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Lived Experiences of Long COVID in Iranian Immigrants in Canada: Implications for Post-Infection Care and Global Health Equity

Articles InPress

Document Type : Original Article(s)

Authors

1 Department of Community Health and Epidemiology, School of Medicine, University of Saskatchewan, Canada

2 Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/ijms.2026.110312.4589

Abstract

Background: This study aimed to explore the lived experiences of Iranian immigrants in Canada with Long COVID (LC) and to examine how these experiences can inform culturally responsive healthcare approaches. 
Methods: This qualitative study employed an interpretive description (ID) methodology and was conducted in Canada in 2024. Twenty adult Iranian immigrants (11 women) with physician-approved LC diagnoses were recruited from across eight Canadian provinces using purposive and snowball sampling via the Telegram application. Data collection comprised one-on-one, semi-structured, in-depth interviews conducted in Persian language through the Zoom video conferencing platform. Interviews lasted an average of 70.8 min (ranging from 51 to 96 min) and were transcribed, translated, and thematically analyzed following Thorn’s ID approach, using manual thematic analysis, constant comparative analysis, and inductive reasoning. The social determinants of health (SDH) framework guided the interpretation, situating findings within broader structural and sociocultural contexts. 
Results: Five major themes emerged: embodied disruptions and symptom unpredictability, systemic barriers and healthcare navigation, emotional and existential distress, economic and workplace insecurity, and cultural integration and healing pathways. Regarding healthcare needs, participants identified systemic barriers to navigating healthcare. 
Conclusion: The findings underscored the need for culturally responsive, linguistically accessible, and holistic care strategies that address both health and socio-economic dimensions. Healthcare providers and policymakers could integrate cultural competence, language accessibility, mental health support, and recognition of diaspora-based coping resources into LC care to improve health outcomes for Iranian immigrant populations.

Highlights

Mehrdad Askarian (Google Scholar)

