Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic

Mandy J. Hill; Ryan M. Huebinger; Imtiaz Ebna Mannan; Huihui Yu; Lauren E. Wisk; Kelli N. O’Laughlin; Nicole L. Gentile; Kari A. Stephens; Michael Gottlieb; Robert A. Weinstein; Katherine Koo; Michelle Santangelo; Sharon Saydah; Erica S. Spatz; Zhenqiu Lin; Kevin Schaeffer; Efrat Kean; Juan Carlos C. Montoy; Robert M. Rodriguez; Ahamed H. Idris; Samuel McDonald; Joann G. Elmore; Arjun Venkatesh

doi:10.1007/s40615-024-02124-8

Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic

Mandy J. Hill
, Ryan M. Huebinger
, Imtiaz Ebna Mannan
, Huihui Yu
, Lauren E. Wisk
, Kelli N. O’Laughlin
, Nicole L. Gentile
, Kari A. Stephens
, Michael Gottlieb
, Robert A. Weinstein
, Katherine Koo
, Michelle Santangelo
, Sharon Saydah
, Erica S. Spatz
, Zhenqiu Lin
, Kevin Schaeffer
, Efrat Kean
, Juan Carlos C. Montoy
, Robert M. Rodriguez
, Ahamed H. Idris

Samuel McDonald, Joann G. Elmore, Arjun Venkatesh

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Differences in acute COVID-19 associated morbidity based on race, ethnicity, and gender have been well described; however, less is known about differences in subsequent longer term health-related quality of life and well-being. Methods: This prospective cohort study included symptomatic adults tested for SARS-CoV-2 who completed baseline and 3-month follow-up surveys. Using the PROMIS-29 tool, a validated measure of health and well-being, we compared outcomes at 3 months and change in outcomes from baseline to 3 months among groups with different races, ethnicities, and/or sexes. Results: Among 6044 participants, 4113 (3202 COVID +) were included. Among COVID + participants, compared to non-Hispanic White participants, Black participants had better PROMIS T-scores for cognitive function (3.6 [1.1, 6.2]) and fatigue (− 4.3 [− 6.6, − 2.0]) at 3 months and experienced more improvement in fatigue over 3 months (− 2.7 [− 4.7, − 0.8]). At 3 months, compared with males, females had worse PROMIS T-scores for cognitive function (− 4.1 [− 5.6, − 2.6]), physical function (− 2.1 [− 3.1, − 1.0]), social participation (− 2.8 [− 4.2, − 1.5]), anxiety (2.8 [1.5, 4.1]), fatigue (5.1 [3.7, 6.4]), and pain interference (2.0 [0.9, 3.2]). Females experienced less improvement in fatigue over 3 months (3.1 [2.0, 4.3]). Transgender/non-binary/other gender participants had worse 3-month scores in all domains except for sleep disturbance and pain interference. Conclusions: Three months after the initial COVID-19 infection, Black participants reported better cognitive function and fatigue, while females and other gender minoritized groups experienced lower well-being. Future studies are necessary to better understand how and why social constructs, specifically race, ethnicity, and gender, influence differences in COVID-19-related health outcomes. Trials Registration ClinicalTrials.gov

Original language	English (US)
Pages (from-to)	3192-3209
Number of pages	18
Journal	Journal of Racial and Ethnic Health Disparities
Volume	12
Issue number	5
DOIs	https://doi.org/10.1007/s40615-024-02124-8
State	Published - Oct 2025
Externally published	Yes

Keywords

COVID-19
Coronavirus
Long COVID
PROMIS outcomes
Registry
SARS-CoV-2

ASJC Scopus subject areas

Health(social science)
Anthropology
Sociology and Political Science
Health Policy
Public Health, Environmental and Occupational Health

Access to Document

10.1007/s40615-024-02124-8

Cite this

Hill, M. J., Huebinger, R. M., Ebna Mannan, I., Yu, H., Wisk, L. E., O’Laughlin, K. N., Gentile, N. L., Stephens, K. A., Gottlieb, M., Weinstein, R. A., Koo, K., Santangelo, M., Saydah, S., Spatz, E. S., Lin, Z., Schaeffer, K., Kean, E., Montoy, J. C. C., Rodriguez, R. M., ... Venkatesh, A. (2025). Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic. Journal of Racial and Ethnic Health Disparities, 12(5), 3192-3209. https://doi.org/10.1007/s40615-024-02124-8

Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic. / Hill, Mandy J.; Huebinger, Ryan M.; Ebna Mannan, Imtiaz et al.
In: Journal of Racial and Ethnic Health Disparities, Vol. 12, No. 5, 10.2025, p. 3192-3209.

