Long-term health-related quality of life in non-hospitalised COVID-19 cases with confirmed SARS-CoV-2 infection in England: Longitudinal analysis and cross-sectional comparison with controls

Abstract

Background: This study measured the long-term health-related quality of life of non-hospitalised COVID-19 cases with PCR-confirmed SARS CoV 2(+) infection using the recommended instrument in England (the EQ-5D). Methods: Prospective cohort study of SARS CoV 2(+) cases aged 12-85 years and followed up for six months from 01 December 2020, with cross-sectional comparison to SARS CoV 2(-) controls. Main outcomes were loss of quality-adjusted life days (QALDs); physical symptoms; and COVID-19-related private expenditures. We analysed results using multivariable regressions with post-hoc weighting by age and sex, and conditional logistic regressions for the association of each symptom and EQ-5D limitation on cases and controls. Results: Of 548 cases (mean age 41.1 years; 61.5% female), 16.8% reported physical symptoms at month 6 (most frequently extreme tiredness, headache, loss of taste and/or smell, and shortness of breath). Cases reported more limitations with doing usual activities than controls. Almost half of cases spent a mean of GBP18.1 on non-prescription drugs (median: GBP10.0), and 52.7% missed work or school for a mean of 12 days (median: 10). On average, all cases lost 15.9 (95%-CI: 12.1, 19.7) QALDs, while those reporting symptoms at month 6 lost 34.1 (29.0, 39.2) QALDs. Losses also increased with older age. Cumulatively, the health loss from morbidity contributes at least 21% of the total COVID-19-related disease burden in England. Conclusions: One in 6 cases report ongoing symptoms at 6 months, and 10% report prolonged loss of function compared to pre-COVID-19 baselines. A marked health burden was observed among older COVID-19 cases and those with persistent physical symptoms.

Prevalence and determinants of persistent symptoms after infection with SARS-CoV-2: protocol for an observational cohort study (LongCOVID-study)

“…Strengths of the current study include the prospective design, allowing for detailed analysis of the prevalence and risk factors of persistent symptoms of SARS-CoV-2 infection. In addition, this study is one of a few studies 41 that allows for comparison between COVID-19 cases and control groups that have similar experiences, such as lockdown measures. This is important because such factors can influence complaints.…”

Inflammatory Biomarkers as Predictors of Mortality and Persistent Symptoms at Follow-up in Patients with Severe COVID-19

“…(27,28) Studies have shown, largely through online surveys, that patients who have a mild illness in the community report symptoms of Long-COVID up to 6 months after the acute illness. (29,30) Long-COVID is clinically heterogenous and the mechanism behind the development of neuropsychiatric sequelae remains unknown. Our study cannot exclude a lower level, persistent inflammatory process during COVID-19 convalescence.…”

Impact of COVID‐19 versus chronic rhinosinusitis/rhinitis associated olfactory dysfunction on health utility and quality of life

“…Multivariate regression analysis was performed to adjust for the potential confounding effects of age, gender, and duration of smell loss on QoL. [21][22][23][24][25] Results retained similar trends to means comparison analysis (without adjustments) between COVID-19 and CRS/R with worse EQ-VAS(p = .03), EQ-5D (p = .63), SNOT-22 (p < .001), and SNOT-22 rhinologic symptoms domain (p < .001) scores in the CRS/R cohort and worse TTO (p = .52), QOD-NS + PS (p = .02) scores in the COVD-19 cohort (Table S1).…”