Background: socio-economic deprivation is well recognised as a risk factor for developing COVID-19. However, the impact of COVID-19 on economic vulnerability has not previously been characterised.

Objective: To determine whether COVID-19 has a significant impact on adequacy of household income to meet basic needs (primary outcome) and work absence due to sickness (secondary outcome), both at the onset of illness (acutely) and subsequently (long-term).

Design: Multivariate mixed regression analysis of self-reported data from monthly on-line questionnaires, completed 1st May 2020 to 28th October 2021, adjusting for baseline characteristics including age, sex, socioeconomic status and self-rated health.

Setting and Participants: Participants (n=16,910) were UK residents aged 16 years or over participating in a national longitudinal study of COVID-19 (COVIDENCE UK).

Results: Incident COVID-19 was independently associated with increased odds of participants reporting household income as being inadequate to meet their basic needs, both acutely (adjusted odds ratio [aOR) 1.39, 95% confidence interval [CI] 1.12–1.73) and in the long-term (aOR 1.15, 95% CI 1.00–1.33). Exploratory analysis revealed the long-term association to be restricted to those who reported ‘long COVID’, defined as the presence of symptoms lasting more than 4 weeks after the acute episode (aOR 1.39, 95% CI 1.10-1.77). Incident COVID-19 associated with increased odds of reporting sickness absence from work in the long-term (aOR 5.29, 95% CI 2.76-10.10) but not acutely (aOR 1.34, 95% CI 0.52-3.49).

Conclusions: We demonstrate an independent association between COVID-19 and increased risk of economic vulnerability, both acutely and in the long-term. Since socioeconomic deprivation also increases risk of COVID-19, our findings suggest a bidirectional relationship between COVID-19 and deprivation. This may generate a 'vicious cycle' of increased vulnerability, impaired health, and poor economic outcomes.


This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Cite as

Williamson, A., Tydeman, F., Miners, A., Pyper, K. & Martineau, A. 2022, 'Short-term and long-term impacts of COVID-19 on economic vulnerability: a population-based longitudinal study (COVIDENCE UK)', BMJ Open, 12(8), article no: e065083. https://doi.org/10.1136/bmjopen-2022-065083

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Last updated: 30 August 2022
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