Research output: Contribution to journal › Article › peer-review

Hill, MJ, Huebinger, RM, Ebna Mannan, I, Yu, H, Wisk, LE, O’Laughlin, KN, Gentile, NL, Stephens, KA, Gottlieb, M, Weinstein, RA, Koo, K, Santangelo, M, Saydah, S, Spatz, ES, Lin, Z, Schaeffer, K, Kean, E, Montoy, JCC, Rodriguez, RM, Idris, AH, McDonald, S, Elmore, JG & Venkatesh, A 2025, 'Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic', Journal of Racial and Ethnic Health Disparities, vol. 12, no. 5, pp. 3192-3209. https://doi.org/10.1007/s40615-024-02124-8

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title = "Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic",

abstract = "Background: Differences in acute COVID-19 associated morbidity based on race, ethnicity, and gender have been well described; however, less is known about differences in subsequent longer term health-related quality of life and well-being. Methods: This prospective cohort study included symptomatic adults tested for SARS-CoV-2 who completed baseline and 3-month follow-up surveys. Using the PROMIS-29 tool, a validated measure of health and well-being, we compared outcomes at 3 months and change in outcomes from baseline to 3 months among groups with different races, ethnicities, and/or sexes. Results: Among 6044 participants, 4113 (3202 COVID +) were included. Among COVID + participants, compared to non-Hispanic White participants, Black participants had better PROMIS T-scores for cognitive function (3.6 [1.1, 6.2]) and fatigue (− 4.3 [− 6.6, − 2.0]) at 3 months and experienced more improvement in fatigue over 3 months (− 2.7 [− 4.7, − 0.8]). At 3 months, compared with males, females had worse PROMIS T-scores for cognitive function (− 4.1 [− 5.6, − 2.6]), physical function (− 2.1 [− 3.1, − 1.0]), social participation (− 2.8 [− 4.2, − 1.5]), anxiety (2.8 [1.5, 4.1]), fatigue (5.1 [3.7, 6.4]), and pain interference (2.0 [0.9, 3.2]). Females experienced less improvement in fatigue over 3 months (3.1 [2.0, 4.3]). Transgender/non-binary/other gender participants had worse 3-month scores in all domains except for sleep disturbance and pain interference. Conclusions: Three months after the initial COVID-19 infection, Black participants reported better cognitive function and fatigue, while females and other gender minoritized groups experienced lower well-being. Future studies are necessary to better understand how and why social constructs, specifically race, ethnicity, and gender, influence differences in COVID-19-related health outcomes. Trials Registration ClinicalTrials.gov",

keywords = "COVID-19, Coronavirus, Long COVID, PROMIS outcomes, Registry, SARS-CoV-2",

author = "Hill, \{Mandy J.\} and Huebinger, \{Ryan M.\} and \{Ebna Mannan\}, Imtiaz and Huihui Yu and Wisk, \{Lauren E.\} and O{\textquoteright}Laughlin, \{Kelli N.\} and Gentile, \{Nicole L.\} and Stephens, \{Kari A.\} and Michael Gottlieb and Weinstein, \{Robert A.\} and Katherine Koo and Michelle Santangelo and Sharon Saydah and Spatz, \{Erica S.\} and Zhenqiu Lin and Kevin Schaeffer and Efrat Kean and Montoy, \{Juan Carlos C.\} and Rodriguez, \{Robert M.\} and Idris, \{Ahamed H.\} and Samuel McDonald and Elmore, \{Joann G.\} and Arjun Venkatesh",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2025",

month = oct,

doi = "10.1007/s40615-024-02124-8",

language = "English (US)",

volume = "12",

pages = "3192--3209",

journal = "Journal of Racial and Ethnic Health Disparities",

issn = "2197-3792",

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number = "5",

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TY - JOUR

T1 - Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic

AU - Hill, Mandy J.

AU - Huebinger, Ryan M.

AU - Ebna Mannan, Imtiaz

AU - Yu, Huihui

AU - Wisk, Lauren E.

AU - O’Laughlin, Kelli N.

AU - Gentile, Nicole L.

AU - Stephens, Kari A.

AU - Gottlieb, Michael

AU - Weinstein, Robert A.

AU - Koo, Katherine

AU - Santangelo, Michelle

AU - Saydah, Sharon

AU - Spatz, Erica S.

AU - Lin, Zhenqiu

AU - Schaeffer, Kevin

AU - Kean, Efrat

AU - Montoy, Juan Carlos C.

AU - Rodriguez, Robert M.

