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

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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

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Elkefi, S., Steffen, A., & Matthews, A. K. (2025). Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-23597-0

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