Who’s Most at Risk from Long COVID’s Mental Toll?

By late 2023, nearly one in seven U.S. adults reported having experienced long COVID symptoms.

A study published in Communications Medicine last month examined data from over 375,000 adults (ages 18-64 years) across the United States to identify which demographics are most affected by long COVID, as well as how the long lasting symptoms associated with long Covid are shaping broader health and economic outcomes.

For the purposes of this study, long COVID was defined as “reporting any symptoms lasting 3 months or longer that were not present prior to having COVID-19 including fatigue, difficulty concentrating and forgetfulness, “brain fog”, shortness of breath, joint or muscle pain, heart palpitations, changes to taste/smell, and inability to exercise.” Adults aged 30–49 years and 40–49 years had the highest risks of developing long Covid, versus those 65+ who significantly lower risks (13-22% higher versus 31-40% lower, respectively). Those with any (versus no) children, of Hispanic ethnicity, and from lower income households, were more likely to report long Covid. Members of the LGBT community and females were also observed as higher risk. “Black and Asian adults and never-married adults were at 20–43% lower risk and 7% lower risk than White adults and married adults, respectively.”

The author examined four economic outcomes for those reporting long Covid symptoms. These included employment status, financial hardship, difficulty paying for usual household expenses, and the frequency of experiencing anxiety and/or depressive symptoms. “The estimated percentages of those with long COVID still experiencing symptoms and reporting a modest to considerable impact on daily functioning were 55.3% and 24.6%, respectively.” In many cases, the severity of these challenges appeared to increase with the duration or intensity of symptoms. As a whole, the economic impact of long COVID in the US has been particularly significant. Estimated lost earnings among working-age adults due to long COVID totaled $211 billion in 2022 and rose to $218 billion in 2023. These results underscore the far-reaching consequences of long COVID, highlighting the urgent need for targeted public health strategies and support systems to address the condition’s lasting effects.

Citation

Kim, D. (2025). A nationwide study of risk factors for long COVID and its economic and mental health consequences in the United States. Commun Med 5, 104. https://doi.org/10.1038/s43856-025-00759-0