Acute and long-term impacts of COVID-19 on economic vulnerability: a population-based longitudinal study in 16,910 adults

ABSTRACT

IntroductionSocio-economic deprivation is a well-recognised risk factor for COVID-19 and other respiratory infections. However, the impact of COVID-19 infection on economic vulnerability has not previously been characterised.ObjectivesTo determine whether COVID-19 has a significant impact on household income and work absence due to sickness, both at onset of illness (acutely) and subsequently (long-term).MethodsMultivariate regression analysis of self-reported data from monthly online questionnaires completed by participants in the COVIDENCE UK population-based longitudinal study (n=16,910) from 1st May 2020 to 28th October 2021, adjusting for baseline characteristics including age, sex, economic status and health.ResultsIncident COVID-19 was independently associated with increased odds of participants reporting household income as being inadequate to meet their basic needs acutely (adjusted odds ratio [aOR) 1.39, 95% confidence interval [CI] 1.12 to 1.73) though this did not persist in the long-term (aOR 1.00, 95% CI 0.86 to 1.16).Exploratory analysis revealed a stronger acute association amongst those who reported ‘long COVID’, defined as the presence of symptoms lasting more than 4 weeks after the acute episode, than those reporting COVID-19 without ‘long COVID’ (p for trend 0.002).Incident COVID-19 associated with increased odds of reporting sickness absence from work in the long-term (aOR 4.73, 95% CI 2.47 to 9.06) but not acutely (aOR 1.34, 95% CI 0.52 to 3.49).ConclusionsWe demonstrate an independent association between COVID-19 and increased risk of economic vulnerability amongst COVIDENCE participants, measured by both household income sufficiency and sickness absence from work.Since socio-economic deprivation also increases risk of COVID-19, our findings suggest a bidirectional relationship between COVID-19 and poverty. This may generate a ‘vicious cycle’ of increased vulnerability, impaired health, and poor economic outcomes.Please refer to page A208 for declarations of interest related to this .