A US population health survey on the impact of COVID-19 using the EQ-5D-5L

Abstract

Background: In addition to health and economic consequences, the COVID-19 pandemic has likely affected population health-related quality of life (HRQoL).Objective: To assess the impact of COVID-19 on US population health using the EQ-5D-5L.Design: We surveyed respondents on health status, employment, and anxiety/depression. We collected information on demographics, brief medical history, socioeconomic status, current COVID-19 status, sleep, dietary, and financial spending changes. Results were compared to US population norms. Predictors of EQ-5D-5L utility were analyzed using post-Lasso OLS regression, a machine learning algorithm designed to enhance prediction accuracy by avoiding overfitting. Robustness of regression coefficients were analyzed with E-Values to quantify unmeasured confounding.Participants: Amazon MTurk users.Main Measures: EQ-5D-5L utility score by age group.Key Results: Survey respondents (n=2776) reported significantly worse mean (SD) HRQoL utility as captured by the EQ-5D-5L among 18-24 year olds, 0.752 (0.281) vs. online, 0.844 (0.184) (p=0.001) and face-to-face norms, 0.919 (0.127) (p<0.001). Among ages 25-34, utility was worse compared to face-to-face norms only (0.825 (0.235) vs. 0.911 (0.111), p<0.001). Among ages 35-64, utility values were higher during-pandemic but only vs. online norms (0.845 (0.195) vs. 0.794 (0.247), p<0.001). At age 65+, utility values (0.827 (0.213)) were similar across all samples. Increasing age and income were correlated with increased utility, while Hawaiian/Pacific islander race, Hispanic ethnicity, married, living alone, history of chronic illness, fear of COVID-19’s impact on health, and having a family member diagnosed with COVID-19 were associated with worse utility scores. Results were relatively robust to unmeasured confounding.Conclusions: HRQoL has decreased during the pandemic compared to US population norms, especially for ages 18-24. The mental