long covid and subjective wellbeing among U.S. working-age adults

Long COVID symptoms can persist for months or years, impeding daily functioning, employment, and social relationships. While prior research links long COVID to adverse clinical mental health outcomes, less attention has been paid to broader subjective wellbeing-including life satisfaction, happiness, and hopefulness. This study examined associations between long COVID symptoms and subjective wellbeing among U.S. working-age adults, including whether associations differ by sex.

This cross-sectional analysis used data from the 2023 and 2024 National Wellbeing Surveys (NWS), a weighted survey of U.S. adults aged 18-64 (N = 13,880). We operationalized long COVID as having experienced any of eight symptoms (tiredness or fatigue, difficulty thinking or concentrating or forgetfulness/memory problems, difficulty breathing or shortness of breath, joint or muscle pain, fast-beating or pounding heart or chest pain, dizziness on standing, depression, anxiety, or mood changes, and symptoms that get worse after physical or mental activities), a symptom count, and a dose-response specification. Subjective wellbeing measures include life satisfaction, happiness, and hopefulness. We estimated regression models for the full sample and separately by sex, adjusting for sociodemographic and economic characteristics. We reported results using point estimates, odds ratios (ORs) and 95% Confidence Intervals (95% CI).

Among all respondents, 39% reported at least one long COVID symptom, with females reporting higher prevalence (43.2%) than males (34.4%) and more symptoms (mean = 1.91) than males (mean = 1.39). In the full sample, long COVID was significantly associated with lower wellbeing across all three subjective wellbeing outcomes for both sexes. A dose-response pattern was observed: having had any symptoms and having more symptoms was associated with worse wellbeing. Among individual symptoms, depression or anxiety and cognitive difficulties exhibited the strongest negative associations with subjective wellbeing. Despite reporting higher long COVID prevalence, females had higher predicted life satisfaction and hopefulness than males at most levels of long COVID severity.

In this national sample of U.S. working-age adults, long COVID was associated with reduced subjective wellbeing across multiple operationalizations of long COVID and dimensions of wellbeing for both males and females. These findings underscore that the burden of long COVID extends beyond clinical mental health outcomes to broader evaluative and experiential dimensions of wellbeing, suggesting long COVID may represent an important population health risk for diminished quality of life.