Health-Related Quality of Life and its Associated Factors in COVID-19 Patients

Examining Well-Being and Cognitive Function in People With Long COVID and ME/CFS, and Age-Matched Healthy Controls: A Case-Case-Control Study

BACKGROUND

Well-being and cognitive function had not previously been compared between people with long COVID and people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Therefore, this study examined well-being and cognitive function in people with long COVID (∼16 months illness duration; n = 17) and ME/CFS (∼16 years illness duration; n = 24), versus age-matched healthy controls (n = 16).

METHODS

Well-being was examined using several questionnaires, namely the Health Visual Analogue Scale (VAS), Fatigue Severity Scale (FSS), post-exertional malaise (PEM), Pittsburgh Sleep Quality Index (PSQI), European Quality of Life-5 Domains (EQ-5D), MRC Dyspnoea, Self-Efficacy (SELTC), The Edinburgh Neurosymptoms Questionnaire (ENS), General Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9). Cognitive function was examined using Single Digit Modalities Test (SDMT), Stroop test and Trails A and B. These were delivered via a mobile application (app) built specifically for this remote data collection.

RESULTS

The main findings of the present investigation were that people with ME/CFS and people with long COVID were generally comparable on all well-being and cognitive function measures, but self-reported worse values for pain, fatigue, post-exertional malaise, sleep quality, general well-being in relation to mobility, usual activities, self-care, breathlessness, neurological symptoms, self-efficacy and other well-being such as anxiety and depression, compared to controls. There was no effect of group for cognitive function measures.

CONCLUSIONS

These data suggest that both people with long COVID and people with ME/CFS have similar impairment on well-being measures examined herein. Therefore, interventions that target well-being of people with ME/CFS and long COVID are required.

Impact of Long COVID on Health-Related Quality of Life Among COVID-19 Survivors in Saudi Arabia

Background: Long COVID (LC) has emerged as a significant epidemiological and public health issue, affecting patients' health-related quality of life (HRQoL). This study explored the impact of LC on HRQoL in COVID-19 survivors in the Eastern Province of Saudi Arabia and examined the sociodemographic and clinical factors that influence HRQoL. Methods: This cross-sectional study included 1024 participants, and data were collected through face-to-face interviews using a structured questionnaire that incorporated the EQ-5D-5L tool to assess HRQoL. Sociodemographic information, acute COVID-19 symptoms, and LC symptoms were recorded. Statistical analyses included bivariate analyses and multivariable generalized linear modelling. Results: Of all participants, 63.8% reported experiencing LC symptoms, with fatigue, cough, and anosmia being the most common. Participants with LC had significantly lower HRQoL scores (mean EQ-5D-5L index score, 0.93) than those without LC (mean score, 0.98; p < 0.001). The key factors influencing lower HRQoL included a higher number of LC symptoms, older age, the presence of pneumonia during acute COVID-19, and pre-existing conditions such as anxiety and hypertension. Conclusions: LC negatively impacts HRQoL, with older age, chronic diseases, and the number of LC symptoms being strong predictors of poor outcomes. Interventions targeting rehabilitation and psychosocial support are critical for improving the long-term health outcomes of patients with LC.

Health-related quality of life and its determinants in patients with migraine relating to the coronavirus disease 2019 pandemic in the Eastern Province of Saudi Arabia

BACKGROUND

Migraine is a neurological disorder associated with different levels of disability that can impact health-related quality of life (HRQoL). The management of this condition worsened with the challenges posed by the coronavirus disease 2019 (COVID-19) pandemic. This study sought to evaluate the effects of migraine on HRQoL and identify key factors contributing to these outcomes in migraineurs in relation to the COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional study was carried out on 198 migraine patients between October 2022 and April 2023. HRQoL was assessed using the EQ-5D-5L comprising five domains. Data was collected by both face-to-face interviews and a self-administered online questionnaire. Categorical variables were described as frequencies and percentages while means with standard deviations or medians with interquartile ranges (IQRs) were computed for continuous variables. Chi-square test was used to assess associations of COVID-19 infection with migraine complications and HRQol.

