Assessment of Post-COVID-19 Quality of Life Using the Quality of Life Index

Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh

BACKGROUND

The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings.

METHODS

COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews.

RESULTS

Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time.

CONCLUSIONS

The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.

Worsening of alcohol abuse disorder in a Spanish population during the first twelve months of the COVID-19 pandemic and associated factors: retrospective, ecological and community study

PURPOSE

To analyse: (1) Changes in clinical parameters and in the use of social healthcare resources by patients with alcohol abuse disorder between the six months prior to the start of the pandemic and the first year of the pandemic. (2) The factors related to a worsening of clinical parameters among patients with alcohol abuse disorder.

METHODS

A retrospective and observational study of a population who have been diagnosed with alcohol abuse disorders according to their primary health care (PHC) electronic medical records was performed. The total sample was made up of 11,384 patients. The variables (sociodemographic variables, chronic comorbidities, analytical parameters related to alcohol abuse disorder, COVID-19 infection, and use of healthcare resources) were collected in three different time periods: (i) six months before the onset of the strict lockdown, (ii) six months following the end of lockdown and (iii) from six to twelve months after the end of lockdown. Paired Student's T-test and a multivariate logistic regression were performed.

RESULTS

Along the first year after the onset of the pandemic, between 44% and 54% of the patients suffered a decline in every clinical parameter. The number of PHC nursing, GP visits and social worker visits reduced significantly. As regards the associated factors related to deterioration of alcohol abuse disorder, being younger than 40 years old, having an income of over 18,000 euros/year and not having visited the social worker were associated with a worsening of the disorder.

CONCLUSIONS

These results suggest that the impact of COVID-19 on this group has been high, and the social care offered to these patients plays a significant role in minimising the repercussions of the pandemic.

Quality of life among the Arab population two years after COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has resulted in severe consequences worldwide. Our study aims to assess the quality of life (QoL) domains and its determinants among the general population in Arab countries after two years of the COVID-19 pandemic.

METHODS

An anonymous online cross-sectional survey using the short version of World Health Organization QoL (WHOQOL-BREF) instrument was distributed among Arab adults in 15 Arab Countries.

RESULTS

A total of 2008 individuals completed the survey. Amongst them, 63.2% were 18-40 years and 63.2% were females, 26.4% had chronic disease, 39.7% confirmed having contracted COVID-19, and 31.5% had experienced the unfortunate loss of relatives due to COVID-19. The survey revealed that 42.7% reported good physical QoL, 28.6% were satisfied with psychological QoL, 32.9% had a sense of well-being in the social domain, and 14.3% had good QoL in the environmental domain. The predictors of physical domains were as follows: being a male (β = 4.23 [95%CI 2.71, 5.82]), being from low-middle income country (β = -3.79 [95%CI -5.92, -1.73]) or being from high-middle-income country (β = -2.95 [95%CI -4.93, -0.92]), having a a chronic disease (β = -9.02 [95%CI -10.62,-7.44]) having a primary/secondary education (β = -2.38 [95%CI -4.41, -0.054]), number of years of work experience ≥ 15 years (β = 3.25 [95%CI 0.83, 5.73]), income-per-capita [ranged from (β = 4.16 [95%CI -5.91, -2.40]) to (β = -11.10 [95CI%, -14.22, -8.11])], a previous COVID-19 infection (β = -2.98 [95%CI -4.41, -1.60]), and having relative died from COVID-19 (β = -1.56 [95%CI -3.01, -0.12]). The predictors of psychological domain were having a chronic disease (β = -3.15 [95%CI -4.52, -1.82]), a postgraduate education (β = 2.57 [95% CI 0.41, 4.82]), number of years of work experience ≥ 15 years (β = 3.19 [95%CI 1.14, 5.33]), income-per-capita [ranged from (β = -3.52 [95%CI -4.91, -1.92]) to (β = -10.31 [95%CI -13.22, -7.44])], and a previous COVID-19 infection (β = -1.65 [95%CI -2.83, -0.41]). The predictors of social domain were being a male (β = 2.78 [95%CI 0.93, 4.73]),  being single, (β =-26.21 [-28.21, -24.32]), being from a low-income country (β = 5.85 [95%CI 2.62, 9.13]), or from a high-middle-income country (β = -3.57 [95%CI -6.10, -2.12]), having a chronic disease (β = -4.11 [95%CI -6.13, -1.11]), and income-per-capita [ranged from (β = -3.62 [95%CI -5.80, -1.41]) to (β = -11.17 [95%CI -15.41, -6.92])]. The predictors of environmental domain were being from a low-middle-income country (β = -4.14 [95%CI -6.90, -1.31), from a high-middle-income country (β = -12.46 [95%CI -14.61, -10.30]), or from a low-income-country (β = -4.14 [95%CI, -6.90, -1.32]), having a chronic disease (β = -3.66 [95%CI -5.30, -1.91]), having a primary/secondary education (β = -3.43 [95%CI -5.71, -1.13]), being not working (β = -2.88 [95%CI -5.61, -0.22]), income-per-capita [ranged from (β = -9.11 [95%CI -11.03, -7.21] to (β = -27.39 [95%CI -31.00, -23.84])], a previous COVID-19 infection (β = -1.67 [95%CI -3.22, -0.21]), and having a relative who died from COVID-19 (β = -1.60 [95%CI -3.12, -0.06].

