The association between Post-COVID syndrome and self-stigma among the adult Israeli population during the COVID-19 pandemic

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BACKGROUND: In the wake of the SARS-CoV-2 pandemic, a novel condition, termed Post-COVID Syndrome (PCS) has emerged, impacting a significant portion of the global population. Concurrently, the global impact of the virus has extended beyond physical health, leading to the emergence of COVID-19 related stigma. This study investigates the link between PCS and self-stigma, shedding light on this underexplored phenomenon. OBJECTIVE: To examine whether exposure to PCS is associated with higher levels of COVID-19–related self-stigma and to identify potential risk factors. METHODS: A retrospective observational cohort study among adult Israeli citizens who tested positive for COVID-19 in a polymerase chain reaction (PCR) test at least twelve weeks before the interview, serving as a pivotal criterion for diagnosing PCS based on self-reported symptoms. The study sample was drawn from the Israeli Ministry of Health’s comprehensive COVID-19 database and data were obtained via a computerized telephone questionnaire conducted from June through December 2021. The quantification of self-stigma entailed the utilization of the COVID-19 self-stigma scale. The study examined the adjusted association between exposure to PCS and self-stigma, controlling for socio-economic characteristics. RESULTS: Seven hundred fifty-nine participants (48.7% male) responded, with a mean age of 47.2 years (SD = 14.9). A quarter (25.2%) of the study population met the criteria for PCS, and 28.1% met the criteria for self-stigma. A significant association was found between PCS and self-stigma, with individuals experiencing PCS reporting higher self-stigma (p < 0.001). Multivariable linear and logistic regression analyses confirmed that PCS was significantly associated with self-stigma modeled as both a continuous and a dichotomous outcome (R2 = 0.09, p < 0.001; OR = 2.5, p < 0.001, respectively). CONCLUSION: This study underscores a significant association between PCS and self-stigma, independently of sociodemographic factors. Given this association, it is imperative to develop comprehensive strategies aimed at stigma reduction among PCS patients. These findings have importance beyond COVID-19, providing lessons for future pandemics and emergencies.

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