Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study
Introduction Social gradients in COVID-19 exposure and severity have been observed internationally. Whether combinations of pre-existing social factors, particularly those that confer cumulative advantage and disadvantage, affect recovery from ongoing symptoms following COVID-19 and long COVID is le...
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BMJ Publishing Group
2025-05-01
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| author | Tim Spector Adrian Hopper Sebastien Ourselin Emma L Duncan Julia Brown Carole H Sudre Jie Deng Christina Hu Ruth C E Bowyer Ellen J Thompson Jonathan Wolf Claire J Steves Marc Modat Benjamin Murray Andy Guise Nicholas Harvey Deborah Hart Alexander Hammers Carole Sudre Michela Antonelli Liane S Canas Erika Molteni Eric Kerfoot Claire Steves Vicky Bowyer Emma Duncan Nathan Cheetham Ayrun Nessa Samuel Wadge Nathan J Cheetham María Paz García J D Carpentieri Rose S Penfold Nicholas R Harvey Khaled Rjoob Liane Canas Joan Capdevila Pujol Lynn Cherkas Katie Doores Michael Malim |
| author_facet | Tim Spector Adrian Hopper Sebastien Ourselin Emma L Duncan Julia Brown Carole H Sudre Jie Deng Christina Hu Ruth C E Bowyer Ellen J Thompson Jonathan Wolf Claire J Steves Marc Modat Benjamin Murray Andy Guise Nicholas Harvey Deborah Hart Alexander Hammers Carole Sudre Michela Antonelli Liane S Canas Erika Molteni Eric Kerfoot Claire Steves Vicky Bowyer Emma Duncan Nathan Cheetham Ayrun Nessa Samuel Wadge Nathan J Cheetham María Paz García J D Carpentieri Rose S Penfold Nicholas R Harvey Khaled Rjoob Liane Canas Joan Capdevila Pujol Lynn Cherkas Katie Doores Michael Malim |
| author_sort | Tim Spector |
| collection | DOAJ |
| description | Introduction Social gradients in COVID-19 exposure and severity have been observed internationally. Whether combinations of pre-existing social factors, particularly those that confer cumulative advantage and disadvantage, affect recovery from ongoing symptoms following COVID-19 and long COVID is less well understood.Methods We analysed data on self-perceived recovery following self-reported COVID-19 illness in two UK community-based cohorts, COVID Symptom Study Biobank (CSSB) (N=2548) and TwinsUK (N=1334). Causal effects of sociodemographic variables reflecting status prior to the COVID-19 pandemic on recovery were estimated with multivariable Poisson regression models, weighted for inverse probability of questionnaire participation and COVID-19 infection and adjusted for potential confounders. Associations between recovery and social strata comprising combinations of sex, education level and local area deprivation were estimated using the intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) approach. Further analyses estimated associations with variables reflecting experiences during the pandemic.Results Gradients in recovery from COVID-19 along the lines of social advantage were observed in intersectional MAIHDA models, with predicted probability of recovery lowest in female strata with lowest education and highest deprivation levels (CSSB: 55.1% (95% CI 44.0% to 65.1%); TwinsUK: 73.9% (95% CI 61.1% to 83.0%)) and highest in male strata with highest education and lowest deprivation levels (CSSB: 79.1% (95% CI 71.8% to 85.1%); TwinsUK: 89.7% (95% CI 82.5% to 94.1%)). Associations were not explained by differences in prepandemic health. Adverse employment, financial, healthcare access and personal experiences during the pandemic were also negatively associated with recovery.Conclusions Inequalities in likelihood of recovery from COVID-19 were observed, with ongoing symptoms several months after coronavirus infection more likely for individuals with greater social disadvantage prior to the pandemic. |
| format | Article |
| id | doaj-art-2223e25a91c44611a4ba138a3d0f7f94 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-2223e25a91c44611a4ba138a3d0f7f942025-08-20T03:28:37ZengBMJ Publishing GroupBMJ Public Health2753-42942025-05-013110.1136/bmjph-2024-001166Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort studyTim SpectorAdrian HopperSebastien Ourselin0Emma L Duncan1Julia BrownCarole H Sudre2Jie DengChristina HuRuth C E Bowyer3Ellen J Thompson4Jonathan WolfClaire J Steves5Marc ModatBenjamin Murray6Andy Guise7Nicholas HarveyDeborah HartAlexander Hammers8Carole Sudre9Michela Antonelli10Liane S Canas11Erika Molteni12Eric Kerfoot13Claire StevesVicky Bowyer14Emma DuncanNathan CheethamAyrun Nessa15Samuel Wadge16Nathan J Cheetham17María Paz García18J D Carpentieri19Rose S Penfold20Nicholas R Harvey21Khaled Rjoob22Liane CanasJoan Capdevila PujolLynn CherkasKatie DooresMichael