To identify subgroups with similar social determinants of health (SDOH) characteristics using latent class analysis (LCA) and examine their associations with physical and mental health, cognitive function and missed workdays at 3 and 6 months post-SARS-CoV-2 infection. We hypothesised that intersecting SDOH factors would differentially influence COVID-19-related health outcomes across subgroups.

Prospective cohort study from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), with longitudinal data collection and cross-sectional analyses at baseline, 3-month and 6-month follow-ups.

Multicentre registry across eight US academic medical centres (Chicago, Dallas, Houston, Los Angeles, New Haven, Philadelphia, San Francisco and Seattle).

Adults aged ≥18 years, fluent in English or Spanish, with self-reported acute COVID-19 symptoms and a confirmed positive SARS-CoV-2 test within 42 days before enrolment (9 December 2020 to 12 August 2022), and access to an internet-connected device. Exclusions included incarceration, inability to provide informed consent, lack of confirmed SARS-CoV-2 infection or no internet access. Of 3791 eligible participants with complete baseline data, 2897 (76.4%) completed the 3-month follow-up and 2666 (70.3%) completed the 6-month follow-up; most were aged 18–49 years (74–75%), female (66–67%), white (86.6–87.5%) and non-Hispanic (86.6–87.5%).

Prespecified primary outcomes were physical and mental health (Patient-Reported Outcomes Measurement Information System (PROMIS)-29 V.2.1 T-scores for depression, anxiety, fatigue, sleep disturbance, pain interference, physical function and social participation), cognitive function (PROMIS Cognitive Function Short Form 8 T-scores) and missed workdays due to illness (binary: >1 week vs ≤1 week, from a single-item survey). All measures were self-reported and collected at baseline, 3 months and 6 months; no changes from protocol.

LCA identified a 4-class model as optimal (lowest Bayesian Information Criterion (BIC) after evaluating 1–7 class models; significant demographic differences (² p

In this US prospective cohort, SDOH-based subgroups showed persistent disparities in health outcomes post-SARS-CoV-2 infection. Findings highlight the urgent need for intersectional approaches to address systemic inequities in post-COVID-19 recovery.

NCT04610515.

The Swedish Prescribed Drugs and Health Cohort (SPREDH) is a population-based cohort based on merged data from four nationwide health data registers in Sweden. SPREDH provides opportunities to investigate how the use of various medications influences cancer risk, cancer prognosis and many other outcomes. The cohort was recently updated to include a longer follow-up, more patients and additional drugs.

SPREDH currently includes 9 454 340 users of selected medications, who have been followed up for a total of 138 015 003 person-years from 1 July 2005 to 31 December 2024, that is, for up to 191/2 years.

SPREDH includes data from the Swedish Prescribed Drug Register, Patient Register, Cancer Register and Cause of Death Register. Available data include participants’ characteristics, use of medication, healthcare utilisation, diagnoses (including detailed information on cancers), surgical procedures and dates and causes of death. The original version of SPREDH has been used for 10 original studies published in scientific journals, primarily in the fields of gastroenterology and oncology. The updated version of SPREDH includes 1 382 698 participants who have developed a cancer during the follow-up.

The newly updated and extended version of SPREDH enables studies with a wide range of study designs and hypotheses, especially pharmacoepidemiological studies evaluating how the use of certain medications affects the risk and prognosis of cancer and other diseases. It also allows for comparative research across classes of medications, as well as investigations of drug utilisation, safety and effectiveness.