Did 'long COVID' increase road deaths in the USA?

OBJECTIVE: To examine data on COVID-19 disease associated with a 10% increase in US road deaths from 2020 to 2021 that raises the question of the potential effect of pandemic stress and neurological damage from COVID-19 disease.

METHODS: Poisson regression was used to estimate the association of recent COVID-19 cases, accumulated cases, maximum temperatures, truck registrations and gasoline prices with road deaths monthly among US states in 2021. Using the regression coefficients, changes in each risk factor from 2020 to 2021 were used to calculate expected deaths in 2021 if each factor had remained the same as in 2020.

RESULTS: Corrected for the other risk factors, road deaths were associated with accumulated COVID-19 cases but not concurrent cases. More than 20 700 road deaths were associated with the changes in accumulated COVID-19 cases but were substantially offset by about 19 100 less-than-expected deaths associated with increased gasoline prices.

CONCLUSIONS: The lingering effects of COVID-19 on neurological function may be a risk factor for behaviour leading to road deaths.