Biopsychosocial and Economic Consequences of Long COVID: A Four-Year Longitudinal Analysis

Faculty Mentor

Dr. Lili Yu

Location

Russell Union Ballroom

Type of Research

Published

Session Format

Oral Presentation

College

Jiann-Ping Hsu College of Public Health

Department

Biostatistics, Epidemiology & Environmental Health Sciences

Abstract

The multi-year consequences of Long COVID remain incompletely characterized, particularly with respect to healthcare utilization and economic burden. We conducted a prospective longitudinal analysis of 4,038 respondents from the Medical Expenditure Panel Survey (MEPS) Panel 24 (year 2019–2022). Participants were classified into three groups: Long COVID (symptoms ≥3 months), COVID-recovered, and no COVID. Hierarchical linear models were used to estimate four-year trajectories of perceived health, psychological distress (K6 scale), and inflation-adjusted healthcare expenditures, adjusting for age, sex, race/ethnicity, insurance status, baseline self-rated health, and comorbidity burden. After full adjustment, COVID-19 status was not independently associated with perceived health or psychological distress over time, and no evidence of differential symptom progression was observed between the groups. In contrast, healthcare expenditures diverged significantly by COVID status. Individuals with Long COVID experienced a substantially faster rate of spending growth compared with COVID-recovered and No-COVID respondents, confirmed by a strong time-by-group interaction (p< 0.0001), independent of baseline health and sociodemographic factors. In this nationally representative cohort, baseline health status explained most variation in long-term health and psychological outcomes following COVID-19 infection, whereas Long COVID was independently associated with escalating healthcare costs. These findings suggest that, in this cohort, the dominant long-term sequela of Long COVID is economic rather than symptomatic, with important implications for healthcare financing, disability policy, and post-acute care planning.

Program Description

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Start Date

4-23-2026 2:15 PM

End Date

4-23-2026 2:30 PM

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Apr 23rd, 2:15 PM Apr 23rd, 2:30 PM

Biopsychosocial and Economic Consequences of Long COVID: A Four-Year Longitudinal Analysis

Russell Union Ballroom

The multi-year consequences of Long COVID remain incompletely characterized, particularly with respect to healthcare utilization and economic burden. We conducted a prospective longitudinal analysis of 4,038 respondents from the Medical Expenditure Panel Survey (MEPS) Panel 24 (year 2019–2022). Participants were classified into three groups: Long COVID (symptoms ≥3 months), COVID-recovered, and no COVID. Hierarchical linear models were used to estimate four-year trajectories of perceived health, psychological distress (K6 scale), and inflation-adjusted healthcare expenditures, adjusting for age, sex, race/ethnicity, insurance status, baseline self-rated health, and comorbidity burden. After full adjustment, COVID-19 status was not independently associated with perceived health or psychological distress over time, and no evidence of differential symptom progression was observed between the groups. In contrast, healthcare expenditures diverged significantly by COVID status. Individuals with Long COVID experienced a substantially faster rate of spending growth compared with COVID-recovered and No-COVID respondents, confirmed by a strong time-by-group interaction (p< 0.0001), independent of baseline health and sociodemographic factors. In this nationally representative cohort, baseline health status explained most variation in long-term health and psychological outcomes following COVID-19 infection, whereas Long COVID was independently associated with escalating healthcare costs. These findings suggest that, in this cohort, the dominant long-term sequela of Long COVID is economic rather than symptomatic, with important implications for healthcare financing, disability policy, and post-acute care planning.