Observational studyAnnals of internal medicine2025
Social Determinants of Health and Risk for Long COVID in the U.S. RECOVER-Adult Cohort.
Abstract readObservational Study
In one paragraph
Observational study in Annals of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Lived Experiences of Long COVID in Iranian Immigrants in Canada: Implications for Post-Infection Care and Global Health Equity.Iranian journal of medical sciences · 2026Article
- Pregnancy Outcomes in Individuals With Long COVID.Obstetrics and gynecology · 2026Article
- School Difficulties and Long COVID in Children and Adolescents.Academic pediatrics · 2026Observational
- Prevalence and Associations of Medical Expenditure Panel Survey-Defined Long COVID Among Adults: Cross-Sectional Study.JMIR formative research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
63 authors.
Candace H FeldmanDivision of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (C.H.F., E.W.K.).ORCID 0000-0002-4980-9770
Leah SantacroceDivision of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (L.S.).ORCID 0000-0001-8951-2296
Ingrid V BassettHarvard Medical School, and Infectious Diseases Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts (I.V.B.).ORCID 0000-0001-6920-6080
Tanayott ThaweethaiHarvard Medical School, and Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (T.T.).
Radica AlicicDepartment of Medicine, University of Washington, Spokane, Washington (R.A.).ORCID 0000-0002-5437-5700
Rachel Atchley-ChallennerBiostatistics, Massachusetts General Hospital, Boston, Massachusetts (R.A.-C.).ORCID 0000-0003-2610-5081
Alicia ChungHealth and Behavior, Department of Population Health, New York University Grossman School of Medicine, New York, New York (A.C.).ORCID 0000-0001-9330-1416
Mark P GoldbergNeurology, UT Health San Antonio, San Antonio, Texas (M.P.G.).ORCID 0000-0003-3534-6979
Carol R HorowitzInstitute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, New York (C.R.H.).
Karen B JacobsonDivision of Research, Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California, and Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford School of Medicine, Stanford, California (K.B.J.).
J Daniel KellyHospitalist Medicine, Department of Medicine, University of California, San Francisco, and F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California (J.D.K.).ORCID 0000-0002-7616-0321
Stacey KnightCardiovascular Research, Cardiology, Intermountain Health, and Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah (S.Knight).
Karen LutrickFamily & Community Medicine, University of Arizona, Tucson, Arizona (K.L.).ORCID 0000-0003-3480-849X
Praveen MudumbiDepartment of Population Health, New York University Grossman School of Medicine, New York, New York (P.M.).ORCID 0000-0003-3792-1789
Sairam ParthasarathyDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona (S.P.).
Heather PrendergastIllinois Research Network (ILLInet), and Emergency Medicine, University of Chicago, Chicago, Illinois (H.P.).ORCID 0000-0001-7476-7587
Yuri QuintanaHarvard Medical School, and Division of Clinical Informatics, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Y.Q.).
Nasser ShararehDepartment of Population Health Sciences, University of Utah Health, Salt Lake City, Utah (N.S.).
Judd ShellitoDivision of Pulmonary, Critical Care, Allergy and Immunology, LSU Health Services Center, New Orleans, Louisiana (J.S.).ORCID 0000-0001-7729-2708
Zaki A SherifDepartment of Biochemistry & Molecular Biology, Department of Medicine, Howard University College of Medicine, Washington, DC (Z.A.S.).ORCID 0000-0002-1772-7041
Brittany D TaylorDivision of Health Strategies, Community Impact, American Heart Association, Atlanta, Georgia (B.D.T.).ORCID 0009-0009-4037-5708
Emily TaylorSolve M.E., Los Angeles, California (E.T.).
Joel TsevatDivision of General Internal Medicine, ReACH Center and Department of Medicine, Division of General Internal Medicine, Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, and Departments of Population Health and Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas (J.T.).ORCID 0000-0002-0413-8969
Zanthia WileyDivision of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia (Z.W., J.Berry, I.O.).ORCID 0000-0002-9718-3709
Natasha J WilliamsInstitute for Excellence in Health Equity, Department of Population Health, New York University Grossman School of Medicine, New York, New York (N.J.W.).
Lynn YeeDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (L.Y.).
Lisa Aponte-SotoIllinois Research Network (ILLInet) and Illinois Unidos, Chicago, Illinois (L.A.-S.).ORCID 0000-0003-3611-4926
Jhony BaissaryCase Western Reserve University School of Medicine, Cleveland, Ohio (J.Baissary, G.A.M.).
Jasmine BerryDivision of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia (Z.W., J.Berry, I.O.).ORCID 0000-0002-3903-6460
Alexander W CharneyCharles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (A.W.C.).
Maged M CostantineDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Ohio State University, Columbus, Ohio (M.M.C.).ORCID 0000-0003-4076-469X
Alexandria M DuvenMedical & Surgical Specialties Research, Providence Swedish Medical Center, Seattle, Washington (A.M.D.).
