Interaction between economic status and healthy lifestyle in long COVID among Chinese older population: a cross-sectional study.

Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd, 2011-

Economic Status* ; Healthy Lifestyle* ; Post-Acute COVID-19 Syndrome*/epidemiology; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; China/epidemiology ; Cross-Sectional Studies ; East Asian People ; Exercise ; Health Behavior ; Pandemics ; Smoking/epidemiology

Objectives: To estimate the interaction between economic status (ES) and healthy lifestyle in long COVID among Chinese older people infected with SARS-CoV-2.
Design: A cross-sectional study based on the Peking University Health Cohort in Anning, Yunnan.
Setting: All primary health institutions in Anning, Yunnan Province, China, from April to May 2023.
Participants: A total of 4804 people aged 60 and older infected with SARS-CoV-2 were included in this study.
Primary and Secondary Outcome Measures: Long COVID was measured by participants' self-reported symptoms using structured questionnaires. ES was measured by last-month personal income, and participants' ES was defined as low if their income was below the per capita monthly income of local residents. Lifestyle score was equal to the number of healthy behaviours (including smoking, drinking, weight, exercise and diet) and grouped using the median score as the cut-off point. Univariate and multivariate logistic models were employed to estimate the association of ES with long COVID. Interaction between ES and lifestyle in long COVID was assessed by multiplicative interaction term.
Results: We enrolled a total of 4804 participants infected with SARS-CoV-2, of whom 57.3% (2754 of 4804) had at least one long COVID symptom. Fatigue (1546, 56.1%), cough (1263, 45.9%) and muscle pain (880, 32.0%) were the top three common symptoms. Patients with low ES had a 48% (adjusted OR: 1.48; 95% CI 1.22, 1.82) increased risk of long COVID. A significant interaction was observed between ES and lifestyle (p value for interaction <0.001) in long COVID.
Conclusion: The interaction between ES and healthy lifestyle in long COVID was prominent. Comprehensive strengthened economic support for patients recovering from COVID-19, especially for those with low healthy lifestyle, should be implemented to prevent and manage long COVID symptoms.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

EClinicalMedicine. 2021 Aug;38:101019. (PMID: 34308300)
Pediatr Obes. 2021 Sep;16(9):e12779. (PMID: 33624443)
Lancet Glob Health. 2020 Jun;8(6):e840-e849. (PMID: 32446349)
Lancet Infect Dis. 2022 Apr;22(4):e102-e107. (PMID: 34951953)
Int J Public Health. 2022 Nov 28;67:1605086. (PMID: 36518871)
Science. 2021 May 28;372(6545):. (PMID: 33906968)
J Med Virol. 2022 Jan;94(1):253-262. (PMID: 34463956)
JAMA Intern Med. 2023 Mar 1;183(3):232-241. (PMID: 36745445)
JPEN J Parenter Enteral Nutr. 2021 Jan;45(1):13-31. (PMID: 33094848)
Clin Microbiol Infect. 2024 Mar;30(3):328-335. (PMID: 37866679)
Thorax. 2021 Apr;76(4):399-401. (PMID: 33273026)
BMJ. 2021 Jul 26;374:n1648. (PMID: 34312178)
Nat Med. 2021 Apr;27(4):601-615. (PMID: 33753937)
Milbank Q. 2021 Jun;99(2):519-541. (PMID: 33783907)
Geroscience. 2020 Dec;42(6):1547-1578. (PMID: 33001410)
Nat Commun. 2022 Apr 12;13(1):1957. (PMID: 35413949)
Front Med (Lausanne). 2022 Oct 24;9:1036556. (PMID: 36353225)
Curr Nutr Rep. 2021 Dec;10(4):352-363. (PMID: 34506003)
Brain Behav Immun. 2022 Mar;101:93-135. (PMID: 34973396)
BMC Public Health. 2016 Feb 29;16:194. (PMID: 26924178)
JAMA Netw Open. 2022 Oct 3;5(10):e2238804. (PMID: 36301542)
J Glob Health. 2022 Aug 09;12:05029. (PMID: 35939273)
Clin Infect Dis. 2021 Sep 7;73(5):e1089-e1098. (PMID: 33220049)
Lancet. 2019 Sep 28;394(10204):1192-1204. (PMID: 31571602)
PLoS Med. 2021 Sep 28;18(9):e1003773. (PMID: 34582441)
Eur J Prev Cardiol. 2017 Jul;24(10):1032-1042. (PMID: 28406328)
Nat Commun. 2022 Jun 28;13(1):3528. (PMID: 35764621)
J Infect Dis. 2022 Nov 1;226(9):1593-1607. (PMID: 35429399)
Cell. 2022 Mar 3;185(5):881-895.e20. (PMID: 35216672)
Nat Hum Behav. 2023 Jul;7(7):1069-1083. (PMID: 37081098)
Lancet Psychiatry. 2018 Dec;5(12):987-1012. (PMID: 30392731)
J R Soc Med. 2023 Aug;116(8):263-273. (PMID: 37164035)
Nat Med. 2022 Aug;28(8):1706-1714. (PMID: 35879616)
Int J Equity Health. 2019 Jun 13;18(1):87. (PMID: 31196102)
Int J Environ Res Public Health. 2022 Nov 30;19(23):. (PMID: 36498103)
Lancet Public Health. 2020 Mar;5(3):e140-e149. (PMID: 32007134)
BMC Med. 2020 Aug 12;18(1):222. (PMID: 32782007)
Nat Commun. 2022 Jan 25;13(1):446. (PMID: 35078982)
Int J Equity Health. 2021 Nov 24;20(1):248. (PMID: 34819081)
JMIR Public Health Surveill. 2021 Apr 13;7(4):e26330. (PMID: 33630747)
SSM Popul Health. 2016 Sep 16;2:708-717. (PMID: 29349182)
Lancet Glob Health. 2017 Mar;5(3):e277-e289. (PMID: 28193397)

Keywords: Aged; Behavior; COVID-19; China; Health economics

Date Created: 20240926 Date Completed: 20240926 Latest Revision: 20241015

20250114

PMC11429274

10.1136/bmjopen-2023-082314

39327050