Keywords

References
  1. COVID - coronavirus statistics [Internet]. 2024 [cited 2024 Mar 22]. Available from: https://www.worldometers.info/coronavirus/
  2. World Health Organization. Post COVID-19 condition (long COVID) [Internet]. 2023 [cited 2023 Dec 5]. Available from: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition
  3. Kim Y, Bae S, Chang HH, Kim SW. Long COVID prevalence and impact on quality of life 2 years after acute COVID-19. Sci Rep. 2023;13:11207. doi: 10.1038/s41598-023-36995-4. PubMed PMID: 37433819; PubMed Central PMCID: PMC10336045.
  4. Kennelly CE, Nguyen ATP, Sheikhan NY, Strudwick G, Ski CF, Thompson DR, et al. The lived experience of long COVID: A qualitative study of mental health, quality of life, and coping. PLoS One. 2023;18:e0292630. doi: 10.1371/journal.pone.0292630. PubMed PMID: 37831706; PubMed Central PMCID: PMC10575511.
  5. Song X, Song W, Cui L, Duong TQ, Pandy R, Liu H, et al. A Comprehensive Review of the Global Epidemiology, Clinical Management, Socio-Economic Impacts, and National Responses to Long COVID with Future Research Directions. Diagnostics (Basel). 2024;14. doi: 10.3390/diagnostics14111168. PubMed PMID: 38893693; PubMed Central PMCID: PMC11171614.
  6. Hossain MM, Das J, Rahman F, Nesa F, Hossain P, Islam AMK, et al. Living with “long COVID”: A systematic review and meta-synthesis of qualitative evidence. PLoS One. 2023;18:e0281884. doi: 10.1371/journal.pone.0281884. PubMed PMID: 36795701; PubMed Central PMCID: PMC9934341.
  7. Xiang J, Zheng H, Cai Y, Chen S, Wang Y, Chen R. Cumulative social disadvantage and its impact on long COVID: insights from a U.S. national survey. BMC Med. 2025;23:207. doi: 10.1186/s12916-025-04039-5. PubMed PMID: 40189508; PubMed Central PMCID: PMC11974196.
  8. Feldman CH, Santacroce L, Bassett IV, Thaweethai T, Alicic R, Atchley-Challenner R, et al. Social Determinants of Health and Risk for Long COVID in the U.S. RECOVER-Adult Cohort. Ann Intern Med. 2025;178:1287-97. doi: 10.7326/ANNALS-24-01971. PubMed PMID: 40720834; PubMed Central PMCID: PMC12352746.
  9. Chen J, Ng E, Wilkins R. The health of Canada’s immigrants in 1994-95. Health Rep. 1996;7:33-45, 37-50. PubMed PMID: 8679956.
  10. Turcotte M, Savage K. The contribution of immigrants and population groups designated as visible minorities to nurse aide, orderly and patient service associate occupations. Ottawa: Statistics Canada; 2020.
  11. Tsai PL, Ghahari S. Immigrants’ Experience of Health Care Access in Canada: A Recent Scoping Review. J Immigr Minor Health. 2023;25:712-27. doi: 10.1007/s10903-023-01461-w. PubMed PMID: 36870008.
  12. Dasarband B, Ziaian T, Augoustinos M, Oudih E, Miller E. Marital Relationships After Migration: A Review of Iranian Migrants’ Experiences. Marriage Fam Rev. 2026;62:95-130. doi: 10.1080/01494929.2025.2514549.
  13. Top 10 countries of birth for foreign-born people Canada 2021 [Internet]. Hamburg: Statista; 2024 [cited 2024 May 12]. Available from: https://www.statista.com/statistics/556078/top-10-countries-of-birth-for-foreign-born-canadian-citizens/
  14. Dastjerdi M, Olson K, Ogilvie L. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory. Int J Equity Health. 2012;11:55. doi: 10.1186/1475-9276-11-55. PubMed PMID: 23021015; PubMed Central PMCID: PMC3519565.
  15. Thompson Burdine J, Thorne S, Sandhu G. Interpretive description: A flexible qualitative methodology for medical education research. Med Educ. 2021;55:336-43. doi: 10.1111/medu.14380. PubMed PMID: 32967042.
  16. Hunt MR. Strengths and challenges in the use of interpretive description: reflections arising from a study of the moral experience of health professionals in humanitarian work. Qual Health Res. 2009;19:1284-92. doi: 10.1177/1049732309344612. PubMed PMID: 19690208.
  17. Widiger TA. Clinical assessment: interview methods. In: Smelser NJ, Baltes PB, editors. International encyclopedia of the social & behavioral sciences. 2nd ed. Oxford: Pergamon; 2001. p. 2016-20. doi: 10.1016/B0-08-043076-7/01289-4.
