Long COVID and Incident Multimorbidity in the United States: Evidence from a Nationally Representative Longitudinal Study.
- 1Department of Biostatistics, Epidemiology, and Environmental Health Science, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
- 2Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
Abstract
Background/Objectives: Long COVID has been associated with elevated risks of individual chronic conditions, but its association with the transition to multimorbidity remains unclear. This study aims to examine whether retrospective COVID-19 status was associated with incident multimorbidity among U.S. adults. Methods: We analyzed Panel 24 of the Medical Expenditure Panel Survey (MEPS; 2019-2022), including 4356 individuals free of multimorbidity at baseline. COVID-19 exposure was classified as Long COVID, COVID-19-recovered, or no COVID-19. Survey-weighted logistic regression estimated associations between retrospective COVID-19 status and incident cross-domain multimorbidity, and generalized estimating equations assessed healthcare expenditures, health-related quality of life, and inpatient utilization. Results: Incident MM occurred in 106 participants: 17 with Long COVID, 41 COVID-19-recovered, and 48 with no COVID-19. In the primary model (4239 participants; 105 events), Long COVID was associated with higher odds of incident MM than no COVID-19 (OR 2.34; 95% CI, 1.14-4.79); the estimate for COVID-19-recovered participants was OR 1.71 (95% CI, 1.01-2.92). Fully adjusted and Firth estimates were directionally consistent. Cardiometabolic plus respiratory MM predominated (79/106). COVID-status-by-year interactions were not significant for total expenditures, out-of-pocket expenditures, physical or mental health scores, or inpatient stays. Conclusions: Retrospectively classified Long COVID was associated with incident cross-domain MM recorded during follow-up, but temporal ordering cannot be established, and sparse events limit precision. Replication with prospectively timed exposure and diagnosis data is needed.
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BibTeX
@article{alliu2026long,
title = {{Long COVID and Incident Multimorbidity in the United States: Evidence from a Nationally Representative Longitudinal Study.}},
author = {Ibrahim Alliu and Gulzar Shah and Subash Thapa and Emmanuel Azu and Timothy Kizza and Logan Cowan},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14203427},
url = {https://europepmc.org/article/MED/42940472},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long COVID and Incident Multimorbidity in the United States: Evidence from a Nationally Representative Longitudinal Study.
AU - Ibrahim Alliu
AU - Gulzar Shah
AU - Subash Thapa
AU - Emmanuel Azu
AU - Timothy Kizza
AU - Logan Cowan
PY - 2026
DA - 2026/10/14
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14203427
UR - https://europepmc.org/article/MED/42940472
AB - Background/Objectives: Long COVID has been associated with elevated risks of individual chronic conditions, but its association with the transition to multimorbidity remains unclear. This study aims to examine whether retrospective COVID-19 status was associated with incident multimorbidity among U.S. adults. Methods: We analyzed Panel 24 of the Medical Expenditure Panel Survey (MEPS; 2019-2022), including 4356 individuals free of multimorbidity at baseline. COVID-19 exposure was classified as Long COVID, COVID-19-recovered, or no COVID-19. Survey-weighted logistic regression estimated associations between retrospective COVID-19 status and incident cross-domain multimorbidity, and generalized estimating equations assessed healthcare expenditures, health-related quality of life, and inpatient utilization. Results: Incident MM occurred in 106 participants: 17 with Long COVID, 41 COVID-19-recovered, and 48 with no COVID-19. In the primary model (4239 participants; 105 events), Long COVID was associated with higher odds of incident MM than no COVID-19 (OR 2.34; 95% CI, 1.14-4.79); the estimate for COVID-19-recovered participants was OR 1.71 (95% CI, 1.01-2.92). Fully adjusted and Firth estimates were directionally consistent. Cardiometabolic plus respiratory MM predominated (79/106). COVID-status-by-year interactions were not significant for total expenditures, out-of-pocket expenditures, physical or mental health scores, or inpatient stays. Conclusions: Retrospectively classified Long COVID was associated with incident cross-domain MM recorded during follow-up, but temporal ordering cannot be established, and sparse events limit precision. Replication with prospectively timed exposure and diagnosis data is needed.
SN - 2227-9032
ER -