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Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom

Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom
Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom

Objectives: to estimate the risk of Long COVID by socioeconomic deprivation and to further examine the inequality by sex and occupation. 

Design: 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.

 Setting: community-based survey in the UK. 

Participants: a total of 201,799 participants aged 16 to 64 years and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 

Main outcome measures: 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. 

Results: nearly 10% (n = 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).

Conclusions: 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.

Long COVID, index of multiple deprivation, occupation, sex, socioeconomic inequality
0141-0768
263-273
Shabnam, Sharmin
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Razieh, Cameron
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Dambha-Miller, Hajira
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Yates, Tom
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Gillies, Clare
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Chudasama, Yogini V.
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Pareek, Manish
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Banerjee, Amitava
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Kawachi, Ichiro
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Lacey, Ben
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Morris, Eva J.A.
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White, Martin
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Zaccardi, Francesco
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Khunti, Kamlesh
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Islam, Nazrul
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Shabnam, Sharmin
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Razieh, Cameron
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Dambha-Miller, Hajira
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Yates, Tom
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Gillies, Clare
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Chudasama, Yogini V.
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Pareek, Manish
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Banerjee, Amitava
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Kawachi, Ichiro
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Lacey, Ben
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Morris, Eva J.A.
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White, Martin
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Zaccardi, Francesco
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Khunti, Kamlesh
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Islam, Nazrul
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Shabnam, Sharmin, Razieh, Cameron, Dambha-Miller, Hajira, Yates, Tom, Gillies, Clare, Chudasama, Yogini V., Pareek, Manish, Banerjee, Amitava, Kawachi, Ichiro, Lacey, Ben, Morris, Eva J.A., White, Martin, Zaccardi, Francesco, Khunti, Kamlesh and Islam, Nazrul (2023) Socioeconomic inequalities of Long COVID: a retrospective population-based cohort study in the United Kingdom. Journal of the Royal Society of Medicine, 116 (8), 263-273. (doi:10.1177/01410768231168377).

Record type: Article

Abstract

Objectives: to estimate the risk of Long COVID by socioeconomic deprivation and to further examine the inequality by sex and occupation. 

Design: 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.

 Setting: community-based survey in the UK. 

Participants: a total of 201,799 participants aged 16 to 64 years and with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 

Main outcome measures: 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. 

Results: nearly 10% (n = 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).

Conclusions: 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.

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Accepted/In Press date: 22 March 2023
e-pub ahead of print date: 10 May 2023
Published date: August 2023
Additional Information: Publisher Copyright: © 2023, The Royal Society of Medicine.
Keywords: Long COVID, index of multiple deprivation, occupation, sex, socioeconomic inequality

Identifiers

Local EPrints ID: 477589
URI: http://eprints.soton.ac.uk/id/eprint/477589
ISSN: 0141-0768
PURE UUID: f0f78819-3568-4d29-b3f5-28c9308cc387
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325

Catalogue record

Date deposited: 09 Jun 2023 16:30
Last modified: 06 Jun 2024 02:15

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Contributors

Author: Sharmin Shabnam
Author: Cameron Razieh
Author: Tom Yates
Author: Clare Gillies
Author: Yogini V. Chudasama
Author: Manish Pareek
Author: Amitava Banerjee
Author: Ichiro Kawachi
Author: Ben Lacey
Author: Eva J.A. Morris
Author: Martin White
Author: Francesco Zaccardi
Author: Kamlesh Khunti
Author: Nazrul Islam ORCID iD

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