Short-term and long-term impacts of COVID-19 on economic vulnerability: a population-based longitudinal study (COVIDENCE UK)

Anne E Williamson; Florence Tydeman; Alec Miners; Kate Pyper; Adrian R Martineau

doi:10.1136/bmjopen-2022-065083

Short-term and long-term impacts of COVID-19 on economic vulnerability: a population-based longitudinal study (COVIDENCE UK)

BMJ Open. 2022 Aug 23;12(8):e065083. doi: 10.1136/bmjopen-2022-065083.

Authors

Anne E Williamson¹, Florence Tydeman¹, Alec Miners², Kate Pyper³, Adrian R Martineau⁴

Affiliations

¹ Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
² Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
³ Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK.
⁴ Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK a.martineau@qmul.ac.uk.

Abstract

Objective: To determine whether COVID-19 has a significant impact on adequacy of household income to meet basic needs (primary outcome) and work absence due to sickness (secondary outcome), both at the onset of illness (short term) and subsequently (long term).

Design: Multilevel mixed regression analysis of self-reported data from monthly online questionnaires, completed 1 May 2020 to 28 October 2021, adjusting for baseline characteristics including age, sex, socioeconomic status and self-rated health.

Setting and participants: Participants (n=16 910) were UK residents aged 16 years or over participating in a national longitudinal study of COVID-19 (COVIDENCE UK).

Results: Incident COVID-19 was independently associated with increased odds of participants reporting household income as being inadequate to meet their basic needs in the short term (adjusted OR (aOR) 1.39, 95% 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 short-term association among those who reported long COVID, defined as the presence of symptoms lasting more than 4 weeks after disease onset, 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 in the short term (aOR 1.34, 95% CI 0.52 to 3.49).

Conclusions: We demonstrate an independent association between COVID-19 and increased risk of economic vulnerability among COVIDENCE participants, measured by both household income sufficiency and sickness absence from work. Taking these findings together with pre-existing research showing that socioeconomic disadvantage increases the risk of developing COVID-19, this may suggest a 'vicious cycle' of impaired health and poor economic outcomes.

Trial registration number: NCT04330599.

Keywords: COVID-19; Economics; Public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / complications
COVID-19* / epidemiology
Humans
Longitudinal Studies
Post-Acute COVID-19 Syndrome
Surveys and Questionnaires
United Kingdom / epidemiology

Associated data

ClinicalTrials.gov/NCT04330599