AU - Idris, Ahamed H.

AU - McDonald, Samuel

AU - Elmore, Joann G.

AU - Venkatesh, Arjun

PY - 2025/10

Y1 - 2025/10

N2 - Background: Differences in acute COVID-19 associated morbidity based on race, ethnicity, and gender have been well described; however, less is known about differences in subsequent longer term health-related quality of life and well-being. Methods: This prospective cohort study included symptomatic adults tested for SARS-CoV-2 who completed baseline and 3-month follow-up surveys. Using the PROMIS-29 tool, a validated measure of health and well-being, we compared outcomes at 3 months and change in outcomes from baseline to 3 months among groups with different races, ethnicities, and/or sexes. Results: Among 6044 participants, 4113 (3202 COVID +) were included. Among COVID + participants, compared to non-Hispanic White participants, Black participants had better PROMIS T-scores for cognitive function (3.6 [1.1, 6.2]) and fatigue (− 4.3 [− 6.6, − 2.0]) at 3 months and experienced more improvement in fatigue over 3 months (− 2.7 [− 4.7, − 0.8]). At 3 months, compared with males, females had worse PROMIS T-scores for cognitive function (− 4.1 [− 5.6, − 2.6]), physical function (− 2.1 [− 3.1, − 1.0]), social participation (− 2.8 [− 4.2, − 1.5]), anxiety (2.8 [1.5, 4.1]), fatigue (5.1 [3.7, 6.4]), and pain interference (2.0 [0.9, 3.2]). Females experienced less improvement in fatigue over 3 months (3.1 [2.0, 4.3]). Transgender/non-binary/other gender participants had worse 3-month scores in all domains except for sleep disturbance and pain interference. Conclusions: Three months after the initial COVID-19 infection, Black participants reported better cognitive function and fatigue, while females and other gender minoritized groups experienced lower well-being. Future studies are necessary to better understand how and why social constructs, specifically race, ethnicity, and gender, influence differences in COVID-19-related health outcomes. Trials Registration ClinicalTrials.gov

AB - Background: Differences in acute COVID-19 associated morbidity based on race, ethnicity, and gender have been well described; however, less is known about differences in subsequent longer term health-related quality of life and well-being. Methods: This prospective cohort study included symptomatic adults tested for SARS-CoV-2 who completed baseline and 3-month follow-up surveys. Using the PROMIS-29 tool, a validated measure of health and well-being, we compared outcomes at 3 months and change in outcomes from baseline to 3 months among groups with different races, ethnicities, and/or sexes. Results: Among 6044 participants, 4113 (3202 COVID +) were included. Among COVID + participants, compared to non-Hispanic White participants, Black participants had better PROMIS T-scores for cognitive function (3.6 [1.1, 6.2]) and fatigue (− 4.3 [− 6.6, − 2.0]) at 3 months and experienced more improvement in fatigue over 3 months (− 2.7 [− 4.7, − 0.8]). At 3 months, compared with males, females had worse PROMIS T-scores for cognitive function (− 4.1 [− 5.6, − 2.6]), physical function (− 2.1 [− 3.1, − 1.0]), social participation (− 2.8 [− 4.2, − 1.5]), anxiety (2.8 [1.5, 4.1]), fatigue (5.1 [3.7, 6.4]), and pain interference (2.0 [0.9, 3.2]). Females experienced less improvement in fatigue over 3 months (3.1 [2.0, 4.3]). Transgender/non-binary/other gender participants had worse 3-month scores in all domains except for sleep disturbance and pain interference. Conclusions: Three months after the initial COVID-19 infection, Black participants reported better cognitive function and fatigue, while females and other gender minoritized groups experienced lower well-being. Future studies are necessary to better understand how and why social constructs, specifically race, ethnicity, and gender, influence differences in COVID-19-related health outcomes. Trials Registration ClinicalTrials.gov

KW - COVID-19

KW - Coronavirus

KW - Long COVID

KW - PROMIS outcomes

KW - Registry

KW - SARS-CoV-2

UR - https://www.scopus.com/pages/publications/85201830518

UR - https://www.scopus.com/pages/publications/85201830518#tab=citedBy

U2 - 10.1007/s40615-024-02124-8

DO - 10.1007/s40615-024-02124-8

M3 - Article

C2 - 39172356

AN - SCOPUS:85201830518

SN - 2197-3792

VL - 12

SP - 3192

EP - 3209

JO - Journal of Racial and Ethnic Health Disparities

JF - Journal of Racial and Ethnic Health Disparities

IS - 5

ER -

Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic

Abstract

Keywords

ASJC Scopus subject areas

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