Malim8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UK6 MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UKDepartment of Twin Research and Genetic Epidemiology, King’s College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK4 Department of Population Health Sciences, King’s College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UKDepartment of Population Science & Experimental Medicine, University College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK8 School of Biomedical Engineering & Imaging Sciences, King’s College London, London, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UKDepartment of Twin Research and Genetic Epidemiology, King`s College London, London, UKDepartment of Twin Research and Genetic Epidemiology, King`s College London, London, UKDepartment of Twin Research and Genetic Epidemiology, King’s College London, London, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UK3 Institute of Education, University College London, London, UK9 Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, The University of Edinburgh, Edinburgh, UK1 Department Of Twin Research & Genetic Epidemiology, King’s College London, London, UK6 MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, UKIntroduction Social gradients in COVID-19 exposure and severity have been observed internationally. Whether combinations of pre-existing social factors, particularly those that confer cumulative advantage and disadvantage, affect recovery from ongoing symptoms following COVID-19 and long COVID is less well understood.Methods We analysed data on self-perceived recovery following self-reported COVID-19 illness in two UK community-based cohorts, COVID Symptom Study Biobank (CSSB) (N=2548) and TwinsUK (N=1334). Causal effects of sociodemographic variables reflecting status prior to the COVID-19 pandemic on recovery were estimated with multivariable Poisson regression models, weighted for inverse probability of questionnaire participation and COVID-19 infection and adjusted for potential confounders. Associations between recovery and social strata comprising combinations of sex, education level and local area deprivation were estimated using the intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) approach. Further analyses estimated associations with variables reflecting experiences during the pandemic.Results Gradients in recovery from COVID-19 along the lines of social advantage were observed in intersectional MAIHDA models, with predicted probability of recovery lowest in female strata with lowest education and highest deprivation levels (CSSB: 55.1% (95% CI 44.0% to 65.1%); TwinsUK: 73.9% (95% CI 61.1% to 83.0%)) and highest in male strata with highest education and lowest deprivation levels (CSSB: 79.1% (95% CI 71.8% to 85.1%); TwinsUK: 89.7% (95% CI 82.5% to 94.1%)). Associations were not explained by differences in prepandemic health. Adverse employment, financial, healthcare access and personal experiences during the pandemic were also negatively associated with recovery.Conclusions Inequalities in likelihood of recovery from COVID-19 were observed, with ongoing symptoms several months after coronavirus infection more likely for individuals with greater social disadvantage prior to the pandemic.https://bmjpublichealth.bmj.com/content/3/1/e001166.full |
| spellingShingle | Tim Spector Adrian Hopper Sebastien Ourselin Emma L Duncan Julia Brown Carole H Sudre Jie Deng Christina Hu Ruth C E Bowyer Ellen J Thompson Jonathan Wolf Claire J Steves Marc Modat Benjamin Murray Andy Guise Nicholas Harvey Deborah Hart Alexander Hammers Carole Sudre Michela Antonelli Liane S Canas Erika Molteni Eric Kerfoot Claire Steves Vicky Bowyer Emma Duncan Nathan Cheetham Ayrun Nessa Samuel Wadge Nathan J Cheetham María Paz García J D Carpentieri Rose S Penfold Nicholas R Harvey Khaled Rjoob Liane Canas Joan Capdevila Pujol Lynn Cherkas Katie Doores Michael Malim Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study BMJ Public Health |
| title | Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study |
| title_full | Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study |
| title_fullStr | Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study |
| title_full_unstemmed | Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study |
| title_short | Social determinants of recovery from ongoing symptoms following COVID-19 in two UK longitudinal studies: a prospective cohort study |
| title_sort | social determinants of recovery from ongoing symptoms following covid 19 in two uk longitudinal studies a prospective cohort study |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001166.full |
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