U-M study: In Michigan, Women, Hispanics and Low-Income Residents Hit Hardest by Long COVID

by Anna Gustafson

About one in five Michiganders infected with coronavirus develop “Long COVID,” and the often debilitating chronic illness that leaves people struggling with fatigue, cardiac issues and breathing problems. And it is more prevalent among women, Hispanics, people with lower incomes and those over the age of 75, according to a new report from the Michigan COVID-19 Recovery Surveillance Study.

A collaboration between the University of Michigan School of Public Health and the Michigan Department of Health and Human Services (DHHS), the study is an ongoing effort to understand the impact of the virus and recovery from it.

“We need to recognize that there are people who are suffering longterm consequences from having COVID-19, and that’s going to continue to affect them in the future,” study co-author and University of Michigan professor of epidemiology Nancy Fleischer said in a prepared statement. 

“And so the clinics and hospitals and physicians and the public health system need to be aware that this is an ongoing part of the pandemic,” Fleischer continued.

Of the 2,700 adults — all of whom are from Michigan — surveyed for the most recent report, 21.4% were classified as having Long COVID. There’s currently no uniform definition of Long COVID among health and government organizations, so the study’s researchers employed the World Health Organization’s definition of Long COVID as proLonged or persistent symptoms lasting at least 90 days following the onset of COVID-19. 

The researchers found that Long COVID affected 25% of women involved in the most recent study, compared to 17.2% of men. Hispanic respondents were also more likely to report having Long COVID; 30.1% of Hispanics suffered from Long COVID compared to 19.8% of non-Hispanic white respondents. 

The numbers were even higher for older individuals, with 35.2% of people over 75 reporting Long COVID symptoms. People with lower incomes aso had higher rates of Long COVID. Of those making under $25,000, 24.7% reported having Long COVID and 25.2% of people making $25,000 to $49,999 said the same.

In Michigan, COVID cases are back on the rise, with 13,102 new cases in the last week and 64 deaths. In total,  2,619,533 Michiganders tested positive for COVID-19 and 36,982 people have died from the virus. Nationally, there have been 87.8 million confirmed COVID cases and 1,017,964 deaths.

Severe COVID-19 cases are heavily correlated with Long COVID, researchers noted — of those who reported having “very severe” symptoms at the onset of their illness, 50% said they had Long COVID. Just under 6% of those who originally had no symptoms or a mild case of COVID reported having Long COVID, while 16.5% of people with moderate cases reported having Long COVID. 

Jana Hirschtick, an assistant research scientist at the U of M School of Public Health who has been working on the Michigan COVID-19 Recovery Surveillance Study, said they don’t have a clear understanding as to why women are being affected by Long COVID more than men. But Hirschtick noted the chronic condition could be impacting lower income and Hispanic individuals more because they were more likely the ones working frontline and essential jobs during the early days of the pandemic. 

“They have gotten a higher viral dose, leading to more severe illness, leading to Long COVID,” Hirschtick said. 

The Michigan researchers are continuing to do follow-up studies to further investigate who is getting Long COVID and why.

This Michigan study and other research, including from the Centers for Disease Control and Prevention (CDC), paints a picture of a nation grappling with potentially tens of millions of people suffering from Long COVID. 

Long COVID patients previously interviewed by the Advance wove a narrative that’s being told across the country, and world: one of never-ending sickness that’s left them unable to work and facing financial ruin. People have lost jobs, been forced to sell their homes to pay bills, and watched their young children have to care for them as they’re unable to move in bed.

Cara Nader, the owner of Strange Matter Coffee in Lansing, said she has struggled with Long COVID for more than a year. At one point, the symptoms were so bad that she couldn’t catch her breath while speaking a sentence. These days, she “can speak and breathe” but the “fatigue and lung damage are super terrible.”

“The lingering symptoms are really, really hard, and I have no idea how somebody who doesn’t have the privilege I do of running my own business and making my own schedule lives,” Nader said. “If I had to punch a clock and work eight hours a day, I couldn’t do it. I can barely handle a six-hour day these days.”

Hirschtick said their findings point to the importance of “having dedicated clinics for people with Long COVID,” as well as support from the government and workplaces – such as providing disability benefits for those with Long COVID and employers offering time off for Long COVID patients.

“Having dedicated clinics so people can have a more holistic approach to their care is really important,” Hirschtick said. 

Michigan Medicine in Ann Arbor, for example, has a Long COVID clinic.

Access to care at those clinics must be addressed, racial justice advocates recently said during a rally in Lansing.

Those in marginalized groups, like Black mothers, face significant barriers to accessing care at Long COVID clinics, Tia Marie Sanders, a parent and community advocate from Novi, said during the Mothering Justice rally in Lansing last month. For Black mothers struggling with Long COVID, they’re also dealing with the fallout from institutionalized racism – including less pay and unaffordable childcare, Sanders said.

“I meet women every single day at the [University of Michigan] clinic for COVID survivors,” said Sanders, who suffers from Long COVID. “It’s predominantly filled with Black women from all over southeastern Michigan. Their worry is, ‘What am I going to do when this day of pay is gone [after seeking care at the clinic]? How am I going to pay for daycare?”