Post-COVID Condition and Disparities in Daily Functional Activities: Findings from Virus Watch - a prospective community cohort study

Background: Post-COVID Condition (PCC) is increasingly recognised to impair daily functioning, particularly work ability, cognitive function, and self-care. This analysis investigates the role of deprivation, migration status, and ethnicity in experiencing limitations in six functional activities: work/education, concentration, self-care, caring for others, performing necessary activities outside the house, and engaging in enjoyable activities. Methods: We analysed data from Virus Watch, a prospective community cohort study in England, identifying 776 individuals (<18 years) with PCC between February 2020 and March 2024. We used logistic regression to assess how deprivation, migration and ethnic minority status were associated with the odds of experiencing each functional limitation, adjusting for sociodemographic variables. Findings: Individuals with PCC in IMD 1 (the most deprived quintile) had higher adjusted odds of limitations in work/education, concentration, self-care, and doing necessary activities outside the house than those in IMD 5 (the least deprived) (adjusted odds ratio (aOR) range: 2.20-2.85). Those in IMD 2 also experienced increased odds of limitations in work/education and concentration compared to those in IMD 5. We found no evidence of associations between migration status or minority ethnicity with functional limitations among PCC individuals. Interpretation: Our findings indicate that socioeconomic deprivation, rather than migration status or ethnicity, is the primary driver of functional limitations within this cohort. Functional limitations may perpetuate cycles of deprivation and further exacerbate health inequalities. Equitable access to rehabilitation and support services, alongside workplace and educational adaptations, is needed to address the functional limitations of those affected by PCC.