Nathaniel ErdmannDivision of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (N.E.).
Kacey C ErnstEpidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (K.C.E., K.P.-B.).
Elen M FeuerriegelDivision of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado (E.M.F.).ORCID 0000-0002-3365-0574
Valerie J FlahermanDepartments of Pediatrics and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California (V.J.F.).ORCID 0000-0003-3117-927X
Minjoung GoHospital Medicine, Stanford University, Stanford, California (M.G.).
Kellie HawkinsDivision of Infectious Disease, Department of Medicine, Public Health Institute at Denver Health, Denver, Colorado, and Division of Infectious Disease, University of Colorado, Aurora, California (K.H.).ORCID 0009-0002-2380-6093
Vanessa JacobyDepartment of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, California (V.J.).
Janice JohnPrimary Care, Family Medicine, Cambridge Health Alliance, Boston, Massachusetts (J.J.).ORCID 0000-0002-1118-2685
Sara KellyIllinois Research Network (ILLInet), Chicago, Illinois, and Research Services, University of Illinois College of Medicine, Peoria, Illinois (S.Kelly).ORCID 0000-0001-8544-4767
Elijah KindredIllinois Research Network (ILLInet) and Bright Star Community Outreach, Chicago, Illinois (E.K.).
Adeyinka LaiyemoDivision of Gastroenterology, Department of Medicine, Howard University, Washington, DC (A.L.).ORCID 0000-0001-9699-4879
Emily B LevitanSchool of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (E.B.L.).
Bruce D LevyHarvard Medical School, and Division of Pulmonology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (B.D.L.).ORCID 0000-0001-9515-5731
Jennifer K LogueDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington (J.K.L.).ORCID 0000-0002-7889-8960
Jai G MaratheDivision of Infectious Diseases, Boston University/Boston Medical Center, Boston, Massachusetts (J.G.M.).ORCID 0000-0002-6084-7145
Jeffrey N MartinDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California (J.N.M.).ORCID 0000-0002-9773-3256
Grace A McComseyCase Western Reserve University School of Medicine, Cleveland, Ohio (J.Baissary, G.A.M.).ORCID 0000-0003-2690-8888
Torri D MetzDivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah (T.D.M.).ORCID 0000-0002-8161-2353
Tony MinorFaith Communities Outreach, Metro Health System, Cleveland, Ohio (T.M.).ORCID 0009-0006-5103-9695
Aoyjai P MontgomeryDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (A.P.M.).ORCID 0000-0003-4649-1258
Janet M MullingtonDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.M.M.).ORCID 0000-0002-9156-9424
Igho OfotokunDivision of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia (Z.W., J.Berry, I.O.).ORCID 0000-0003-2735-1903
Megumi J OkumuraDepartments of Pediatrics and Internal Medicine, University of California, San Francisco, San Francisco, California (M.J.O.).
Michael J PelusoDivision of Infectious Diseases, HIV and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California (M.J.P.).ORCID 0000-0003-0585-6230
Kristen Pogreba-BrownEpidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (K.C.E., K.P.-B.).ORCID 0000-0003-2957-7068
Hengameh RaissyDivision of Pulmonary, Department of Pediatrics, University of New Mexico, Health Sciences Center, Albuquerque, New Mexico (H.R.).
Johana M RosasPopulation Health, Department of Medicine, NYU Langone Health, New York, New York (J.M.R.).ORCID 0000-0001-5639-2961
Upinder SinghDivision of Infectious Diseases, Department of Medicine, Stanford University, Stanford, California (U.S.).
Timothy VanWagonerDepartment of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (T.V.).ORCID 0000-0001-6103-590X
Cheryl R ClarkDivision of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (C.R.C.).
