Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study

Han T Vo; Thang V Dao; Tinh X Do; Binh N Do; Tan T Nguyen; Khue M Pham; Vinh H Vu; Linh V Pham; Lien T H Nguyen; Lan T H Le; Hoang C Nguyen; Tuan V Tran; Trung H Nguyen; Anh T Nguyen; Hoan V Nguyen; Phuoc B Nguyen; Thu T M Pham; Tien D Dao; Thuy T Le; Thao T P Nguyen; Cuong Q Tran; Kien T Nguyen; Tuyen V Duong

doi:10.1016/j.puhe.2024.12.032

Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study

Han T Vo, Thang V Dao, Tinh X Do, Binh N Do, Tan T Nguyen, Khue M Pham, Vinh H Vu, Linh V Pham, Lien T H Nguyen, Lan T H Le, Hoang C Nguyen, Tuan V Tran, Trung H Nguyen, Anh T Nguyen, Hoan V Nguyen, Phuoc B Nguyen, Thu T M Pham, Tien D Dao, Thuy T Le, Thao T P NguyenCuong Q Tran, Kien T Nguyen, Tuyen V Duong

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

Abstract

OBJECTIVES: We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.

STUDY DESIGN: An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.

METHODS: A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.

RESULTS: Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94-0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98-0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99-1.03]; p = 0.332).

CONCLUSIONS: In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.

Original language	English
Pages (from-to)	87-93
Number of pages	7
Journal	Public Health
Volume	239
DOIs	https://doi.org/10.1016/j.puhe.2024.12.032
Publication status	E-pub ahead of print - Jan 10 2025

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Vo, H. T., Dao, T. V., Do, T. X., Do, B. N., Nguyen, T. T., Pham, K. M., Vu, V. H., Pham, L. V., Nguyen, L. T. H., Le, L. T. H., Nguyen, H. C., Tran, T. V., Nguyen, T. H., Nguyen, A. T., Nguyen, H. V., Nguyen, P. B., Pham, T. T. M., Dao, T. D., Le, T. T., ... Duong, T. V. (2025). Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study. Public Health, 239, 87-93. Advance online publication. https://doi.org/10.1016/j.puhe.2024.12.032

Vo, HT, Dao, TV, Do, TX, Do, BN, Nguyen, TT, Pham, KM, Vu, VH, Pham, LV, Nguyen, LTH, Le, LTH, Nguyen, HC, Tran, TV, Nguyen, TH, Nguyen, AT, Nguyen, HV, Nguyen, PB, Pham, TTM, Dao, TD, Le, TT, Nguyen, TTP, Tran, CQ, Nguyen, KT & Duong, TV 2025, 'Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study', Public Health, vol. 239, pp. 87-93. https://doi.org/10.1016/j.puhe.2024.12.032

@article{4dd8dcd5fdb14ef9b947e9fa09b044e7,

title = "Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study",

abstract = "OBJECTIVES: We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.STUDY DESIGN: An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.METHODS: A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.RESULTS: Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94-0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98-0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99-1.03]; p = 0.332).CONCLUSIONS: In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.",

keywords = "COVID-19 survivors, Health literacy, Hospitalized, Long COVID, Underlying health conditions, Vietnam",

author = "Vo, {Han T} and Dao, {Thang V} and Do, {Tinh X} and Do, {Binh N} and Nguyen, {Tan T} and Pham, {Khue M} and Vu, {Vinh H} and Pham, {Linh V} and Nguyen, {Lien T H} and Le, {Lan T H} and Nguyen, {Hoang C} and Tran, {Tuan V} and Nguyen, {Trung H} and Nguyen, {Anh T} and Nguyen, {Hoan V} and Nguyen, {Phuoc B} and Pham, {Thu T M} and Dao, {Tien D} and Le, {Thuy T} and Nguyen, {Thao T P} and Tran, {Cuong Q} and Nguyen, {Kien T} and Duong, {Tuyen V}",

year = "2025",

month = jan,

day = "10",

doi = "10.1016/j.puhe.2024.12.032",

language = "English",

volume = "239",

pages = "87--93",

journal = "Public Health",

issn = "0033-3506",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy

T2 - A multi-center study

AU - Vo, Han T

AU - Dao, Thang V

AU - Do, Tinh X

AU - Do, Binh N

AU - Nguyen, Tan T

AU - Pham, Khue M

AU - Vu, Vinh H

AU - Pham, Linh V

AU - Nguyen, Lien T H

AU - Le, Lan T H

AU - Nguyen, Hoang C

AU - Tran, Tuan V

AU - Nguyen, Trung H

AU - Nguyen, Anh T

AU - Nguyen, Hoan V

AU - Nguyen, Phuoc B

AU - Pham, Thu T M

AU - Dao, Tien D

AU - Le, Thuy T

AU - Nguyen, Thao T P

AU - Tran, Cuong Q

AU - Nguyen, Kien T

AU - Duong, Tuyen V

PY - 2025/1/10

Y1 - 2025/1/10

N2 - OBJECTIVES: We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.STUDY DESIGN: An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.METHODS: A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.RESULTS: Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94-0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98-0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99-1.03]; p = 0.332).CONCLUSIONS: In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.

AB - OBJECTIVES: We investigated the effect modification of health literacy (HL) in ameliorating the negative impact of underlying health conditions (UHC) on long COVID among non-hospitalized and hospitalized survivors.STUDY DESIGN: An online cross-sectional study was conducted in Vietnam from December 2021 to October 2022.METHODS: A sample of 4507 participants recruited from 18 hospitals and health centers were those aged 18 or older, had contracted COVID-19 for at least 28 days, and were not in the acute phase of reinfection. Participants reported their long COVID symptoms, UHC, health literacy, socio-demographics, clinical parameters, the COVID-19 impact battery disability scale, and health-related behaviors. The logistic regression models were used to examine the associations and interactions.RESULTS: Underlying health conditions were associated with a higher likelihood of long COVID in non-hospitalized participants (adjusted odds ratio, aOR = 2.10 [1.61, 2.61]; p < 0.001), and hospitalized ones (aOR = 2.26 [1.87, 2.73]; p < 0.001). In non-hospitalized participants, higher HL scores were significantly linked to a reduced likelihood of experiencing long COVID (aOR = 0.96 [0.95, 0.97]; p < 0.001). Furthermore, HL moderated the adverse effect of underlying health conditions (UHC) on long COVID in this group (aOR = 0.97 [0.94-0.99]; p = 0.042). In hospitalized participants, although higher HL scores were also associated with a lower risk of long COVID (aOR = 0.99 [0.98-0.99]; p = 0.036), HL did not significantly mitigate the negative impact of UHC on long COVID (aOR = 1.01 [0.99-1.03]; p = 0.332).CONCLUSIONS: In non-hospitalized individuals, high health literacy ameliorated the negative impact of UHC on long COVID. Such effects of health literacy were not observed in hospitalized COVID-19 survivors.

KW - COVID-19 survivors

KW - Health literacy

KW - Hospitalized

KW - Long COVID

KW - Underlying health conditions

KW - Vietnam

U2 - 10.1016/j.puhe.2024.12.032

DO - 10.1016/j.puhe.2024.12.032

M3 - Article

C2 - 39798220

SN - 0033-3506

VL - 239

SP - 87

EP - 93

JO - Public Health

JF - Public Health

ER -

Association between underlying health conditions and long COVID among non-hospitalized and hospitalized individuals as modified by health literacy: A multi-center study

Abstract

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