Long COVID and the Increased Risk of Food Insecurity Among Participants in Arizona CoVHORT: A matched cohort study.

ObjectivesTo assess whether individuals with long COVID face a higher risk of food insecurity compared with those without long COVID. MethodsWe used data from the Arizona CoVHORT, which is a prospective longitudinal study of SARS-CoV-2 health outcomes initiated in May 2020. Participants with confirmed infections who completed a symptom survey [≥]6 months post-infection were eligible (n = 2415). We matched participants with long COVID to participants who did not have long COVID by gender, age group, income bracket, and date of first assessment of food insecurity ({+/-}6 months). We estimated the association between long COVID and food insecurity using a conditional logistic regression analysis. ResultsParticipants with long COVID had significantly greater odds of food insecurity (adjusted odds ratio = 1.47; 95% confidence interval = 1.06 - 2.04). ConclusionsLong COVID significantly increases vulnerability to food insecurity. This highlights the need for integrated health and social interventions for individuals with long COVID. WHAT IS ALREADY KNOWN ON THIS TOPICFood Insecurity has been shown to be an important risk factor for long COVID, but we do not know whether long COVID independently increases the risk of food insecurity, nor have studies adopted a cohort design approach to examine the relationship between long COVID and food insecurity. This study is the first to analyze the association between long COVID and food Insecurity using a matched cohort data within the United States. WHAT THIS STUDY ADDSThis study uniquely adds to the current knowledge base by providing evidence that long COVID is independently associated with a significantly increased risk of food insecurity among adults in Arizona, after adjusting for confounders. We found that adults with long COVID in the Arizona CoVHORT had 47% higher odds of experiencing food insecurity compared to matched controls without long COVID. This study provides robust statistical support for a direct association between long COVID and food insecurity and advances the field by evidencing a previously under-explored dimension of the pandemics long-term impact, thus, highlighting an urgent need for integrated screening and intervention strategies at the intersection of chronic illness and nutrition insecurity. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICYOur study provides evidence that long COVID not only affects health of individuals but also social and economic well-being, including food access and stability. Healthcare and public health systems should integrate routine screening for food insecurity in outpatient care, primary care, and long COVID clinics. Early detection and referral to nutritional or financial assistance programs may reduce the combined effects of chronic illness and economic strain. These interventions are critical for groups disproportionately impacted by the pandemics longer-term effects, including low-income households, women, and communities of color. Expanding safety net programs and tracking social consequences of infectious diseases are vital for public health preparedness.