NATIONAL surveillance data has found that individuals who experienced adverse childhood events (ACEs) face significantly higher odds of developing long-term COVID symptoms. Drawing on 2022 data from the Behavioral Risk Factor Surveillance System, the research offers one of the most comprehensive looks at how early life trauma may influence post-COVID outcomes in adulthood.
Among 14,560 U.S. adults surveyed, nearly one in four reported long-term COVID symptoms. The findings show a strong, graded association between the number of childhood adversities and the likelihood of experiencing persistent symptoms after COVID-19 infection. Those with four or more ACEs were significantly more likely to report long COVID compared to those with none.
Specific ACEs most strongly associated with long COVID included sexual abuse (odds ratio [OR]=1.43), household mental illness (OR=1.35), physical abuse (OR=1.18), emotional abuse (OR=1.13), and household substance abuse (OR=1.14). The association held even after adjusting for age, sex, and race/ethnicity.
Demographic factors also played a role. Females were more likely to report long COVID symptoms (OR=1.61). Adults aged 35 to 69 showed higher odds than younger adults, while those aged 70 and older did not differ significantly. Racial differences emerged as well, with Black and Asian respondents less likely to report long COVID than White individuals, and American Indian respondents more likely (OR=1.72).
The study emphasizes the long-term health impacts of early trauma and underscores the need for clinicians to consider psychosocial history when evaluating patients with prolonged post-COVID symptoms. The authors call for additional research to explore biological pathways linking childhood adversity with immune and inflammatory responses that may underlie persistent COVID-related conditions.
Reference:
Elkefi S et al. Association between Adverse Childhood Events (ACEs) and long-term COVID-19 symptoms: evidence from the 2022 behavioral risk factor surveillance system. BMC Public Health. 2025;25(1):2448.
