Trajectories of health-related quality of life and their predictors in adult COVID-19 survivors: A longitudinal analysis of the Biobanque Québécoise de la COVID-19 (BQC-19)

Tanguay, Pamela; Décary, Simon; Lemaire-Paquette, Samuel; Léonard, Guillaume; Piché, Alain; Dubois, Marie-France; Kairy, Dahlia; Bravo, Gina; Corriveau, Hélène; Marquis, Nicole; Tousignant, Michel; Chassé, Michaël; Carvalho, Lívia Pinheiro

doi:10.1007/s11136-023-03406-0

Cited by 6 publications

(8 citation statements)

References 45 publications

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“…This is consistent with findings from other studies. 29 , 30 A longitudinal study of patients with COVID-19 infection found worse HRQL at 12 months for patients with more than one initial COVID symptom. 25 Garg et al found symptoms during acute illness did not relate to reduced PROMIS-GH scores for patients seen in a PASC clinic, but patients with multiple symptoms at 3 months post-infection did have worse scores.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life for Patients with Post-Acute COVID-19 Syndrome: Identification of Symptom Clusters and Predictors of Long-Term Outcomes

Lapin,

Li,

Englund

et al. 2024

J GEN INTERN MED

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Background Following COVID-19 infection, as many as a third of patients have long-term symptoms, known as post-acute sequelae (PASC). The mechanisms contributing to PASC remain largely unknown and, due to the heterogeneity of symptoms, treating PASC provides unique challenges. Objective Our study sought to (1) identify clinical symptom profiles based on PROMIS Global Health (GH) items, (2) evaluate demographic and clinical differences across profiles, and (3) identify predictors of change in health-related quality of life (HRQL) over time. Design This was an observational cohort study of patients with PASC who completed PROMIS-GH between 2/11/21 and 12/3/21 as part of routine care, with data extracted from the electronic health record. Participants There were 1407 adult patients (mean age 49.6 ± 13.7, 73% female, 81% White race) with PASC seen in the recovery clinic between 2/11/21 and 12/3/21, with 1129 (80.2%) completing PROMIS-GH as routine care. Main Measures HRQL was measured with PROMIS-GH at initial visit and after 12 months. Key Results Latent profile analysis identified symptom classes based on five PROMIS-GH items (mental health, ability to carry out physical activities, pain, fatigue, and emotional problems). Four latent profiles were identified: (1) “Poor HRQL” (n = 346), (2) “Mixed HRQL: good mental/poor physical” (n = 232), (3) “Mixed HRQL: poor mental/good physical” (n = 324), and (4) “Good HRQL” (n = 227). Demographics and comorbidities varied significantly across profile with patients with more severe COVID-19 infection more likely to be in profiles 1 and 2. Overall, patients improved 2 T-score points on PROMIS-GH after 12 months, with differences by profile. Predictors of improved HRQL included profile, lower body mass index, and fewer COVID symptoms. Conclusions Patients with PASC have distinct HRQL symptom profiles which were able to differentiate across COVID-19 severity and symptoms. Improvement over 12 months differed by profile. These profiles may be used to better understand the mechanisms behind PASC. Future research should evaluate their ability to guide treatment decisions to improve HRQL.

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Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life for Patients with Post-Acute COVID-19 Syndrome: Identification of Symptom Clusters and Predictors of Long-Term Outcomes

Lapin,

Li,

Englund

et al. 2024

J GEN INTERN MED

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“…Literature investigating determinants of HRQoL in adults with COVID-19 using patient-reported EQ-5D tools have reported mixed results for age [7][8][9][10][11]. Some studies associated younger age with lower HRQoL [7,8], while others reported older age as a determinant of low HRQoL [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Studies and literature reviews investigating determinants of HRQoL in adults with COVID-19 have associated certain baseline characteristics with HRQoL, measured using patient-reported EQ-5D tools [7][8][9][10][11]. These include female gender, pre-existing comorbidity and unemployment status.…”

Section: Introductionmentioning

confidence: 99%

“…These include female gender, pre-existing comorbidity and unemployment status. Results for age are mixed, calling for further research: some studies associated younger age with lower HRQoL [7,8], while others reported older age as a determinant of poor HRQoL [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Features of COVID-19 disease have also been associated with diminished HRQoL, including acute disease severity (e.g., ICU admission), not being vaccinated and symptoms burden at the time of infection [7][8][9][10][11]. Although numerous studies have explored the burden of COVID-19 symptoms on HRQoL, most assessed the burden separately for the acute and long COVID phases and compared the HRQoL in long COVID patients with limited control groups [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID-19 Infection on Health-Related Quality of Life, Work Productivity and Activity Impairment by Symptom-Based Long COVID Status and Age in the US

