Quality of Life (QoL) Is Reduced in Those with Severe COVID-19 Disease, Post-Acute Sequelae of COVID-19, and Hospitalization in United States Adults from Northern Colorado

Abstract

The longitudinal quality of life (QoL) of COVID-19 survivors, especially those with post-acute sequelae (PASC) is not well described. We evaluated QoL in our COVID-19 survivor cohort over 6 months using the RAND SF-36 survey. From July 2020–March 2021 we enrolled 110 adults from the United States with a positive SARS-CoV-2 nasopharyngeal polymerase chain reaction (PCR) into the Northern Colorado Coronavirus Biobank (NoCo-COBIO). Demographic data and symptom surveillance were collected from 62 adults. In total, 42% were hospitalized, and 58% were non-hospitalized. The Rand SF-36 consists of 36 questions and 8 scales, and questions are scored 0–100. A lower-scale score indicates a lower QoL. In conclusion, hospitalization, PASC, and disease severity were associated with significantly lower scores on the RAND SF-36 in Physical Functioning, Role Limitation due to Physical Health, Energy/Fatigue, Social Functioning, and General Health. Long-term monitoring of COVID-19 survivors is needed to fully understand the impact of the disease on QoL and could have implications for interventions to alleviate suffering during recovery.

Persistent 129Xe MRI Pulmonary and CT Vascular Abnormalities in Symptomatic Individuals with Post-acute COVID-19 Syndrome

“…We were surprised to detect relationships for MRI RBC AUC with post-exertion SpO 2 , exertional dyspnea (modified Borg Dyspnea Scale) and IPAQ score. Similar to previous studies of post- COVID patients, 5 , 25 , 30 in our study, there was abnormal SGRQ (31±17 vs. 6±9 in general population 31 ), CAT (13±7, >90 th percentile general population 32 ) and mMRC dyspnea (1.0±0.7, >91 st percentile general population 33 ). Whilst there were no relationships for MRI and CT measurements with SGRQ (which is validated for use in COPD), 14 there was a correlation for IPAQ activity and MRI RBC AUC.…”

“…Other vascular changes, such as vascular injury, vascular remodelling or shunting may also be possible and has previously been hypothesized post-COVID-19. 5 , 9 , 25 Post-mortem micro-CT imaging of COVID-19 infection supports these interpretations as abnormal alveolar- level structures and occluded capillaries were observed. 27 …”

“…In addition, RBC:barrier ratio (controls 0.41±0.10, participants with ever-COVID 0.32±0.06; P=.06) trended toward a difference as compared with never-COVID controls. As in previous studies, 25 we used hospitalization status to dichotomize post-COVID patients and detected MRI differences in never- and ever-hospitalized participants including 129 Xe MRI RBC and barrier AUC. Whereas the CT measurements in never-hospitalized participants were similar to never-COVID values previously reported (BV5/TBV=56%, BV10/TBV=28%), 9 CT pulmonary vascular measurements in ever- hospitalized COVID-19 patients were consistent with vascular pruning, similar to previous findings.…”

Post-acute sequelae of SARS-CoV-2 (PASC) impact quality of life at 6, 12 and 18 months post-infection

“…This data extend to 18 months previously reported PASC symptoms and associations with QoL measures at earlier time points. [7][8][9][10][11] Fatigue, brain fog, nasal congestion and discharge, headache, sleep disturbances, and body aches were the most common symptoms. Neurological, mood, and systemic symptoms persisted in over half of participants surveyed at 18 months post-COVID-19.…”

Post-COVID-19 condition is not only a question of persistent symptoms: structured screening including health-related quality of life reveals two separate clusters of post-COVID

“…One important parameter for identifying patients with a high burden of post-COVID-symptoms is patient-reported quality of life (QoL). The effects of ongoing symptoms on QoL differ depending which symptoms do persist as well as the severity and number of symptoms [ 4 , 5 ]. Regarding post-COVID-symptoms, the number of patients reporting diminished QoL differs depending on the cohorts and the time after infection; frequencies between 31 and 72% of patients have been reported [ 6 , 7 ] and partly associated with the COVID-19 disease severity [ 4 , 5 ].…”