Elizabeth W KarlsonDivision of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (C.H.F., E.W.K.).ORCID 0000-0001-5455-7443
Funding
ACTIV Integration of Host-targeting Therapies for COVID-19 Administrative Coordinating CenterOT2HL156812 · NHLBI · RESEARCH TRIANGLE INSTITUTE · PI NOLEN, TRACY L, THOMAS, SONIA M · 2020 to 2024
$1270.7MOTA-21-015A Post-Acute Sequelae of SARS-CoV-2 Infection Initiative: NYU Langone Health Clinical Science Core, Data Resource Core, and PASC Biorepository CoreOT2HL161847 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI GROSS, RACHEL SHARON, HORWITZ, LEORA · 2021 to 2025
$651.0MNHLBI Maternal Morbidity and Mortality (3M) Administrative Coordinating CenterOT2HL158287 · NHLBI · WESTAT, INC. · PI Chanza Baytop · 2020 to 2026
$433.8MInteractive Data Portals and Robust Analytic Tools to Wrap PASC Cohorts (iDRAW) OTA-21-015AOT2HL161841 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI FOULKES, ANDREA S, KARLSON, ELIZABETH W · 2021 to 2024
$182.2MCOVID-19 Supplement - Center for Innovative TRIals in ChilDrEN and AdulTs (TRIDENT)U24TR001608 · NCATS · DUKE UNIVERSITY · PI BENJAMIN, DANIEL K. · 2016 to 2022
$177.0MAIM-AHEAD Coordinating Center - All Four CoresOT2OD032581 · OD · UNIVERSITY OF NORTH TEXAS HLTH SCI CTR · PI Paul Avillach, Bettina M. Beech · 2021 to 2026
$168.7MSOUTHWEST ENVIRONMENTAL HEALTH SCIENCES CENTERP30ES006694 · NIEHS · UNIVERSITY OF ARIZONA · PI George S Watts · 1994 to 2026
$36.7MClinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages to Equity in Health (CLE Health)UM1TR004528 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI GRACE A MCCOMSEY · 2023 to 2026
$32.1MInstitute for Integration of Medicine & Science: A Partnership to Improve HealthUM1TR004538 · NCATS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI ROBERT A CLARK, Kenneth M Hargreaves · 2023 to 2026
$22.3MTranslational Approaches to Health Disparities in Lung, Sleep, and PandemicsR25HL126140 · NHLBI · UNIVERSITY OF ARIZONA · PI FRANCISCO A MORENO, JANKO Z. NIKOLICH · 2014 to 2026
$4.6MImproving COVID-19 Vaccine Uptake Among Racial and Ethnic Minority Groupswith Rheumatic DiseasesR01MD019235 · NIMHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Maria Ioana Danila · 2023 to 2026
$3.1MLeveraging Community-Academic Partnerships and Social Networks to Disseminate Vaccine-Related Information and Increase Vaccine Uptake Among Black Individuals with Rheumatic DiseasesR01AR080089 · NIAMS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI FELDMAN, CANDACE HILLARY, RAMSEY-GOLDMAN, ROSALIND · 2022 to 2024
$2.2MNCATS NIH HHS U24 TR001608NCATS NIH HHS UM1 TR004528NCATS NIH HHS UM1 TR004538NHLBI NIH HHS OT2 HL156812NHLBI NIH HHS OT2 HL158287NHLBI NIH HHS OT2 HL161841NHLBI NIH HHS OT2 HL161847NHLBI NIH HHS R25 HL126140NIAMS NIH HHS R01 AR080089NIEHS NIH HHS P30 ES006694NIH HHS OT2 OD032581NIMHD NIH HHS R01 MD019235
Abstract
backgroundSocial determinants of health (SDoH) contribute to disparities in SARS-CoV-2 infection, but their associations with long COVID are unknown.
objectiveTo determine associations between SDoH at the time of SARS-CoV-2 infection and risk for long COVID.
designProspective observational cohort study.
setting33 states plus Washington, DC, and Puerto Rico.
participantsAdults (aged ≥18 years) enrolled in RECOVER-Adult (Researching COVID to Enhance Recovery) between October 2021 and November 2023 who were within 30 days of SARS-CoV-2 infection; completed baseline SDoH, comorbidity, and pregnancy questionnaires; and were followed prospectively. MEASUREMENTS: Social risk factors from SDoH baseline questionnaires, ZIP code poverty and household crowding measures, and a weighted score of 11 or higher on the Long COVID Research Index 6 months after infection.
resultsAmong 3787 participants, 418 (11%) developed long COVID. After adjustment for demographic characteristics, pregnancy, disability, comorbidities, SARS-CoV-2 severity, and vaccinations, financial hardship (adjusted marginal risk ratio [ARR], 2.36 [95% CI, 1.97 to 2.91]), food insecurity (ARR, 2.36 [CI, 1.83 to 2.98]), less than a college education (ARR, 1.60 [CI, 1.30 to 1.97]), experiences of medical discrimination (ARR, 2.37 [CI, 1.94 to 2.83]), skipped medical care due to cost (ARR, 2.87 [CI, 2.22 to 3.70]), and lack of social support (ARR, 1.79 [CI, 1.50 to 2.17]) were associated with increased risk for long COVID. Living in ZIP codes with the highest (vs. lowest) household crowding was also associated with greater risk (ARR, 1.36 [CI, 1.05 to 1.71]). LIMITATION: Selection bias may influence observed associations and generalizability.
conclusionParticipants with social risk factors at the time of SARS-CoV-2 infection had greater risk for subsequent long COVID than those without. Future studies should determine whether social risk factor interventions mitigate long-term effects of SARS-CoV-2 infection. PRIMARY FUNDING SOURCE: National Institutes of Health.
Indexed as
COVID-19Social Determinants of HealthAdultAgedFemaleHumansMaleMiddle AgedPost-Acute COVID-19 SyndromePovertyProspective StudiesRisk FactorsSARS-CoV-2United States
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