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Sociodemographic factors, biomarkers and comorbidities associated with post-acute COVID-19 sequelae in UK Biobank

Marta Alcalde-Herraiz1, Shahed Iqbal2, Jeffrey J Wallin2

  • 1Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK.

Nature Communications
|July 30, 2025
PubMed

Insights

Long COVID and post-acute complications of SARS-CoV-2 infection (PACS) are linked to sociodemographic factors, biomarkers, and comorbidities. Identifying high-risk groups can inform public health strategies and targeted interventions.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Long-term sequelae of COVID-19, including Long COVID (LC) and post-acute complications of SARS-CoV-2 infection (PACS), present significant public health challenges.
  • Limited therapeutic options necessitate a deeper understanding of risk factors associated with these conditions.

Purpose of the Study:

  • To investigate the association between sociodemographic factors, clinical biomarkers, and comorbidities with the risk of developing Long COVID and PACS.
  • To differentiate risk factors contributing to LC versus PACS.

Main Methods:

  • Two case-control studies were conducted using data from the UK Biobank, including 8,668 participants for LC and 108,407 for PACS.
  • Analysis explored associations between various factors and the incidence of LC (self-reported symptoms) and PACS (clinically diagnosed complications).

Main Results:

  • Age and sex showed opposing associations with LC and PACS.
  • Obesity, socioeconomic deprivation, elevated C-reactive protein, triglycerides, HbA1c, cystatin C, urate, alanine aminotransferase, and comorbidities like CKD and COPD were associated with LC.
  • Decreased HDL cholesterol and IGF-1 were also linked to LC. Most identified factors for LC were also significant for PACS, with exceptions for alanine aminotransferase and vitamin D.

Conclusions:

  • Sociodemographic factors, biomarkers, and comorbidities play a role in the development of Long COVID and PACS.
  • Findings suggest potential mechanistic differences between LC and PACS.
  • Identifying high-risk individuals can guide targeted public health interventions, such as vaccination strategies.

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