  18. World Health Organization. A conceptual framework for action on the social determinants of health. Geneva: WHO; 2010.
  19. Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval. 1986;1986:73-84. doi: 10.1002/ev.1427.
  20. Gentilotti E, Gorska A, Tami A, Gusinow R, Mirandola M, Rodriguez Bano J, et al. Clinical phenotypes and quality of life to define post-COVID-19 syndrome: a cluster analysis of the multinational, prospective ORCHESTRA cohort. EClinicalMedicine. 2023;62:102107. doi: 10.1016/j.eclinm.2023.102107. PubMed PMID: 37654668; PubMed Central PMCID: PMC10466236.
  21. Sekar P, Dominic M, Balakrishnan S, Sreelakshmi VK, Haneendhar R, Gopan SJ, et al. Post-COVID-19 Complications: A Study on Long COVID Symptoms and Their Pathophysiology. J Pharm Bioallied Sci. 2025;17:S2557-S9. doi: 10.4103/jpbs.jpbs_880_25. PubMed PMID: 41164629; PubMed Central PMCID: PMC12563606.
  22. Multazam A, Pratiwi DN, Rahmawati NA. Relationship between anxiety levels and dyspnea among post-COVID-19 patients. Phys Ther J Indones. 2023;4:125-8. doi: 10.51559/ptji.v4i2.89.
  23. Bayard-Burfield L, Sundquist J, Johansson SE.
    Ethnicity, self reported psychiatric illness, and intake of psychotropic drugs in five ethnic groups in Sweden. J Epidemiol Community Health. 2001;55:657-64. doi: 10.1136/jech.55.9.657. PubMed PMID: 11511645; PubMed Central PMCID: PMC1731973.
  24. Emami A, Benner PE, Lipson JG, Ekman SL. Health as continuity and balance in life. West J Nurs Res. 2000;22:812-25. doi: 10.1177/01939450022044773. PubMed PMID: 11077549.
  25. Askarian M, Ahmadkhani A, Mousavi S, Muhajarine N, Sadeghi A, Zarei S, et al. Adherence to national and international vaccine information sources and future pandemic preparedness among Iranian adults in the post-COVID-19 era. BMC Public Health. 2025;25:2859. doi: 10.1186/s12889-025-24161-6. PubMed PMID: 40836327; PubMed Central PMCID: PMC12366105.
  26. Maier HE, Kowalski-Dobson T, Eckard A, Gherasim C, Manthei D, Meyers A, et al. Reduction in Long COVID Symptoms and Symptom Severity in Vaccinated Compared to Unvaccinated Adults. Open Forum Infect Dis. 2024;11:ofae039. doi: 10.1093/ofid/ofae039. PubMed PMID: 38328496; PubMed Central PMCID: PMC10847810.
  27. Volk P, Rahmani Manesh M, Warren ME, Besko K, Goncalves de Andrade E, Wicki-Stordeur LE, et al. Long-term neurological dysfunction associated with COVID-19: Lessons from influenza and inflammatory diseases? J Neurochem. 2024;168:3500-11. doi: 10.1111/jnc.16016. PubMed PMID: 38014645.
  28. Avais LS, Pacheco EC, Gomes L, Baldani MH, Martins CM, Waldman EA, et al. Oral Manifestations in the Post COVID-19 Condition: A Systematic Review With Meta-Analysis. Rev Med Virol. 2025;35:e70057. doi: 10.1002/rmv.70057. PubMed PMID: 40663038; PubMed Central PMCID: PMC12262108.
  29. Leggat FJ, Heaton-Shrestha C, Fish J, Siriwardena AN, Domeney A, Rowe C, et al. An exploration of the experiences and self-generated strategies used when navigating everyday life with Long Covid. BMC Public Health. 2024;24:789. doi: 10.1186/s12889-024-18267-6. PubMed PMID: 38481230; PubMed Central PMCID: PMC10938753.
  30. Taylor OL, Treneman-Evans G, Riley M, Bond-Kendall J, Pike KC. How young people experienced long covid services: a qualitative analysis. BMJ Paediatr Open. 2025;9. doi: 10.1136/bmjpo-2024-003206. PubMed PMID: 40234084; PubMed Central PMCID: PMC12004467.
  31. Moratalla-Cebrian ML, Marcilla-Toribio I, Berlanga-Macias C, Perez-Moreno A, Garcia-Martinez M, Martinez-Andres M. Perceptions of Long COVID Patients Regarding Health Assistance: Insights from a Qualitative Study in Spain. Nurs Rep. 2024;14:3361-77. doi: 10.3390/nursrep14040243. PubMed PMID: 39585134; PubMed Central PMCID: PMC11587481.
  32. Villatoro C, Henning E, Ng R, Kogut M, Steinberg J, Chen B, et al. Enhancing Pediatric Long COVID Care Through Telementoring: Insights From an ECHO Program. Clin Pediatr (Phila). 2025;64:1209-17. doi: 10.1177/00099228251323396. PubMed PMID: 40077880; PubMed Central PMCID: PMC12464857.