RESULTS

The majority of the cohort were predominantly females (67.7%), university graduates (79.8%), and unemployed (63.3%). About 53% of migraineurs who reported no COVID-19 infection, indicated an increase in migraine attacks during the pandemic, whereas 51.9% of the participants who had COVID-19 reported an increase in attacks (P = 0.894). Migraineurs aged <30 years reported a significantly higher HRQoL score (median=0.94, IQR = 0.17, P < 0.001). Participants with higher income levels reported better HRQol (median: 0.89). Those with multi-comorbidities (median= 0.84 vs. 0.99, P < 0.05) showed significantly lower HRQoL.

CONCLUSION

Study highlighted significant impact of COVID-19 on increasing frequency of migraine attacks in individuals infected with COVID-19, which in turn led to a decline in HRQol. Correlates of poor HRQoL included advancing age, low income, presence of multiple comorbidities, and unhealthy body mass index. An urgent intervention to improve the HRQol should be implemented after the pandemic.

Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19

ObjectiveCleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic.DesignCross-sectional StudySettingCLP team at Tehran University of Medical Sciences (TUMS).Patients/ParticipantsThirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP.InterventionsST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19.Main Outcome Measure(s)A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS.ResultsTotal and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05).ConclusionsQOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.

Post COVID-19 infection and quality of life of healthcare workers at Sahloul University Hospital of Sousse in Tunisia

BACKGROUND

Since the COVID-19 pandemic, health care workers (HCWs) faced an enormous physical and mental burden, sometimes altering their quality of life due mainly to persistent challenges stemming from their frontline position.

AIMS

Todetermine the prevalence of post-COVID-19 syndrome, and its impact on the Health-Related Quality of Life (HRQoL) among HCWs.

METHODS

This is an exhaustive cross-sectional study with analytical scope, conducted among all HCWs of the University Hospital Sahloul of Sousse, Tunisia, who have contracted COVID-19 between September 2020 and 30 March 2021 (N=529 cases).The post-covid medical check-up was carried out three months after the acute phase of the COVID-19 infection (December 2020 to June 2021). HRQoL was assessed using the SF-12 (12-item Short Form Health Survey) questionnaire. Bivariate study and multiple linear regressions were performed to identify the different factors influencing the quality of life of HCWs.

RESULTS

During the study period, 529 HCWs were diagnosed with SARS CoV-2 infection, out of them 249 participants were included (47% participation rate). Post covid-19 syndrome was reported in 65% of cases. A low overall quality of life (QoL) score was reported in 28.6% of cases. Low physical and mental composite scores were reported in 34.3% and 29.4% of cases respectively. In the multiple linear regression analysis, gender, post COVID-19 syndrome and time off work were significantly associated with SF12 scores.

CONCLUSION

In our study, HCWs experienced a significant deterioration in HRQoL after COVID-19 with a high incidence of post-COVID-19 syndrome. The need of long-term follow-up after SARS-CoV-2 infection remains essential to support HCWs and mitigate long-term impacts.

Health Preferences in Transition: Differences from Pandemic to Post-Pandemic in Valuation of COVID-19 and RSV Illness in Children and Adults

Objective: This study aimed to measure changes in preferences regarding health-related quality of life associated with COVID-19 and RSV illness in children and adults from 2021 (during the COVID-19 pandemic) to 2023 (post-pandemic). Methods: A stated-preference survey elicited time trade-off (TTO) values from US adults in spring 2021 (n = 1014) and summer 2023 (n = 1186). Respondents were asked to indicate how much time they would hypothetically be willing to trade from the end of their life to avoid the effects of varying severities of COVID-19 and RSV illness for: (1) children; (2) parents of an ill child (family spillover); and (3) adults. Attitudes relating to COVID-19 vaccination and data on experience with COVID-19 or RSV illness were also collected. The primary outcome measure was the loss in quality-adjusted life years (QALYs). Changes in preferences over the time period from 2021 to 2023 were evaluated using regression analysis. Results: QALY losses increased with disease severity and were highest for Long COVID. Across all COVID-19 and RSV health states, QALY losses associated with child health states were higher than family spillover or adult health states. In the regression analysis, QALY losses reported in the 2023 survey were significantly lower than 2021 QALY losses for COVID-19, but not RSV. Conclusions: Preferences may change over time in a pandemic context and therefore, economic analyses of pandemic interventions should consider the timeframe of health preference data collection to determine whether they are suitable to include in an economic evaluation. Even with the impacts on health-related quality of life attenuated over time, childhood illnesses still had a measurable impact on caregivers' quality of life.

