People from disadvantaged backgrounds are more likely to experience COVID-19 symptoms for longer, new research suggests.
The research from King's College London by authors funded by the National Institute for Health and Care Research (NIHR) reveals that social factors such as education level, financial stability, and the areas where people live played a significant role in whether individuals reported recovery from the virus more than a year after infection.
The research analysed data from over 3,800 participants across two UK cohorts: the COVID Symptom Study Biobank and TwinsUK. Using a questionnaire, participants were asked if they still had symptoms after having COVID-19.
Analyses revealed that participants with fewer social and economic advantages at the start of the pandemic were more likely to have ongoing symptoms. Women with lower education levels living in the most deprived areas had the lowest predicted probability of recovery, while men with higher education levels in less deprived areas were the most likely to feel fully recovered. Recovery rates varied between 73% and 90% in TwinsUK, and between 55% and 80% in the COVID Symptom Study Biobank, which had a larger proportion of people with long COVID.
The findings were published today in BMJ Public Health .
The inequalities in recovery were not explained by pre-existing health conditions but instead linked to broader social disadvantages. Financial and employment instability during the pandemic further contributed to poorer outcomes, suggesting that the impact of COVID-19 extended beyond physical health to economic and social wellbeing.
Dr Nathan Cheetham, Senior Postdoctoral Data Scientist at King's College London and lead author of the paper, explains: "Inequalities in health between people who are more or less advantaged within society aren't new, but this study is the first to look at the association between multiple socio-demographic factors and recovery from COVID-19.
"It's very likely that social factors also influence the ability to recover from other illnesses and manage other long-term conditions, which makes addressing social disadvantage even more crucial."
This research adds to growing evidence that health outcomes are shaped by social factors, reinforcing the need for policies that address healthcare access and economic inequality. The findings come at a time when many people are still living with the long-term effects of COVID-19, highlighting the importance of continued support for those struggling to recover.
Professor Claire Steves, Professor of Ageing and Health at King's College London and senior author on the paper, said: "This research emphasises how social factors affect long-term health outcomes. Disadvantaged groups don't just experience more severe illness - they also face additional challenges when it comes to recovery."
Dr Cheetham and the team are building on these findings by investigating how different social backgrounds influenced people's experiences of healthcare during the pandemic. Early results suggest that those in more deprived areas had greater difficulty accessing care, particularly for long COVID, with access to GP appointments being the most common barrier. With this additional work, the team hopes to provide further insight into how inequalities in healthcare access may have affected long-term recovery from COVID-19.
The research received funding from several sources including the NIHR-UKRI funded Convalescence study into long COVID.
Read the full study: https://bmjpublichealth.bmj.com/content/3/1/e001166
