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. IdrisSamuel McDonald, Joann G. Elmore, Arjun Venkatesh

Research output: Contribution to journalArticlepeer-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 languageEnglish (US)
Pages (from-to)3192-3209
Number of pages18
JournalJournal of Racial and Ethnic Health Disparities
Volume12
Issue number5
DOIs
StatePublished - Oct 2025
Externally publishedYes

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

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