Evaluating health-related quality of life in Ethiopia: systematic review and meta-analysis of EQ-5D-based studies

Background

Health-related quality of life (HRQoL) is crucial for understanding how health conditions impact overall well-being. The EuroQol-5 Dimension (EQ-5D) is a widely used tool for measuring HRQoL across diseases. In Ethiopia, this tool has been employed to assess HRQoL across various healthcare settings. This study aims to summarize EQ-5D-derived health outcomes in Ethiopian populations and identify key determinants influencing these outcomes.

Methods

A systematic search of PubMed, Embase, and Scopus was conducted through May 2024, with no publication date restrictions, focusing on HRQoL and EQ-5D instruments in Ethiopian populations. Grey literature searches were also performed using Google's Advanced Search. Cross-sectional studies across various diseases were included. Data were extracted by two independent reviewers, and pooled mean EQ-5D utility and EQ-5D visual analog scale (EQ-VAS) scores were calculated using a random-effects model in STATA software version 17. Study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) checklist, and heterogeneity was assessed using the I² statistic.

Results

Fourteen cross-sectional studies involving 5,639 patients from 2019 to 2024 in Ethiopia were analyzed. Health utility values varied across diseases, with pain/discomfort and anxiety/depression being the most commonly affected dimensions. The pooled EQ-5D utility for HIV patients was 0.88, and the EQ-VAS score was 76.59. For diabetes mellitus (DM) patients, the pooled utility was 0.78, and the EQ-VAS score was 69.36. For COVID-19 patients, the pooled utility was 0.86, and the EQ-VAS score was 74.56. Cancer patients had a pooled EQ-VAS score of 67.87.

Conclusion

The EQ-5D is a reliable tool for measuring HRQoL in Ethiopian patients across various diseases. The study's pooled EQ-5D scores provide valuable insights for future economic evaluations in the Ethiopian healthcare system.

Systematic Review Registration

https://doi.org/10.1136/bmjopen-2024-085354, PROSPERO (CRD42024505028).

Physical therapy management of an individual with post-COVID fatigue considering emotional health in an outpatient setting: A case report

PURPOSE

The purpose of this case report is to provide a plan of care with an emphasis on patient education and consideration of emotional health for a patient with post-COVID fatigue in an outpatient setting.

CASE DESCRIPTION

A 50-year-old woman, ten-weeks post-COVID syndrome, participated in an examination that revealed deficits in exercise capacity, strength, breathing pattern, mild depression, emotional breakdown, and mild anxiety accompanied by "brain fog" with activity. Her primary complaint was fatigue with ordinary activities around her home that impeded her from returning to work. On examination, scores included six-minute walk test distance (6MWD): 79.5 m, UCSD Shortness of Breath Questionnaire (SOBQ): 72/120, and Patient Health Questionnaire (PHQ-9): 6/27. The patient participated in 20 biweekly sessions with a focus on patient education, supporting emotional health, aerobic training, strengthening exercises, breathing exercises, and home exercise program.

OUTCOMES

At discharge, the patient's exercise capacity, muscle strength, dyspnea, and depression improved, beyond the MCID/MID values, 6MWD: 335 m, SOBQ: 34/120; and PHQ-9 :1/27. The patient had no anxiety with activity and reported confidence to resume activities, allowing her to return to work safely.

CONCLUSION

Following an intervention that addressed emotional needs with physical symptoms, our patient with post-COVID fatigue showed substantial improvements in exercise capacity, muscle strength, dyspnea, and depression. This highlights the consideration of psychosocial well-being in our plan of care for this population.

