A Mixed Methods Analysis of Long COVID Symptoms in Black Americans: Examining Physical and Mental Health Outcomes

While several reports confirm that long COVID is associated with poorer health, few studies explore how long COVID directly impacts the lives of Black Americans who experienced higher mortality rates early in the pandemic. Even fewer studies utilize both quantitative and qualitative methods to identify pertinent long COVID symptoms. The current study, therefore, sought to identify points of overlap and divergence when comparing qualitative vs. quantitative descriptions of long COVID experiences among Black adults in the United States.

We analyzed cross-sectional surveys collected from the AmeriSpeak panel through the National Opinion Research Center (NORC) at the University of Chicago. This panel includes a probability-based sample of adults across the United States. Respondents completed online surveys between April and June 2022. We compared outcomes among participants who reported experiencing post-acute sequelae of COVID-19 (i.e., long COVID) to those who reported experiencing SARS-CoV-2 without long COVID.

Nearly all qualitative responses focused on matters of physical health like prolonged coughing, cardiovascular concerns, troubled breathing, fatigue, headaches, memory loss, and bodily pains. Quantitative results, however, showed that Black adults living with long COVID reported significantly more anxiety, depressive symptoms, and hopelessness. Persons with long COVID were also significantly more likely to report experiencing psychosis, suicidal ideation, suicide plans, and suicide attempts within the last year.

Black adults with long COVID experienced worse outcomes across all mental health measures. Despite the COVID-19 Public Health Emergency expiration in May 2023, urgent efforts are still required to not only treat both the physical and mental health needs of persons living with long COVID, but to effectively prevent the spread and transmission of COVID-19.