Long-Term Health Consequences of Post-COVID-19 Condition on Individuals, Families, and Communities: A Mixed-Methods Study in Upper

Abstract

Background Post COVID 19 condition Long COVID is a multisystem syndrome affecting a substantial proportion of COVID 19 survivors worldwide yet evidence on its community level and family level consequences in lower middle income country LMIC settings remains limited Addressing the long term health sequelae of COVID 19 is directly relevant to the United Nations Sustainable Development Goals particularly SDG 3 Good Health and Well Being SDG 10 Reduced Inequalities and SDG 1 No Poverty given the disproportionate burden carried by vulnerable populations and under resourced families

Objectives This study examined 1 the level of long term health impacts of post COVID 19 condition across physical psychological and social dimensions 2 its effects on family roles and community participation and 3 potential primary care strategies to support affected individuals

Methods A mixed methods explanatory sequential design was employed Quantitative data were collected from 255 adults previously diagnosed with COVID 19 and treated at public hospitals in Health Region 8 Upper Northeastern Thailand Udon Thani Nong Khai and Nong Bua Lamphu provinces recruited via convenience sampling A validated questionnaire Cronbachs alpha 0 89 assessed physical psychological and social impacts Semi structured interviews were conducted with a purposive subsample of 20 participants Descriptive statistics independent t tests and one way ANOVA were used for quantitative analysis thematic analysis was applied to qualitative data

Results The overall level of long term impact was moderate M 2 54 SD 0 64 Family level impact was highest M 2 95 followed by community level impact M 2 72 while individual physical and psychological impacts were relatively lower The number of COVID 19 infections was significantly associated with impact severity F 3 246 3 843 p 0 010 participants with three or four infections reported significantly higher impacts than those with a single infection post hoc p 0 05 Qualitative themes included chronic fatigue and role disruption redistribution of caregiving burden and altered social participation

Conclusions Post COVID 19 condition exerts a disproportionate burden at the family and community levels beyond individual health metrics Repeated infection compounds this burden Integrated biopsychosocial informed primary care models that address family caregiving and community reintegration are urgently needed in LMIC contexts These findings have direct implications for SDG 3 4 reducing premature mortality from non communicable and post infectious conditions SDG 3 8 achieving universal health coverage and SDG 10 2 promoting social inclusion for all.