Health-related quality of life and social determinants of health following COVID-19 infection in a predominantly Latino population

Abstract

Background As the COVID-19 pandemic evolves, more information is needed on its long-term impacts on health-related quality of life (HRQoL) and social determinants of health (SDoH). The aim of the study was to assess HRQoL and SDoH among a predominantly Latino population of COVID-19 survivors and to compare effects in Latinos versus non-Latinos. Methods This cross-sectional study consisted of a survey (in English and Spanish) of COVID-19 survivors from December 2020 to July 2021. The study assessed sociodemographic data, clinical characteristics, and SDoH, consisting of 10 COVID-19—related concerns. The PROMIS-29 + 2 (PROPr) measure, which captures 8 HRQoL domains and a preference-based health utility, was used to assess HRQoL. Bivariate analyses included chi-square tests and t-tests. Generalized linear models were conducted for multivariable analyses. Results Of 230 respondents (6.3% response rate), the mean [SD] age was 43.1 [14.3] years; 83.0% were Latino; the mean [SD] time since diagnosis was 8.1 [3.2] months; and 12.6% had a history of hospitalization with COVID-19. HRQoL scores were slightly worse than population norms on all domains, especially anxiety; the mean [SD] PROPr health utility was 0.36 [0.25]. Domain scores were similar by ethnicity except for cognitive function—abilities, where scores were lower in Latinos. Multivariable analyses revealed that: (1) financial concerns were associated with worse health utility, as well as worse scores on all 8 PROMIS domains; (2) interpersonal conflict was associated with worse health utility and worse scores on 6 of the 8 PROMIS domains (anxiety, depression, fatigue, sleep disturbance, social function, and pain interference); and (3) Latino ethnicity was only associated with 1 PROMIS domain (cognitive function—abilities) after controlling for covariates. Conclusion COVID-19 infection is associated with HRQoL decrements long after the acute infection, and financial concerns and interpersonal conflict are particularly associated with worse HRQoL.

Factors Associated With Long COVID Symptoms in an Online Cohort Study

“…Despite extensive research documenting the role of adverse social determinants of health increasing risk of acute SARS-CoV-2 infection, there are limited prior data regarding associations between social determinants and Long COVID. Consistent with our study, one prior study found that financial concerns were associated with worse health utility and quality of life among those recovering from COVID-19 [ 27 ]. Similarly, an online survey-based study found that graduate education and urban residence were associated with lower odds of Long COVID [ 15 ].…”

Lowered Quality of Life in Long COVID Is Predicted by Affective Symptoms, Chronic Fatigue Syndrome, Inflammation and Neuroimmunotoxic Pathways

“…For instance, 90 days after the acute phase, patients exhibiting symptoms of Long COVID (such as fatigue, sadness, myalgia, joint pain, dyspnea, anxiety, and vertigo) had significantly poorer SF-36 ratings for physical function, vitality, mental health, and physical health [ 26 ]. Another study found that HR-QoL was substantially lower 8.1 (±3.2) months after the acute episode [ 27 ]. In both systematic review and meta-analysis studies, HR-QoL was considerably decreased in Long COVID-19 patients especially in those with fatigue and admission to critical care units, with up to 37% (95% confidence interval: 18 to 60%) of the patients exhibiting decreased HR-QoL [ 28 , 29 , 30 ].…”

Five cluster classifications of long COVID and their background factors: A cross-sectional study in Japan

“…Notably, cluster 3 had the highest percentage of leaves of absence in our study. Financial concerns owing to symptoms have been reported to be associated with an increase in both anxiety and depression [19]. In addition, in a previous study, which investigated "post-COVID-19 status, unspecified" using the International Classification of Diseases, 10th revision, long COVID patients were skewed toward those living in areas of low poverty and unemployment [20].…”