CONCLUSION

The study highlights the need for public health interventions to support the general population in the Arab countries and mitigate its impact on their QoL.

Decrease in Health-Related Quality of Life and Post-COVID-19 Syndrome in Health Care Workers After SARS-CoV-2 Infection: A Cohort Study

OBJECTIVES

The aim of this study is to assess the persistence of symptoms, the prevalence of post-COVID-19 syndrome, and the health-related quality of life (HRQOL) among health care workers (HCWs) 6 months after severe acute respiratory syndrome coronavirus 2 infection.

METHODS

A prospective cohort study was conducted. All HCWs with confirmed COVID-19 from January to June 2021 were invited to participate. Health-related quality of life was evaluated in three moments: before COVID-19, after COVID-19 (on return to work), and after 6 months. Persistence of symptoms post-COVID-19 was also assessed.

RESULTS

There was a worsening in all dimensions of HRQOL. After 6 months, self-rated health on EuroQol visual analog scale did not return to pre-COVID-19 values. At total, 36.2% of HCWs were diagnosed with post-COVID-19 syndrome.

CONCLUSIONS

There was a significant deterioration in HRQOL among HCWs who had COVID-19 and a high frequency of post-COVID-19 syndrome.

What is the quality of life in patients with long COVID compared to a healthy control group?

Introduction

Many patients have prolonged symptoms after COVID-19 infection, which can affect patient quality of life (QOL). The aim of this study is to determine the quality of life in patients with long COVID, compared with healthy controls.

Material and methods

The study was a prospective cross-sectional study using an anonymous online survey. The SF-36 questionnaire was chosen for quality of life measurement. The survey was distributed through the Facebook social media platform targeting groups of patients with long COVID. The control group was made up of physiotherapy and physical education students.

Results

There was a significant difference in physical function, with a mean score of 94.9 (±9.4) among the students, compared to long COVID patients with a mean score of 66.2 (±25.4) (p < 0.001). A similar result was found in the physical role (p < 0.001). The overall quality of life score for college students was 578.0 (±111.9), and the overall score for patients with long COVID was 331.9 (±126.9).

Conclusions

Patients with long COVID had a lower quality of life compared to the healthy control group, and this was associated with the negative effect of long-COVID. Lower quality of life in patients with long COVID is an important therapeutic goal, which requires attention.

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

Purpose

Some patients experience long-term sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, despite a present post-COVID condition, defined as “any symptom lasting longer than 12 weeks,” only a subset of patients search for medical help and therapy.

Method

We invited all adults with a positive real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 between March 2020 and September 2021 (n = 4091) in the city of Jena to answer a standardized questionnaire including demographic information, the course of the acute infection and current health status. K-means-clustering of quality of life (QoL) was used to explore post-COVID subgroups.

Results

A total of 909 participants at a median interval of 367 (IQR 291/403) days after acute infection were included in the analysis. Of those, 643 (70.7%) complained of having experienced persistent symptoms at the time of the survey. Cluster analysis based on QoL revealed two subgroups of people with persistent post-COVID symptoms. Whereas 189/643 participants (29.4%) showed markedly diminished QoL, normal QoL was detected in 454/643 individuals (70.6%).

Conclusion

Despite persistent symptoms being reported by nearly three quarters of participants, only one-third of these described a significant reduction in QoL (cluster 1), whereas the other two-thirds reported a near-normal QoL (cluster 2), thus indicating a differentiation between “post-COVID disease” and “post-COVID condition”. The prevalence of clinically relevant post-COVID disease was at least 20.7%. Health policies should focus on this subset.