Predictors of health-related quality of Life for COVID-19 survivors living in Dhaka, Bangladesh: A repeated Follow-Up after 18 months of their recovery

The study aimed to explore the key determinants that impact the quality of life (QoL) transformation of those who have recuperated from COVID-19 in the Dhaka metropolis, particularly 18 months post-recovery. RT-PCR confirmed that 1,587 COVID-19 patients from Dhaka were included in the study. The baseline was June - November 2020, subsequently recovered and interviewed 18 months after their initial recovery. The follow-up included 1587 individuals using the WHOQOL-BREF questionnaire. After excluding 18 deaths, 53 refusals, 294 inaccessible participants, and 05 incomplete data entries, we analysed the data of the 1217 respondents. The average physical domain score decreased significantly from baseline to follow-up, whereas a significant increase in average scores has been observed in other domains at the follow-up (p<0.05). GEE equation shows after adjusting for other factors, older age, female gender, higher education, higher family income, hospital admission during COVID-19, and the number of comorbidities were significantly associated with changing individuals' QoL scores. Monthly family income >60000 BDT, being married and having no previous vaccination history are significant in reducing people's QoL scores in the psychological domain. On the other hand, age, employment status, monthly family income, marital status, smoking history, and COVID-19 reinfection were significantly associated with altering an individual's QoL scores in the social domain. The overall QoL of COVID-19 recovered people improved in all domains after 18 months, except the physical realm. Participants' age, employment status, family income, marital status, smoking history, comorbidities, COVID-19 vaccination, and COVID-19 reinfection were responsible for altering people's QoL index.

COVID-19 Recovery Time and Its Predictors among Hospitalized Patients in Designated Hospitals in the Madhesh Province of Nepal: A Multicentric Study

This study aimed to determine COVID-19 recovery time and identify predictors among hospitalized patients in the Dhanusha District of Madhesh Province, Nepal. This hospital-based longitudinal study involved 507 COVID-19 patients admitted to three distinct medical facilities for therapeutic intervention between April and October 2021. Data were collected for patient demography, symptoms, vital signs, oxygen saturation levels, temperatures, heart rates, respiratory rates, blood pressure measurements, and other health-related conditions. Kaplan-Meier survival curves estimated the recovery time, and a Cox proportional hazard model was used to identify the predictors of recovery time. For the total participants, mean age was 51.1 (SD = 14.9) years, 68.0% were males. Of the total patients, 49.5% recovered, and 16.8% died. The median for patient recovery was 26 days (95% CI: 25.1-26.7). Patients with severe or critical conditions were less likely to recover compared to those with milder conditions (hazard ratio (HR) = 0.34, 95% CI: 0.15-0.79; p = 0.012). In addition, an increase in oxygen saturation was associated with an elevated likelihood of recovery (HR = 1.09, 95% CI = 1.01-1.17, p = 0.018). This study underscores the need for early admission to hospital and emphasizes the targeted interventions in severe cases. Additionally, the results highlight the importance of optimizing oxygen levels in COVID-19 patient care.

Examining the Trajectory of Health-Related Quality of Life among Coronavirus Disease Patients

BACKGROUND

Recent studies have reported a reduction in health-related quality of life (HR-QoL) among post-coronavirus disease 2019 (COVID-19) patients. However, there remains a gap in research examining the heterogeneity and determinants of HR-QoL trajectory in these patients.

OBJECTIVE

To describe and identify factors explaining the variability in HR-QoL trajectories among a cohort of patients with history of COVID-19.

DESIGN

A prospective study using data from a cohort of COVID-19 patients enrolled into a registry established at a health system in New York City.

PARTICIPANTS

Participants were enrolled from July 2020 to June 2022, and completed a baseline evaluation and two follow-up visits at 6 and 12 months.

METHODS

We assessed HR-QoL with the 29-item Patient Reported Outcomes Measurement Information System instrument, which was summarized into mental and physical health domains. We performed latent class growth and multinomial logistic regression to examine trajectories of HR-QoL and identify factors associated with specific trajectories.

RESULTS

The study included 588 individuals with a median age of 52 years, 65% female, 54% White, 18% Black, and 18% Hispanic. We identified five physical health trajectories and four mental health trajectories. Female gender, having pre-existing hypertension, cardiovascular disease, asthma, and hospitalization for acute COVID-19 were independently associated with lower physical health. In addition, patients with increasing body mass index were more likely to experience lower physical health over time. Female gender, younger age, pre-existing asthma, arthritis and cardiovascular disease were associated with poor mental health.

CONCLUSIONS

We found significant heterogeneity of HR-QoL after COVID-19, with women and patients with specific comorbidities at increased risk of lower HR-QoL. Implementation of targeted psychological and physical interventions is crucial for enhancing the quality of life of this patient population.

