Psychometric properties of the Spanish version of the EuroQol-5D-5L in previously hospitalized COVID-19 survivors with long COVID

Abstract

The EuroQol 5-dimensions 5-levels (EQ-5D-5L) is a generic patient-reported outcome measures (PROM) used for evaluating health-related quality of life (HRQoL). No data on its psychometric properties in COVID-19 survivors is available. We aimed to describe internal consistency, test–retest reliability, and construct validity of the EQ-5D-5L in people with long-COVID. Ninety-three (n = 93) individuals previously hospitalized due to COVID-19 with post-COVID symptoms completed the EQ-5D-5L questionnaire twice one year after hospital discharge in a three-week interval. Internal consistency (Cronbach alpha and Omega value), test–retest reliability (kappa and ICC2,1) and construct validity (factor analysis), and floor/ceiling effects were calculated. No ceiling effect was observed in any dimension whereas the floor effect ranged from 53.76 to 94.62%. The overall Cronbach’s α value was 0.75 (95%CI 0.64–0.83) and the Omega ω value was 0.77 (95%CI 0.66–0.84), showing good internal consistency of the questionnaire. Further, Cronbach’s alpha values the of each dimension ranged from 0.63 to 0.77 whereas those for Omega values ranged from 0.70 to 0.79. The test–retest reliability of the total score was excellent (ICC2,1 0.86, 95%CI 0.798–0.911). The agreement percentage ranged from 85.13 to 96.77%; but kappa coefficients ranged from fair (κ: 0.37) to good (κ: 0.61). The factor analysis showed factor loadings from 0.585 to 0.813 supporting good construct validity. The EQ-5D-5L has good psychometric properties to be used as a PROM to assess HRQoL in hospitalized COVID-19 survivors with long-COVID.

Sleep Quality Mediates the Effect of Sensitization-Associated Symptoms, Anxiety, and Depression on Quality of Life in Individuals with Post-COVID-19 Pain

“…Health-related quality of life (HRQoL) was assessed with the paper-based five-level version of EuroQol-5D (EQ-5D-5L) [ 32 ]. This PROM assesses the following items: mobility, self-care, daily life activities, pain symptoms, and depression/anxiety into 5-point Likert scales ranging from 0 (no problem) to 4 (severe problems) points.…”

“…Responses are converted into a single index number ranging from 0 (health state judged to be equivalent to death) to 1 (optimal health) by applying crosswalk index values for Spain life [ 33 ]. The EQ-5D-5L has shown excellent test–retest reliability in individuals with post-COVID-19 (ICC 0.86) [ 32 ].…”

Associations of COVID-19 Symptoms with Omicron Subvariants BA.2 and BA.5, Host Status, and Clinical Outcomes: A Registry-Based Observational Study in Sapporo, Japan

“…However, data linking patient manifestations to viral, host factor, and clinical outcomes must be continuously updated to maximize their utility and guide appropriate healthcare strategies 13,14 . Studies designed to compare the symptoms of alpha vs. delta SARS-CoV-2 variants with those of the original Wuhan strain 15 , and the original omicron variant compared to the delta variant, helped guide healthcare strategies 8 . However, no large-scale epidemiological studies describing COVID-19 symptoms and outcomes as a function of host factors across newer omicron subvariants are available.…”

Prolonged Symptoms after COVID-19 in Japan: A Nationwide Survey of the Symptoms and Their Impact on Patients’ Quality of Life

“… 23 , 24 A study suggested that changes in the EQ-5D-5L score in a certain time interval (e.g., 6 months) enable us to assess their QOL in a long-term follow up precisely. 25 In contrast, very few studies using somatic score to understand the severity of somatic symptoms due to long COVID were published. Somatic symptoms were assessed by each symptom rather than overall symptom severity such as SSS-8 score.…”