213 - Associations between Adverse Childhood Experiences, COVID and Long COVID: A population-based study

Objectives: To evaluate the association between Adverse Childhood Experiences (ACEs) and long COVID.

Design: We used data from the 2022 Behavioral Risk Factor Surveillance System, a cross-sectional population-based survey to assess the association between ACEs, COVID, and long COVID in 61,945 adults. Participants were asked about exposure to 8 ACE categories prior to age 18, including experiences of abuse and family dysfunction. Participants were considered to have had COVID if they reported a positive home test or were diagnosed by a health care professional. In those reporting COVID, long COVID was defined as having symptoms for longer than 3 months that the participant did not have before having COVID. The complex survey design and survey weights were accounted for in all analyses. Analyses included descriptive statistics and logistic regression to control for age, sex and race/ethnicity.

Results: Overall, 33.3% (32.6-34.0) of participants reported having had COVID; the percent reporting COVID increased from 28.7% (27.4-29.9) for those reporting no ACEs to 40.6% (38.9-42.4) in those reporting ≥4 ACEs. Of those who reported COVID (n = 19, 403), 23.5% (22.3-24.7) developed long COVID. Again, the percentage increased with increasing ACEs count, from 17.2% (15.5-18.9) of those with no ACEs to 30.6% (28.1-33.2) for those with ≥4 ACEs. In logistic regressing analyses controlling for demographic variables, the odds of COVID increased with higher ACE count, and was 1.38 (1.25-1.52) for those with ≥4 ACEs compared to those with no ACEs. Finally, the increase in the odds of developing long COVID compared to those with no ACEs was 1.3 (1.1-1.6) for those reporting 1 ACE to 2.1 (1.7-2.5) for those reporting ≥4 ACEs.

Conclusions: Participants with high ACE exposure appear to be more vulnerable to long COVID. Further research is necessary to understand the mechanisms underlying this association.