Comparison of survey questions to define long COVID: Implications for prevalence and disparities

Authors

Jana L. Hirschtick, Advocate Health - MidwestFollow
Elizabeth Slocum, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
Blair Whittington, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
Michael R. Elliott, Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.
Sameera Ahmed, Michigan Department of Health and Human Services, 320 S. Walnut Street, Lansing, MI 48933, United States of America.
Nancy L. Fleischer, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America.

Recommended Citation

Hirschtick JL, Slocum E, Whittington B, Elliott MR, Ahmed S, Fleischer NL. Comparison of survey questions to define long COVID: Implications for prevalence and disparities. Prev Med Rep. 2025;59:103269. Published 2025 Oct 3. doi:10.1016/j.pmedr.2025.103269

Abstract

Objective: To understand whether variation in survey-based Long COVID estimates is partially due to how and when survey questions are asked.

Methods: We compared Long COVID prevalence using distinct questions within a population-based, longitudinal survey of adults with confirmed SARS-CoV-2 before June 2022 in Michigan.

Results: In our sample (n = 3826), 17.0 % reported symptoms for 90+ days at baseline, a median of 4.4 months after COVID-19 onset. A median of 18.4 months after COVID-19 onset, 24.5 % reported ever experiencing Long COVID, 16.9 % reported current Long COVID, and 10.8 % reported diagnosed Long COVID. Among adults without 90-day symptoms at baseline, 17.3 % reported ever Long COVID at follow-up. Relatedly, among adults with 90-day symptoms at baseline, 31.1 % reported they never had Long COVID at follow-up. After adjustment for reinfection, respondents who were Hispanic (vs. White) or lower income (

Conclusion: Surveys should employ several questions to define Long COVID and interpret findings within the context of factors likely contributing to discrepancies, including reinfection, stigma, awareness, and care-seeking behaviors.

Document Type

Article

PubMed ID

41142667