Di Fusco,

Cappelleri,

Anatale-Tardiff

et al. 2023

Healthcare

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COVID-19 infection adversely impacts patients’ wellbeing and daily lives. This survey-based study examined differences in patient-reported COVID-19 symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Activity Impairment (WPAI) among groups of patients defined based on age and symptom-based long COVID status. Symptomatic, COVID-19-positive US outpatients were recruited from 31 January–30 April 2022. Outcomes were collected via validated instruments at pre-COVID, Day 3, Week 1, Week 4, Month 3 and Month 6 following infection, with changes assessed from pre-COVID and between groups, adjusting for covariates. EQ-5D-5L HRQoL and WPAI scores declined in all groups, especially during the first week. Long COVID patients reported significantly higher symptoms burden and larger drops in HRQoL and WPAI scores than patients without long COVID. Their HRQoL and WPAI scores did not return to levels comparable to pre-COVID through Month 6, except for absenteeism. Patients without long COVID generally recovered between Week 4 and Month 3. Older (>50) and younger adults generally reported comparable symptoms burden and drops in HRQoL and WPAI scores. During the first week of infection, COVID-19-related health issues caused loss of 14 to 26 work hours across the groups. These data further knowledge regarding the differential impacts of COVID-19 on clinically relevant patient groups.

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Neurologic Manifestations of Long COVID Disproportionately Affect Young and Middle‐Age Adults

Choudhury,

Mukherjee,

Singer

et al. 2024

Annals of Neurology

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ObjectiveTo investigate neurologic manifestations of post‐acute sequelae of SARS‐CoV‐2 infection (Neuro‐PASC) in post‐hospitalization Neuro‐PASC (PNP) and non‐hospitalized Neuro‐PASC (NNP) patients across the adult lifespan.MethodsCross‐sectional study of the first consecutive 200 PNP and 1,100 NNP patients evaluated at a Neuro‐coronavirus disease 2019 (COVID‐19) clinic between May 2020 and March 2023. Patients were divided into younger (18–44 years), middle‐age (45–64 years), and older (65+ years) age groups.ResultsYounger and middle‐age individuals accounted for 142 of 200 (71%) of PNP and 995 of 1100 (90.5%) of NNP patients. Significant age‐related differences in the frequencies of comorbidities and abnormal neurologic findings demonstrated higher prevalence in older patients. Conversely, 10 months from COVID‐19 onset, we found significant age‐related differences in Neuro‐PASC symptoms indicating lower prevalence, and therefore, symptom burden, in older individuals. Moreover, there were significant age‐related differences in subjective impression of fatigue (median [interquartile range (IQR)] patient‐reported outcomes measurement information system [PROMIS] score: younger 64 [57–69], middle‐age 63 [57–68], older 60.5 [50.8–68.3]; p = 0.04) and sleep disturbance (median [IQR] PROMIS score: younger 57 [51–63], middle‐age 56 [53–63], older 54 [46.8–58]; p = 0.002) in the NNP group, commensurate with higher impairment in quality of life (QoL) among younger patients. Finally, there were significant age‐related differences in objective executive function (median [IQR] National Institutes of Health [NIH] toolbox score: younger 48 [35–63], middle‐age 49 [38–63], older 54.5 [45–66.3]; p = 0.01), and working memory (median [IQR] NIH toolbox score: younger 47 [40–53], middle‐age 50 [44–57], older 48 [43–58]; p = 0.0002) in NNP patients, with the worst performance coming from the younger group.InterpretationYounger and middle‐age individuals are disproportionally affected by Neuro‐PASC regardless of acute COVID‐19 severity. Although older people more frequently have abnormal neurologic findings and comorbidities, younger and middle‐age patients suffer from a higher burden of Neuro‐PASC symptoms and cognitive dysfunction contributing to decreased QoL. Neuro‐PASC principally affects adults in their prime, contributing to profound public health and socioeconomic impacts warranting dedicated resources for prevention, diagnosis and interventions. ANN NEUROL 2024

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Trajectories of health-related quality of life and their predictors in adult COVID-19 survivors: A longitudinal analysis of the Biobanque Québécoise de la COVID-19 (BQC-19)

Cited by 6 publications

References 45 publications

Health-Related Quality of Life for Patients with Post-Acute COVID-19 Syndrome: Identification of Symptom Clusters and Predictors of Long-Term Outcomes

Health-Related Quality of Life for Patients with Post-Acute COVID-19 Syndrome: Identification of Symptom Clusters and Predictors of Long-Term Outcomes

Impact of COVID-19 Infection on Health-Related Quality of Life, Work Productivity and Activity Impairment by Symptom-Based Long COVID Status and Age in the US

Neurologic Manifestations of Long COVID Disproportionately Affect Young and Middle‐Age Adults

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