Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system

Abstract Objective This study investigated the association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms. Methods We used data from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to assess the association between long-term CO...

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Main Authors: Safa Elkefi, Alana Steffen, Alicia K. Matthews
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23597-0
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author Safa Elkefi
Alana Steffen
Alicia K. Matthews
author_facet Safa Elkefi
Alana Steffen
Alicia K. Matthews
author_sort Safa Elkefi
collection DOAJ
description Abstract Objective This study investigated the association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms. Methods We used data from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to assess the association between long-term COVID symptoms and ACEs, adjusting for demographic characteristics (race/ethnicity, age, and sex). Survey weights were applied. Results Of the 14,560 participants, 46.73% experienced 1–3 ACEs, and 26.81% experienced 4 + ACEs—23.38% experienced long-term COVID-19 symptoms. Blacks (OR = 0.76, P =.002) and Asians (OR = 0.56, P =.009) were less likely than Whites to experience long-term COVID-19, but American Indians (OR = 1.72) were more likely. Adults aged 35–69 had a higher likelihood of long-term symptoms than younger adults (OR = 1.24), whereas those aged 70 or older did not differ from younger adults. Females were also more likely to experience them (OR = 1.61). Exposure to ACEs was positively associated with long-term COVID-19 symptoms. The more adverse events individuals were exposed to, the more risk of long-term COVID-19. Specifically, experience of household substance abuse (OR = 1.14, 95%, P =.008), physical abuse (OR = 1.18, 95%, P =.001), emotional abuse (OR = 1.13, 95%, P =.014), sexual abuse (OR = 1.43, 95%, P <.001), and household mental illness (OR = 1.35, 95%, P <.001) were positively associated with the long-term COVID-19 experience. Conclusions Study findings contribute to the extensive literature demonstrating the negative health consequences of childhood adversities. More adverse events resulted in more risk to experience long term COVID-19 symptoms. Additional research is needed to better understand and intervene in the biological vulnerabilities associated with childhood adversities.
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spelling doaj-art-0ea396d89dde4c3e8fa8d14c61e8e4e02025-08-20T03:46:23ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23597-0Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance systemSafa Elkefi0Alana Steffen1Alicia K. Matthews2School of Nursing, Columbia UniversitySchool of Nursing, University of Illinois ChicagoSchool of Nursing, Columbia UniversityAbstract Objective This study investigated the association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms. Methods We used data from the 2022 Behavioral Risk Factor Surveillance System. Multivariable logistic regression was used to assess the association between long-term COVID symptoms and ACEs, adjusting for demographic characteristics (race/ethnicity, age, and sex). Survey weights were applied. Results Of the 14,560 participants, 46.73% experienced 1–3 ACEs, and 26.81% experienced 4 + ACEs—23.38% experienced long-term COVID-19 symptoms. Blacks (OR = 0.76, P =.002) and Asians (OR = 0.56, P =.009) were less likely than Whites to experience long-term COVID-19, but American Indians (OR = 1.72) were more likely. Adults aged 35–69 had a higher likelihood of long-term symptoms than younger adults (OR = 1.24), whereas those aged 70 or older did not differ from younger adults. Females were also more likely to experience them (OR = 1.61). Exposure to ACEs was positively associated with long-term COVID-19 symptoms. The more adverse events individuals were exposed to, the more risk of long-term COVID-19. Specifically, experience of household substance abuse (OR = 1.14, 95%, P =.008), physical abuse (OR = 1.18, 95%, P =.001), emotional abuse (OR = 1.13, 95%, P =.014), sexual abuse (OR = 1.43, 95%, P <.001), and household mental illness (OR = 1.35, 95%, P <.001) were positively associated with the long-term COVID-19 experience. Conclusions Study findings contribute to the extensive literature demonstrating the negative health consequences of childhood adversities. More adverse events resulted in more risk to experience long term COVID-19 symptoms. Additional research is needed to better understand and intervene in the biological vulnerabilities associated with childhood adversities.https://doi.org/10.1186/s12889-025-23597-0Adverse childhood experiencesChildhood maltreatmentHealth effectsTraumaViolence prevention
spellingShingle Safa Elkefi
Alana Steffen
Alicia K. Matthews
Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
BMC Public Health
Adverse childhood experiences
Childhood maltreatment
Health effects
Trauma
Violence prevention
title Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
title_full Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
title_fullStr Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
title_full_unstemmed Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
title_short Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system
title_sort association between adverse childhood events aces and long term covid 19 symptoms evidence from the 2022 behavioral risk factor surveillance system
topic Adverse childhood experiences
Childhood maltreatment
Health effects
Trauma
Violence prevention
url https://doi.org/10.1186/s12889-025-23597-0
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