Association of pulmonary function test abnormalities and quality-of-life measures after COVID-19 infection

BACKGROUND

Long-COVID is a multisystem disease that can lead to significant impairments in health-related quality of life (HRQoL). Following COVID-19 infection, abnormalities on pulmonary function tests (PFT) are common. The primary aim of this study is to evaluate for any correlation between PFT abnormalities and impairment in HRQoL scores following COVID-19 infection.

METHODS

This is an analysis of a prospective cohort of patients in Louisville, KY who were infected with COVID-19. Data collected included demographics, past medical history, laboratory tests, PFTs, and several HRQoL questionnaires such as the EuroQol 5 Dimension HRQoL questionnaire (EQ-5D-5 L), Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire (PHQ-9), and Posttraumatic stress disorder checklist for DSM-5 (PCL-5). Descriptive statistics were performed, comparing PFTs (normal vs abnormal) and time since COVID-19 infection (3- vs 6- vs ≥ 12 months).

RESULTS

There were no significant differences in FEV1, FVC, or the percentage of patients with abnormal PFTs over time after COVID-19 infection. Following COVID-19, patients with normal PFTs had worse impairment in mobility HRQoL scores and change in GAD-7 scores over time. There were no differences over time in any of the HRQoL scores among patients with abnormal PFTs.

CONCLUSIONS

Among patients with an abnormal PFT, there was no temporal association with HRQoL scores as measured by EQ-5D-5 L, GAD-7, PHQ-9, and PCL-5. Among patients with a normal PFT, mobility impairment and anxiety may be associated with COVID-19 infection. Following COVID-19 infection, impairment in HRQoL scores is not completely explained by the presence of abnormalities on spirometry.

Assessment of the quality of life of COVID-19 recovered patients at the Ghana Infectious Disease Centre

BACKGROUND

The Coronavirus Disease (COVID-19), initially thought to be a respiratory disease, is now known to affect multiple organ systems with variable presentation and devastating or fatal complications. Despite the large numbers of people who have suffered this disease globally, the mid- to long-term impact of COVID-19 on a person's general well-being and physical function has not been fully investigated in Ghana.

AIM

This study sought to determine the Quality of Life (QoL) and associated factors among Ghanaian patients following clinical recovery from COVID-19 infection.

METHODS

This was a cross-sectional quantitative study involving 150 COVID-19 recovered patients attending the review clinic of the Ghana Infectious Disease Centre. Quality of life was estimated using the EuroQol Group Association five-domain, five-level questionnaire (EQ-5D-5L) while participants' overall health status was measured on a visual analogue scale (EQ-VAS): a scale ranging from 0 (worst health) to 100 (best health). Kruskal-Wallis tests were used to assess differences in domain and overall QoL scores while quantile regression was used to determine demographic and clinical factors associated with QoL scores.

RESULTS

The mean QoL from the EQ-5D-5L assessment tool was (81.5 ± 12.0) %, while the self-reported QoL from the EQ-VAS tool (75.6 ± 22.0) %. Persistence of symptoms after 30 days was significantly associated with EQ-5D-5L QoL (Adjusted median difference [95% CI] = -9.40 [-14.19, -4.61], p<0.001) while access to rehabilitative centres was significantly associated with EQ-VAS QoL (Adjusted median difference [95% CI] = -29.60 [-48.92, -10.29], p = 0.003).

CONCLUSION

Quality of life was relatively good among the COVID-19 recovered patients. Persistence of symptoms and access to rehabilitative centres significantly predicted one's QoL.

A lifestyle adjustments program in long COVID-19 improves symptomatic severity and quality of life. A randomized control trial

OBJECTIVE

To evaluate the efficacy of a therapeutic intervention based on self-adjustment strategies for improving of symptomatic severity and quality of life.

METHODS

The study was a randomised single-blind clinical trial. Quality of life, disability, and functional impairment were collected. The control group received a leaflet with information on the main symptoms of Long-COVID-19 syndrome, in addition to standard medical treatment. The intervention group received treatment following a dual approach; on the one hand, monitoring and recognition of symptomatology and on the other hand, adaptation and functional improvement.

