Predictors and burden of post-acute COVID-19 syndrome (long-COVID) with a focus on equity

Post-acute COVID-19 syndrome (long-COVID) is a complex condition where patients experience persistent symptoms after recovering from their initial illness. Long-COVID can be mild to severe and involve a range of physical, cognitive, and psychological symptoms. Evidence on long-COVID scarce; the incidence, natural history, risk factors for long-COVID, and burden of disease - in terms of health outcomes, resource use, and cost - are currently unknown. We propose to conduct a population-based matched cohort study in Ontario and British Columbia to characterise the burden of long-COVID through an equity lens. We will use population-based laboratory, reportable disease, immunization, and health administrative databases, enriched by individually-linked detailed clinical data from Canadian patients with long-COVID. We will match patients with long-COVID to patients without long-COVID and the general population to determine the incidence, predictors,and long-term health outcomes, resource and cost of long-COVID. We will stratify our population by demographic (e.g., age, sex), clinical (e.g., severity of acute COVID episode, comorbidities, vaccination status, variant of concern), and social and equity-relevant variables (e.g., gender, marginalization, essential workers, multigenerational and large households, congregate settings). Our work will significantly enhance the understanding of long-COVID and inform the value of potential interventions and hence will directly support clinical and health policy decision-making aimed at reducing the impact of long-COVID on Canadians.