Analysis of Long COVID Demographics in the US

Introduction

On June 7, 2024, a briefing article in JAMA presented findings from a comprehensive analysis by US government researchers regarding the demographics of long COVID. This analysis sheds light on the prevalence and characteristics of individuals affected by this condition.

Prevalence of Long COVID in the US

The researchers estimate that approximately 6.9% of Americans have experienced long COVID. This estimate is based on data from the Medical Expenditure Panel Survey (MEPS), funded by the US federal government to gather health-related data for the Department of Health and Human Services. The MEPS collects information from a diverse group of Americans, healthcare providers, and insurance companies to track health spending and conditions.

Using data from the household component of the survey, the researchers analyzed self-reported information from over 17,000 independently living Americans. This sample represents an adult population of approximately 259 million, allowing for a thorough assessment of long COVID prevalence.

Out of 8,275 adults who reported having COVID-19, 1,202 also indicated that they suffered from long COVID. This translates to about 6.9% of the total US population, or nearly 15% of individuals who had contracted COVID-19. With the ongoing pandemic, the number of Americans experiencing long COVID is expected to continue increasing.

Canadian COVID-19 Insights

In Canada, data from the 2023 COVID-19 Antibody and Health Survey indicated that up to two-thirds of Canadians may have been infected with SARS-CoV-2. By June 2023, 11% of Canadian adults reported lingering COVID-19 symptoms, with 2.1 million still experiencing these issues.

Statistics Canada noted that repeated COVID-19 infections increase the likelihood of developing long COVID, estimating that long COVID symptoms led to 14.5 million missed days of work or school among over 600,000 Canadians. Differences in health data collection, access to healthcare, and cultural attitudes towards illness suggest that long COVID may be under-reported in the US.

The CDC’s Nationwide Blood Donor Seroprevalence Survey in 2022 indicated that up to 77% of Americans over 16 had contracted COVID-19 at some point. While the figure of 17.8 million Americans with long COVID is significant, further investigation reveals that this may only represent the beginning of a larger issue.

Demographic Disparities

In the US, reports of long COVID are more prevalent among women (8.6%) compared to men (5.1%). Notably, over 10% of women aged 50 to 64 reported having long COVID, while men exhibited more consistent reporting across different age groups. Individuals with pre-existing conditions, such as obesity, diabetes, and heart disease, are also more likely to report long COVID symptoms.

The difference in reporting rates between genders may stem from varying health-seeking behaviors or greater clinical vulnerability among women.

Impact of Vaccination

Individuals who received multiple COVID-19 vaccine boosters reported lower instances of long COVID, with 5.8% experiencing lingering symptoms. This aligns with Canadian findings indicating that repeated infections raise the risk of developing long COVID. Those who participated only in the initial vaccine rollout had a higher likelihood (8.7%) of developing long COVID compared to unvaccinated individuals, possibly reflecting a false sense of security.

Furthermore, disparities are evident among racial groups, with white Americans (approximately 7%) reporting long COVID symptoms more than Asian Americans (3.3%). Asian Americans, who showed a more cautious approach towards infection, were also more likely to seek COVID-19 booster shots.

Socioeconomic Factors

Household income and education levels significantly influenced long COVID reporting. Lower-income households reported fewer cases of COVID-19, contrasting with data from Toronto that indicated lower-income, high-immigration neighborhoods were disproportionately affected during 2022. Similar trends were noted for long COVID reports, with lower rates among low-income and less-educated households.

The reliance on self-reported data raises questions about access to healthcare and information regarding long COVID. Socioeconomic factors and family attitudes toward health may contribute to under-reporting of long COVID among low-income families.

The Ongoing Challenge of Long COVID

As COVID-19 continues to circulate and health authorities reduce surveillance efforts, monitoring the number of individuals developing long COVID remains crucial. Researchers are still investigating whether the risk of long COVID varies with viral mutations. It is known that the omicron variant has introduced new long COVID symptoms, and repeated infections significantly increase the risk of developing long COVID.

With more than 77% of adults having experienced at least one COVID-19 infection, the number of Americans suffering from long COVID could potentially reach 40 million or more in the coming years.

References

Fang Z, Ahrnsbrak R, Rekito A. Evidence Mounts That About 7% of US Adults Have Had Long COVID. JAMA. Published online June 7, 2024. doi:10.1001/jama.2024.11370
Government of Canada SC. Experiences of Canadians with long-term symptoms following COVID-19. Published December 8, 2023. Accessed June 12, 2024. https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.html
Adjaye-Gbewonyo D, Vahratian A, Cria G. P, Bertolli J. Long COVID in Adults: United States, 2022. National Center for Health Statistics (US); 2023. doi:10.15620/cdc:132417
O’Neill B, Kalia S, Hum S, et al. Socioeconomic and immigration status and COVID-19 testing in Toronto, Ontario: retrospective cross-sectional study. BMC Public Health. 2022;22:1067. doi:10.1186/s12889-022-13388-2