  33. Faugno E, Galbraith AA, Walsh K, Maglione PJ, Farmer JR, Ong MS. Experiences with diagnostic delay among underserved racial and ethnic patients: a systematic review of the qualitative literature. BMJ Qual Saf. 2025;34:190-200. doi: 10.1136/bmjqs-2024-017506. PubMed PMID: 39496473; PubMed Central PMCID: PMC11839380.
  34. Fabry L, McDermott S, Wilford B. Culturally Competent Care for Diverse Populations: A Review of Transcultural Nursing Education. Adv Emerg Nurs J. 2024;46:274-82. doi: 10.1097/TME.0000000000000526. PubMed PMID: 39094089.
  35. Claeys A, Berdai-Chaouni S, Donder LD. Identifying experiences, enablers and barriers of healthcare providers for delivering culturally competent care. Int J Integr Care. 2018;18:23. doi: 10.5334/ijic.s2237. PubMed PMID: 30456789; PubMed Central PMCID: PMC6234567.
  36. Zhong Y, Ji Q, Zhou L. Sleep disorders of post-COVID-19 conditions. Sleep Breath. 2023;27:2435-6. doi: 10.1007/s11325-023-02848-7. PubMed PMID: 37162709; PubMed Central PMCID: PMC10170021.
  37. Tefera GM, Yu M. Immigrant women’s access to healthcare services in the United States: a qualitative meta-synthesis. J Soc Serv Res. 2022;48:285-99. doi: 10.1080/01488376.2022.2035300.
  38. Taghva A, Farsi Z, Javanmard Y, Atashi A, Hajebi A, Khademi M. Stigma Barriers of Mental Health in Iran: A Qualitative Study by Stakeholders of Mental Health. Iran J Psychiatry. 2017;12:163-71. PubMed PMID: 29062367; PubMed Central PMCID: PMC5640577.
  39. Zhong B. Exploring the multifaceted dimensions of mental health stigma: culture, religion, and healthcare institutions. SHS Web Conf. 2024;193:02014. doi: 10.1051/shsconf/202419302014.
  40. Babic R, Babic M, Rastovic P, Curlin M, Simic J, Mandic K, et al. Resilience in Health and Illness. Psychiatr Danub. 2020;32:226-32. PubMed PMID: 32970640.
  41. Anderson MA, Buffo C, Ketcher D, Nguyen H, MacKenzie JJ, Reblin M, et al. Applying the RISE Model of Resilience in Partners Post-Stroke: A Qualitative Analysis. Ann Behav Med. 2022;56:270-81. doi: 10.1093/abm/kaab053. PubMed PMID: 34228090; PubMed Central PMCID: PMC8887576.
  42. Cal SF, Sá LRD, Glustak ME, Santiago MB. Resilience in chronic diseases: a systematic review. Cogent Psychol. 2015;2:1024928. doi: 10.1080/23311908.2015.1024928.
  43. Yeo G, Fortuna KL, Lansford JE, Rudolph KD. The effects of digital peer support interventions on physical and mental health: a review and meta-analysis. Epidemiol Psychiatr Sci. 2025;34:e9. doi: 10.1017/S2045796024000854. PubMed PMID: 39945388; PubMed Central PMCID: PMC11886969.
  44. Berkanish P, Pan S, Viola A, Rademaker Q, Devine KA. Technology-Based Peer Support Interventions for Adolescents with Chronic Illness: A Systematic Review. J Clin Psychol Med Settings. 2022;29:911-42. doi: 10.1007/s10880-022-09853-0. PubMed PMID: 35147830; PubMed Central PMCID: PMC8853345.
  45. Arias Lopez MDP, Ong BA, Borrat Frigola X, Fernandez AL, Hicklent RS, Obeles AJT, et al. Digital literacy as a new determinant of health: A scoping review. PLOS Digit Health. 2023;2:e0000279. doi: 10.1371/journal.pdig.0000279. PubMed PMID: 37824584; PubMed Central PMCID: PMC10569540.
  46. Ogundipe R. Digital health citizenship: Mapping existing tools for digital, health and civic literacy. medRxiv. 2024. doi: 10.1101/2024.12.26.24319674.
  47. MacEwan SR, Rahurkar S, Tarver WL, Eiterman LP, Melnyk H, Olvera RG, et al. The Impact of Long COVID on Employment and Well-Being: A Qualitative Study of Patient Perspectives. J Gen Intern Med. 2025;40:1070-7. doi: 10.1007/s11606-024-09062-5. PubMed PMID: 39379779; PubMed Central PMCID: PMC11968618.
  48. Anderson E, Hunt K, Wild C, Nettleton S, Ziebland S, MacLean A. Episodic disability and adjustments for work: the ‘rehabilitative work’of returning to employment with Long Covid. Disabil Soc. 2025;40:1239-61. doi: 10.1080/09687599.2024.2331722.
