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

Introduction: 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. Methods: 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. Results: 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). Conclusions: 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.