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Abstract
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.
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Details
1 Hiroshima University, Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Minami-ku, Hiroshima, Japan (GRID:grid.257022.0) (ISNI:0000 0000 8711 3200)
2 Hiroshima University, Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Minami-ku, Hiroshima, Japan (GRID:grid.257022.0) (ISNI:0000 0000 8711 3200)
3 Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan (GRID:grid.257022.0)
4 Hiroshima University, Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan (GRID:grid.257022.0) (ISNI:0000 0000 8711 3200)
5 Miyoshi Central Hospital, Hiroshima, Japan (GRID:grid.257022.0)
6 Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan (GRID:grid.257022.0)