Metabolic risk factors and long COVID: a cross-sectional study in Aotearoa New Zealand

To describe the association between metabolic risk factors and the risk of developing long COVID in Aotearoa New Zealand.

Individuals aged 16 years and above who had confirmed or probable COVID-19 before December 2021 were eligible for inclusion. Metabolic risk factors were high body mass index (BMI, ≥25kg/m2), high blood pressure, diabetes, heart disease and stroke. Logistic regression was used to estimate the association between metabolic risk factors and long COVID.

Of the 990 survey respondents, 21.9% met the definition of long COVID. After adjusting for socio-demographic factors, COVID-19 vaccination and hospitalisation, high BMI was strongly associated with long COVID (adjusted odds ratio [aOR] 2.35; 95% confidence interval [CI] 1.33-4.17, p=0.003). There was a suggestion of an association between heart disease and long COVID (aOR 4.31; 95% CI 0.80-23.3, p=0.090). No other metabolic factors were associated with long COVID. Among Māori, no associations were found between high BMI and long COVID compared with underweight/normal BMI.

High BMI as a risk factor adds to accumulating evidence on the aetiology of long COVID.