RESULTS

A total of 54 participants were included, 27 were included in the intervention group and 27 in the control group. At the beginning of the study, no significant differences were found between groups. After intervention, the quality of life variable showed significant differences between groups in the self-care and anxiety/depression dimensions. Significant between-groups differences were also found for the self-care subscale of the disability variable. The intervention group showed significant differences from baseline on some subscales of the quality of life, disability, and functional impairment variables.

CONCLUSION

Strategies based on lifestyle adjustments are adequate for the improvement of quality of life and symptom severity in the long COVID-19 population.

PRACTICE IMPLICATION

The findings suggest that applying an intervention focused in self-adjustment for long COVID patients can have positive effects.

Impact of long COVID on health-related quality-of-life: an OpenSAFELY population cohort study using patient-reported outcome measures (OpenPROMPT)

Background

Long COVID is a major problem affecting patient health, the health service, and the workforce. To optimise the design of future interventions against COVID-19, and to better plan and allocate health resources, it is critical to quantify the health and economic burden of this novel condition. We aimed to evaluate and estimate the differences in health impacts of long COVID across sociodemographic categories and quantify this in Quality-Adjusted Life-Years (QALYs), widely used measures across health systems.

Methods

With the approval of NHS England, we utilised OpenPROMPT, a UK cohort study measuring the impact of long COVID on health-related quality-of-life (HRQoL). OpenPROMPT invited responses to Patient Reported Outcome Measures (PROMs) using a smartphone application and recruited between November 2022 and October 2023. We used the validated EuroQol EQ-5D questionnaire with the UK Value Set to develop disutility scores (1-utility) for respondents with and without Long COVID using linear mixed models, and we calculated subsequent Quality-Adjusted Life-Months (QALMs) for long COVID.

Findings

The total OpenPROMPT cohort consisted of 7575 individuals who consented to data collection, with which we used data from 6070 participants who completed a baseline research questionnaire where 24.6% self-reported long COVID. In multivariable regressions, long COVID had a consistent impact on HRQoL, showing a higher likelihood or odds of reporting loss in quality-of-life (Odds Ratio (OR): 4.7, 95% CI: 3.72-5.93) compared with people who did not report long COVID. Reporting a disability was the largest predictor of losses of HRQoL (OR: 17.7, 95% CI: 10.37-30.33) across survey responses. Self-reported long COVID was associated with an 0.37 QALM loss.

Interpretation

We found substantial impacts on quality-of-life due to long COVID, representing a major burden on patients and the health service. We highlight the need for continued support and research for long COVID, as HRQoL scores compared unfavourably to patients with conditions such as multiple sclerosis, heart failure, and renal disease.

Funding

This research was supported by the National Institute for Health and Care Research (NIHR) (OpenPROMPT: COV-LT2-0073).

Health-related quality of life among adults living with chronic non-communicable diseases in the Ho Municipality of Ghana: a health facility-based cross-sectional study

BACKGROUND

Morbidity and mortality rates from chronic non-communicable diseases (CNCDs) are increasing globally. In Ghana, CNCDs account for 43% of all deaths. We examined the Health-Related Quality of Life (HRQoL) and associated factors among adults living with CNCDs in the Ho Municipality.

METHODS

This was a health facility-based descriptive cross-sectional study among 432 adults living with cancer, diabetes, chronic kidney disease (CKD), stroke, and hypertension in the Ho Municipality of Ghana. The study adopted the EQ-5D-5L instrument and the Ugandan value set to compute respondents' HRQoL index. Quantile regression models were used in analysing the data with STATA v17.0 at 95% Confidence Intervals, and statistical significance set at p < 0.05.

RESULTS

63.7% of our respondents reported having a problem across the five dimensions of the EQ-5D-5L. The most problems were reported in the dimensions "Anxiety/Depression" (94.4%) and "Pain/Discomfort" (91.4%). Divorced/separated respondents (aOR=-0.52, 95% CI=-0.71, -0.33) and those living with comorbidities (aOR=-0.95, 95% CI=-0.15, -0.04,) were less likely to report high index for HRQoL. However, respondents diagnosed with CKD (aOR = 0.26, 95% CI = 0.10, 0.42), diabetes (aOR = 0.28, 95% CI = 0.11, 0.45), hypertension (aOR = 0.35, 95% CI = 0.19, 0.50) and stroke (aOR = 0.26, 95% CI = 0.11, 0.40) were more likely to report higher index than those diagnosed with cancer.

