# Associations between different measures of SARS-CoV-2 infection status and subsequent economic inactivity: A pooled analysis of five longitudinal surveys linked to healthcare records

## TL;DR

This study found no strong link between SARS-CoV-2 infection and economic inactivity in the UK after adjusting for various factors.

## Contribution

The study compares healthcare-recorded and self-reported infection status in relation to economic inactivity during the pandemic.

## Key findings

- Testing positive for SARS-CoV-2 was not significantly associated with economic inactivity.
- Self-reported infection status showed a marginally non-significant association with economic inactivity.
- Record linkage processes may introduce small biases in the results.

## Abstract

Following the acute phase of the COVID-19 pandemic, a record number of people became economically inactive in the UK. We investigated the association between coronavirus infection and subsequent economic inactivity among people employed pre-pandemic, and whether this association varied between self-report versus healthcare recorded infection status.

We pooled data from five longitudinal studies (1970 British Cohort Study, English Longitudinal Study of Ageing, 1958 National Child Development Study, Next Steps, and Understanding Society), in two databases: the UK Longitudinal Linkage Collaboration (UKLLC), which links study data to NHS England records, and the UK Data Service (UKDS), which does not. The study population were aged 25-65 years between April 2020 to March 2021. The outcome was economic inactivity measured at the time of the last survey (November 2020 to March 2021). The exposures were COVID-19 status, indicated by a positive SARS-CoV-2 test in NHS records (UKLLC sample only), or by self-reported measures of coronavirus infection (both samples). Logistic regression models estimated odds ratios (ORs) adjusting for potential confounders including sociodemographic variables and pre-pandemic health.

Within the UKLLC sample (N = 8,174), both a positive SARS-CoV-2 test in NHS records (5.9% of the sample; OR 1.08, 95%CI 0.68-1.73) and self-reported positive tests (6.5% of the sample; OR 1.07, 95%CI 0.68-1.69), were marginally and non-significantly associated with economic inactivity (5.3% of the sample) in adjusted analyses. Within the larger UKDS sample (n = 13,881) reliant on self-reported ascertainment of infection (6.4% of the sample), the coefficient indicated a null relationship (OR 0.98, 95%CI 0.68-1.40) with economic inactivity (5.0% of sample).

Among people employed pre-pandemic, testing positive for SARS-CoV-2 was not associated with increased economic inactivity, although we could not exclude small effects. Ascertaining infection through healthcare records or self-report made little difference to results. However, processes related to record linkage may introduce small biases.