A research team has undertaken a study to better understand the relationship between perceived discrimination and work impairment that are commonly observed in COVID-19 survivors. The study states that discrimination does play an important role in the development of psychological distress and work impairment, and that both discrimination and mental health should be targets of intervention for COVID-19 survivors.

The findings were published in the journal Scientific Reports on Dec. 23, 2022.

Acute COVID-19, an infectious disease that led to a global pandemic, was initially considered to be a time-limited disease. However, grave concerns have recently been raised about the long-term effects of COVID-19. Evidence shows that symptoms such as fatigue, shortness of breath, headaches, and loss of smell or taste may persist for months.

Some COVID-19 survivors experience persistent neuropsychiatric symptoms such as cognitive dysfunction, depression, anxiety, reduced sleep quality, and posttraumatic stress. Even those who had mild cases have experienced functional impairment in their work, social, and home life after they recovered from the initial COVID illness. These long-term symptoms that linger after the acute phase of the illness are well documented.

In addition to the long-term physical and mental effects of COVID-19, scientists are also aware of the discrimination that surrounds the illness. Discrimination affects approximately one-third of COVID-19 survivors. As COVID-19 spread worldwide, fear of contagion and limited knowledge promoted negative attitudes or even discrimination towards people of Asian descent, because of the presumed origin of the virus, as well as toward those suspected to have COVID-19. Anti-Asian discrimination was widespread, particularly in Western countries, and it negatively affected their mental and physical health and well-being. Discrimination influenced their health behaviors as well, leading to low compliance with social-distancing recommendations.

"Since COVID-19 patients may face discrimination against the disease, particularly in the initial phase of the pandemic, we think it is important to understand the mechanisms underlying discrimination, mental health and associated functional impairment in COVID-19 patients," said Shinya Ishii, contributing professor at the Graduate School of Biomedical and Health Sciences, Hiroshima University. The team undertook their study in order to better understand the relationship between discrimination and the adverse long-term effects of COVID-19.

The team conducted a cross-sectional study of data collected from two major COVID-19 hospitals in Hiroshima Prefecture, Japan. Between April 2020 and November 2021, the team recruited 309 patients at the two hospitals. These patients completed standardized questionnaires that included questions about COVID-19 long-term effects, psychological distress, impairments in work performance and perceived discrimination. The majority of patients (62.5%) had experienced one or more long-term effects of COVID-19. Through their analysis, the team determined that COVID-19 long-term effects and discrimination were connected to both a person's mental distress and their ability to work. Next they replicated their findings when examining a smaller subgroup limited to patients with mild COVID-19.

Beyond determining that the long-term symptoms of COVID-19 and discrimination were associated with both mental distress and work impairment, the team's detailed analysis suggested that long-term COVID-19 symptoms may cause mental distress, which in turn affects a person's ability to perform well in the workplace. "Interventions to prevent or reduce work impairment after the recovery from COVID-19 need to include programs to help patients cope with mental distress and public enlightenment to reduce social stigma and discrimination against the infection," said Ishii.

Looking ahead the team acknowledges that the property and behaviors of the coronavirus may change over time, but people with certain characteristics such as older adults will most likely remain vulnerable to the infection. "My ultimate goal is to understand the impact of COVID-19 on such vulnerable groups and develop ways to lessen adverse influences," said Ishii.