LONG COVID THROUGH A ONE HEALTH LENS: CLINICAL, SOCIAL, AND ENVIRONMENTAL FACTORS IN THE AMAZON

Vollständiger Abstract

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Objective: To characterize persistent manifestations following COVID-19 and analyze their associations with clinical, social, environmental, and psychosocial factors among individuals from the Brazilian Amazon from a One Health perspective. Methods: This observational, cross-sectional, analytical epidemiological study included a retrospective component addressing acute SARS-CoV-2 infection. The analysis comprised 98 participants. High symptom burden was exploratorily defined as four or more post-COVID manifestations among participants with usable data. Descriptive and bivariate analyses were performed, with odds ratios (OR) and 95% confidence intervals (95%CI). Selected logistic models were adjusted for age and sex. Statistical significance was set at p<0.05. Results: Persistent manifestations were recorded in 69 of 98 participants (70.4%). Lack of paid employment was associated with high symptom burden (OR=3.43; 95%CI: 1.25–9.40; p=0.017). Each one-point increase in the exploratory social vulnerability index was associated with higher odds of high symptom burden (OR=1.57; 95%CI: 1.02–2.42; p=0.040), but the association was attenuated after adjustment for age and sex (aOR=1.50; 95%CI: 0.97–2.33; p=0.070). COVID-19-related bereavement or loss was associated with high symptom burden (OR=3.63; 95%CI: 1.20–10.94; p=0.036) and remained significant after adjustment (aOR=3.12; 95%CI: 1.00–9.70; p=0.049). Environmental variables and healthcare-seeking were not significantly associated with high symptom burden. Conclusion: The findings suggest that persistent symptom burden following COVID-19 is related to social and psychosocial dimensions, supporting an integrated One Health interpretation of long COVID in the Amazonian context.