CONCLUSIONS: Long-COVID symptom burden is associated with substantial, modifiable social and behavioral factors. Most notably, financial hardship was associated with more than three times the risk of high versus low Long-COVID symptom burden. These findings suggest the need for multi-pronged support in the absence of a cure, such as symptom palliation, telehealth, social services, and psychosocial support.
方法:这项研究的重点是2023年春季报告患有COVID的参与者(n=656;85%为女性,平均年龄=55岁,59%上大学)。使用19种长COVID症状的潜在特征分析将参与者分为症状负担组。措施包括人口统计学;生活质量和幸福感(QOL);和COVID特定的压力源。检查了症状负担的双变量和多变量关联。
结果:三剖面解决方案反映低,中等,和高症状负担,与医疗保健提供者的诊断确认和治疗保持一致。较高的症状负担与报告更多的合并症有关;未婚,难以支付账单,被禁止工作,没有大学学位,年龄较小,较高的体重指数,患有多次COVID,更糟糕的QOL报告,报告的财务困难和担忧更大;适应不良的应对,以及更糟糕的医疗保健中断,健康/医疗保健压力,种族不平等压力,家庭关系问题,和社会支持。多变量建模揭示了财务困难,担心,冒险,合并症,健康/医疗保健压力,年龄和年龄是较高症状负担的危险因素,而社会支持和减少物质使用是保护因素。
结论:长期COVID症状负担与实质性,可改变的社会和行为因素。最值得注意的是,经济困难与长期COVID症状负担的高风险和低风险的三倍以上相关。这些发现表明,在没有治愈的情况下,需要多管齐下的支持,如症状缓解,远程医疗,社会服务,和社会心理支持。