CONCLUSION

Our study revealed elevated proportions of reported problems in the "Anxiety/Depression" and "Pain/Discomfort" dimensions, indicating noteworthy concerns in these areas of HRQoL. The prevalent issues reported across HRQoL dimensions are cause for concern, posing potential exacerbation of health conditions. We advocate for collaborative efforts from the Ministry of Health, Ghana Health Service, and relevant stakeholders to scrutinize and implement interventions targeting social and psychological factors. These efforts should specifically address contributors to diminished health-related quality of life, particularly among less educated, divorced, and comorbid individuals.

Symptoms, Mental Health, and Quality of Life Among Patients After COVID-19 Infection: A Cross-sectional Study in Vietnam

OBJECTIVES

This study was conducted to characterize the symptoms, mental health, quality of life (QoL), and associated factors following the coronavirus disease 2019 (COVID-19) infection.

METHODS

This cross-sectional study included 394 participants previously infected with COVID-19 in Ho Chi Minh City, Vietnam. Mental health was assessed using the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Participants self-reported health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale.

RESULTS

Among the participants, 76.4% reported experiencing at least one symptom following COVID-19 infection. The most common symptoms were fatigue (42.1%), cognitive dysfunction (42.9%), and hair loss (27.9%). According to the DASS-21 results, the proportions of depression, anxiety, and stress were 28.7%, 26.4%, and 20.6%, respectively. The mean scores on the EQ-5D-5L and the EuroQol Visual Analog Scale were 0.94±0.11 and 84.20±13.11, respectively. Regarding QoL issues, the highest proportion of participants (32.7%) reported experiencing anxiety or depression, followed by pain or discomfort (25.4%). Multivariable logistic regression analysis revealed that factors associated with the presence of symptoms following COVID-19 infection included female (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.65 to 4.91) and having QoL issues (OR, 3.25; 95% CI, 1.71 to 6.19).

CONCLUSIONS

The study investigated the prevalence rates of various symptoms following COVID-19 infection. These findings underscore the need to prioritize comprehensive care for individuals recovering from COVID-19 and to implement strategies to mitigate the long-term impact of the disease on mental health and QoL.

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

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.

Evaluation of Primary Allied Health Care in Patients Recovering From COVID-19 at 6-Month Follow-up: Dutch Nationwide Prospective Cohort Study

BACKGROUND

Patients recovering from COVID-19 often experience persistent problems in their daily activities related to limitations in physical, nutritional, cognitive, and mental functioning. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19.

OBJECTIVE

This study aimed to evaluate the primary allied health care of patients recovering from COVID-19 at 6-month follow-up and to explore which baseline characteristics are associated with changes in the scores of outcomes between baseline and 6-month follow-up.

METHODS

This Dutch nationwide prospective cohort study evaluated the recovery of patients receiving primary allied health care (ie, dietitians, exercise therapists, occupational therapists, physical therapists, and speech and language therapists) after COVID-19. All treatments offered by primary allied health professionals in daily practice were part of usual care. Patient-reported outcome measures on participation, health-related quality of life, fatigue, physical functioning, and psychological well-being were assessed at baseline and at 3- and 6-month follow-up. Linear mixed model analyses were used to evaluate recovery over time, and uni- and multivariable linear regression analyses were used to examine the association between baseline characteristics and recovery.

RESULTS

A total of 1451 adult patients recovering from COVID-19 and receiving treatment from 1 or more primary allied health professionals were included. For participation (Utrecht Scale for Evaluation of Rehabilitation-Participation range 0-100), estimated mean differences of at least 2.3 points were observed at all time points. For the health-related quality of life (EuroQol Visual Analog Scale, range 0-100), the mean increase was 12.3 (95% CI 11.1-13.6) points at 6 months. Significant improvements were found for fatigue (Fatigue Severity Scale, range 1-7): the mean decrease was -0.7 (95% CI -0.8 to -0.6) points at 6 months. However, severe fatigue was reported by 742/929 (79.9%) patients after 6 months. For physical functioning (Patient-Reported Outcomes Measurement Information System-Physical Function Short Form 10b, range 13.8-61.3), the mean increase was 5.9 (95% CI 5.9-6.4) points at 6 months. Mean differences of -0.8 (95% CI -1.0 to -0.5) points for anxiety (Hospital Anxiety and Depression Scale range 0-21) and -1.6 (95% CI -1.8 to -1.3) points for depression were found after 6 months. A worse baseline score, hospital admission, and male sex were associated with greater improvement between baseline and 6-month follow-up, whereas age, the BMI, comorbidities, and smoking status were not associated with mean changes in any outcome measures.

