The role of discrimination in the relation between COVID-19 sequelae, psychological distress, and work impairment in COVID-19 survivors

• Published in: Scientific reports Vol. 12; no. 1; p. 22218
• Main Authors: Ishii, Shinya, Sugiyama, Aya, Ito, Noriaki, Miwata, Kei, Kitahara, Yoshihiro, Okimoto, Mafumi, Kurisu, Akemi, Abe, Kanon, Imada, Hirohito, Akita, Tomoyuki, Kubo, Tatsuhiko, Nagasawa, Akira, Nakanishi, Toshio, Takafuta, Toshiro, Kuwabara, Masao, Tanaka, Junko
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 23.12.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/477; 692/308/174; Complications; Coronaviruses; COVID-19; COVID-19 - complications; Humanities and Social Sciences; Humans; Japan - epidemiology; multidisciplinary; Psychological Distress; Science; Science (multidisciplinary); Stress, Psychological - psychology; Survivors - psychology; Japan
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-26332-6

Perceived discrimination and work impairment are commonly observed in COVID-19 survivors, but their relationship has not been well understood. We aimed to evaluate the role of discrimination in the development of psychological distress and work impairment in COVID-19 survivors. From April 2020 to November 2021, 309 patients were recruited at two designated COVID-19 hospitals in Japan. Participants completed a standardized questionnaire including COVID-19 sequelae, psychological distress, impairments in work performance and perceived discrimination. The majority of participants (62.5%) experienced one or more COVID-19 sequelae. Psychological distress was observed in 36.9% and work impairment in 37.9%. In multivariate logistic regression analyses, COVID-19 sequelae and discrimination were associated with both psychological distress and work impairment. Mediation analysis demonstrated that the direct effect of sequelae on work impairment was non-significant after accounting for psychological distress, suggesting that the effect of sequelae on work impairment was mainly mediated through psychological distress. These findings were replicated in a subgroup analysis limited to patients with mild COVID-19. We conclude that discrimination plays an important role in the development of psychological distress and work impairment, and that both discrimination and psychological distress should be targets of intervention in COVID-19 survivors.