COVID-19 Pandemic
Social support and resilience among individuals with long COVID: Findings from a cross-sectional survey within the Arizona CoVHORT longitudinal cohort study Chidera Ejike* Chidera Ejike Ejike Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO Box 245163, Tucson, Arizona 85724
Objective: We examined whether feeling supported within a social support network is associated with resilience among individuals with Long COVID (LC+), and whether this relationship is modified by symptom burden or functional disability status.
Methods: We analyzed data from 589 LC+ participants in the Arizona CoVHORT with complete data on key variables. Linear regression models estimated unadjusted and adjusted associations between having social support for their LC symptoms (Y/N) and Brief Resilience Scale scores (5 questions, 1-5 Likert scale), controlling for age, gender, race, symptom burden, and disability status. Effect modification by symptom burden and disability was assessed using interaction terms. Multiple imputation using predictive mean matching (20 imputations, 50 iterations) evaluated the robustness of results to missing data.
Results: Among people with LC, having social support was significantly associated with greater resilience scores in unadjusted analyses (β = 0.24, 95% CI: 0.08–0.41, p = 0.005). After adjustment for covariates, the association attenuated but remained positive (β = 0.15, 95% CI: –0.01–0.31, p = 0.064). Neither symptom burden (interaction β = 0.002, 95% CI: -0.016–0.020, p = 0.82) nor disability status (interaction β = -0.20, 95% CI: -0.55–0.15, p = 0.26) significantly modified this relationship. Multiple imputation produced results nearly identical to the complete case analysis (β = 0.154 vs. β = 0.151), indicating strong robustness to missing data.
Conclusions: Social support shows a consistent positive association with resilience among individuals with Long COVID, independent of symptom burden and functional disability. These findings suggest that social support interventions may benefit individuals across the spectrum of Long COVID severity.