  49. Silver SR, Li J, Ford ND, Saydah SH. Functional disabilities and adverse well-being by COVID-19 and Long COVID history and employment status: 2022 Behavioral Risk Factor Surveillance System. Am J Ind Med. 2024;67:1089-107. doi: 10.1002/ajim.23669. PubMed PMID: 39450880; PubMed Central PMCID: PMC11609551.
  50. Yaru Y, Wau H. Barriers to healthcare access among immigrant populations: a review paper. Peta Int J Public Health. 2025;2:14-32. doi: 10.59088/pijph.v2i2.73.
  51. Hinson JD, Weiser D. Analyzing mental health among Black immigrant families through intersectionality. J Fam Theory Rev. 2025. doi: 10.1111/jftr.12610.
  52. Monari E, Younas A, Salimi S. Barriers and Facilitators to Self-Management of Multimorbidity Among Culturally and Linguistically Diverse Immigrants: A Qualitative Descriptive Study. J Adv Nurs. 2026;82:647-61. doi: 10.1111/jan.16971. PubMed PMID: 40213925.
  53. Sweis JJG, Alnaimat F, Esparza V, Prasad S, Azam A, Modi Z, et al. From Acute Infection to Prolonged Health Consequences: Understanding Health Disparities and Economic Implications in Long COVID Worldwide. Int J Environ Res Public Health. 2024;21. doi: 10.3390/ijerph21030325. PubMed PMID: 38541324; PubMed Central PMCID: PMC10970637.
  54. Mkoma GF, Goldschmidt MI, Petersen JH, Benfield T, Cederstrom A, Rostila M, et al. Socioeconomic disparities in long COVID diagnosis among ethnic minorities in Denmark. Soc Sci Med. 2025;372:117944. doi: 10.1016/j.socscimed.2025.117944. PubMed PMID: 40101664.
  55. Rebecca CF. A cultural perspective on the use of herbal medicine in diabetic care. Res Invent J Public Health Pharm. 2025;4:1-6. doi: 10.59298/RIJPP/2025/4116.
  56. Wal A, Verma N, Balakrishnan SK, Gahlot V, Dwivedi S, Sahu PK, et al. A Systematic Review of Herbal Interventions for the Management of Cardiovascular Diseases. Curr Cardiol Rev. 2024;20:e030524229664. doi: 10.2174/011573403X286573240422104647. PubMed PMID: 38706368; PubMed Central PMCID: PMC11337612.
  57. Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, et al. Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship? BMC Complement Med Ther. 2020;20:65. doi: 10.1186/s12906-020-2854-4. PubMed PMID: 32111222; PubMed Central PMCID: PMC7076897.
  58. Derasin LM. Resilience amid adversity: lived experiences of Filipino families navigating chronic illness. Int J Sci Manag Stud. 2024;7:155-61. doi: 10.51386/25815946/ijsms-v7i5p114.
  59. Snowshoe A, Crooks CV, Tremblay PF, Craig WM, Hinson RE. Development of a Cultural Connectedness Scale for First Nations youth. Psychol Assess. 2015;27:249-59. doi: 10.1037/a0037867. PubMed PMID: 25222432.
  60. Bayh GK, Birara AG, Ambaye YG. Community conception and treatment of jaundice (Wofie/Ye’wof Beshyita) in Gondar City, Ethiopia. Ethiop Renaiss J Soc Sci Humanit. 2024;11:175-94. doi: 10.4314/erjssh.v11i2.10.
  61. Busse M, Pallmann P, Riaz M, Potter C, Leggat FJ, Harris S, et al. Effectiveness of a personalised self-management intervention for people living with long covid (Listen trial): pragmatic, multicentre, parallel group, randomised controlled trial. BMJ Med. 2025;4:e001068. doi: 10.1136/bmjmed-2024-001068. PubMed PMID: 40046291; PubMed Central PMCID: PMC11881025.
  62. Adie EA. Cultural and social perspectives on steroid therapy: navigating ethical challenges in multicultural healthcare settings. IDOSR J Appl Sci. 2025;10:9-13. doi: 10.59298/IDOSRJAS/2025/101.913000.
  63. Jacka BP, Cheng QL, Schiavone B, Darley DR, Kelleher AD, Dore GJ, et al. Trajectories of Health-Related Quality of Life 2 Years After Mild/Moderate Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the Pre-Omicron Era. Open Forum Infect Dis. 2025;12:ofaf142. doi: 10.1093/ofid/ofaf142. PubMed PMID: 40406371; PubMed Central PMCID: PMC12096008.
Iranian Journal of Medical Sciences

Articles InPress, Corrected Proof
Available Online from 22 August 2026
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History
  • Received: 31 December 2025
  • Revised: 23 February 2026
  • Accepted: 09 April 2026
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