Supplementary Information

The online version contains supplementary material available at 10.1007/s15010-022-01886-9.

Quality of Life and Adherence to Healthcare Services During the COVID-19 Pandemic: A Cross-Sectional Analysis

PURPOSE

To determine the relationship of various domains of quality of life (QoL) with healthcare adherence during the COVID-19 pandemic in Saudi Arabia.

METHODS

The study sample comprised 795 participants among which 203 had a current diagnosis of any major NCDs, including cardiovascular diseases, diabetes mellitus, asthma, chronic pulmonary diseases, and chronic psychiatric illnesses and a control group of 592 participants who had no NCD. Participants completed an online survey questionnaire which obtained data on socio-demographic variables, types of NCDs, and healthcare adherence during the year 2020, the period during which Saudi Arabia underwent the first two waves of the COVID-19 pandemic. World Health Organization Quality of Life (WHOQOL-BREF) assessed the QoL in four domains physical, psychological, social and environmental and used standard scores in the analysis. GraphPad Prism 5 and SPSS 25V were employed for the statistical analysis. Bar graphs and frequency distribution tables present descriptive data. Bivariate and multivariate logistic regression analyses were computed to determine the significance of the relationship between QoL and healthcare adherence.

RESULTS

Almost equal proportions of participants with NCDs (n=109/203; 54%) and without NCDs (n=327/592; 55%) demonstrated nonadherence to their regular healthcare during the COVID-19 pandemic (χ2=0.14; p=0.71). Patients with NCDs experienced lower quality of life in the psychological, social and environmental domains of QoL (p<0.05). Results from the multivariate regression analysis showed that female gender (AOR=1.52; p<0.05) psychological QoL (AOR=1.99; p<0.05), social QoL (AOR=1.98; p<0.05) and environmental QoL (AOR=1.95; p<0.05) significantly relate with adherence to healthcare.

CONCLUSION

Psychological, social and environmental may influence healthcare adherence among patients with NCDs during pandemics and should be focused on while devising future healthcare policy and interventions.

Quality of life among patients with chronic non-communicable diseases during COVID-19 pandemic in Southern Ethiopia: A cross-sectional analytical study

BACKGROUND

The COVID-19 outbreak became a continuing global health agenda. It has a significant impact on individuals' quality of life (QOL). Patients with preexisting medical conditions may have severely reduced QOL. The aim of this study was to assess QOL and its associated factors among patients with chronic non-communicable diseases (NCDs) during COVID-19 pandemic at Sidama Regional State, southern Ethiopia.

METHODS

We conducted a multicenter, cross-sectional study from 1 June to 1 September 2021. A total of 633 participants took part in the study, using an interviewer-administered structured questionnaire. The QOL was measured using the World Health Organization Quality of Life (WHOQOL-BREF) Scale, which has 12 items. To describe different variables, descriptive statistics were employed. To find independent factors associated with QOL, we used multivariable linear regression analysis. P-value of < 0.05 was declared statistically significant at 95% confidence interval (CI).

RESULTS

The majority (56.4%) of participants were male and about half (53.1%) had a diagnosis of diabetes mellitus. The multivariable linear regression model showed statistically significant negative association between different independent variables such as age (β = -0.188, 95% CI = -0.238 to -0.139), being female (β = -1.942, 95% CI = -3.237 to -0.647), duration of illness ≤ 5 years (β = -4.222, 95% CI = -6.358 to -2.087), alcohol use in the past 3 months (β = -4.574, 95% CI = -6.905 to -2.243), common mental disorder (CMD) (β = -1.512, 95% CI = -2.924 to -0.100), insomnia (β = -0.274, 95% CI = -0.380 to -0.168), and QOL. Also, there is a statistically significant positive association between QOL and being illiterate (β = 3.919, 95% CI = 1.998-5.841) and living in the rural area (β = 2.616, 95% CI = 1.242-3.990).

CONCLUSION

In general, the findings confirmed that the COVID-19 pandemic had a negative impact on patients with chronic NCDs QOL. The QOL was significantly influenced by age, gender, educational status, residence area, duration of illness, alcohol use, CMD, and insomnia during COVID-19 pandemic. Thus, this study suggests that addressing insomnia, co-morbidities of mental disorders, and alcohol use has the potential effect to improve the QOL of patients with chronic medical illnesses.