# Long COVID and Associated Factors Among Chinese Residents Aged 16 Years and Older in Canada: A Cross-Sectional Online Study

## TL;DR

This study examines long COVID among Chinese residents in Canada, finding that 12.83% experienced it, with factors like multiple infections and traditional Chinese medicine use being linked.

## Contribution

The study is the first to investigate long COVID among Chinese residents in Canada, identifying unique risk and protective factors.

## Key findings

- 12.83% of participants reported long COVID with an average duration of 5.31 months.
- Multiple infections and traditional Chinese medicine use were strongly associated with long COVID.
- Good health status was a protective factor against long COVID.

## Abstract

As the COVID-19 pandemic evolved, long COVID emerged as a significant threat to public health, characterized by one or more persistent symptoms impacting organ systems beyond 12 weeks of infection. Informative research has been derived from assessments of long COVID among the Chinese populace. However, none of these studies considered the COVID-19 experience of Chinese residents in Canada. Objectives: We aimed to fill this literature gap by delineating the long COVID experience, prevalence, and associated factors among a sample of Chinese residing in Canada during the pandemic. Methods: The present study employed a cross-sectional online survey questionnaire distributed to a sample of Canadian Chinese using a convenience sampling procedure from 22 December 2022 to 15 February 2023. Respondents were probed for sociodemographic background and health-, COVID-, and vaccine-related characteristics. Logistic LASSO regression was used for model building, and multivariate logistic regression was used to identify factors associated with developing long COVID. Results: Among 491 eligible participants, 63 (12.83%) reported experiencing long COVID with a mean duration of 5.31 (95% CI: 4.06–6.57) months and major symptoms including difficulty concentrating (21.67%), pain/discomfort (15.00%), as well as anxiety/depression (8.33%). Our final model identified significant associations between long COVID and two or more COVID-19 infections (OR = 23.725, 95% CI: 5.098–110.398, p < 0.0001), very severe/severe symptoms (OR = 3.177, 95% CI: 1.160–8.702, p = 0.0246), over-the-counter medicine (OR = 2.473, 95% CI: 1.035–5.909, p = 0.0416), and traditional Chinese medicine (OR = 8.259, 95% CI: 3.016–22.620, p < 0.0001). Further, we identified a significant protective effect of very good/good health status (OR = 0.247, 95% CI: 0.112–0.544, p = 0.0005). Conclusions: Long COVID effected a notable proportion of Canadian Chinese for a prolonged period during the COVID-19 pandemic. Our findings underscore the importance of preexisting health status and reinfection prevention when managing long COVID. Moreover, our work indicates an association between using over-the-counter medicine or traditional Chinese medicine and long COVID experience among Canadian Chinese.