CONCLUSIONS

Patients recovering from COVID-19 who receive primary allied health care make progress in recovery but still experience many limitations in their daily activities after 6 months. Our findings provide reference values to health care providers and health care policy makers regarding what to expect from the recovery of patients who receive health care from 1 or more primary allied health professionals.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04735744; https://tinyurl.com/3vf337pn.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2340/jrm.v54.2506.

One-year quality of life among post-hospitalization COVID-19 patients

Introduction

The long-term effects of SARS-CoV-2 are unclear, as are the factors influencing the evolution. Objective: to assess health-related quality of life 1 year after a hospital admission due to COVID-19 and to identify factors that may influence it.

Materials and methods

Retrospective observational study in a tertiary hospital from March 2021 to February 2022. Inclusion criteria: ≥18 years old and admitted for SARS-CoV-2 infection. Exclusion criteria: death, not located, refusal to participate, cognitive impairment, and language barrier. Variables: demographic data, medical history, clinical and analytical outcomes during hospital admission, treatment received, and vaccination against SARS-CoV-2 following admission. Participants were interviewed by phone 1 year after admission, using the SF-36 quality of life questionnaire.

Results

There were 486 included patients. The domains yielding the lowest scores were general health (median 65%, interquartile range [IQR] 45-80), vitality (median 65%, IQR 45-80), and mental health (median 73.5%, IQR 60-100). Multivariable analysis showed that female sex and fibromyalgia/fatigue had a negative influence on all domains. Obesity was associated with worse outcomes in physical functioning, physical role, bodily pain, and vitality. Other factors associated with worse scores were an older age in physical functioning and high age-adjusted Charslon comorbidity in physical functioning and general health. Age was associated with better results in emotional role and High C-reactive protein at admission on vitality.

Conclusion

One year after admission for COVID-19, quality of life remains affected, especially the domains of general health, vitality, and mental health. Factors associated with worse outcomes are female sex, fibromyalgia/chronic fatigue, and obesity.

Post-COVID-19 fatigue and health-related quality of life in Saudi Arabia: a population-based study

Background

Despite substantial literature on symptoms and long-term health implications associated with COVID-19; prevalence and determinants of post-acute COVID-19 fatigue (PCF) remain largely elusive and understudied, with scant research documenting health-related quality of life (HRQoL). Hence, prevalence of PCF and its associated factors, and HRQoL among those who have survived Covid-19 within the general population of Saudi Arabia (KSA) is the subject under examination in this research.

Methods

This cross-sectional study was conducted on 2063 individuals, selected from the KSA's general population, using a non-probability sampling approach. An online survey was used to employ a self-administered questionnaire to the participants, which included socio-demographic information, the patient's COVID-19 infection history, 12-item Short Form Health Survey (SF-12) to assess quality of life, and Chalder Fatigue Scale (CFS) (CFQ 11) to evaluate the extent and severity of fatigue. Data were analyzed using SPSS version 26. A p < 0.05 was considered to be strong evidence against the null hypothesis.

Results

The median age of participants was 34 (IQR = 22) years, with females comprising the majority (66.2%). According to the SF-12 questionnaire, 91.2% of patients experienced physical conditions, and 77% experienced depression. The prevalence of PCF was 52% on CFQ 11 scale. Female gender, higher levels of education, a pre-existing history of chronic disease, as well as the manifestations of shortness of breath and confusion during acute COVID-19 infection, were identified as independent predictors of fatigue.

Conclusion

To facilitate timely and effective intervention for post-acute COVID-19 fatigue, it is essential to continuously monitor the individuals who have recovered from acute COVID-19 infection. Also, it is critical to raise health-education among these patients to improve their quality of life. Future research is required to determine whether COVID-19 survivors would experience fatigue for an extended duration and the impact of existing interventions on its prevalence and severity.

[Health-related quality of life in Chileans from vulnerable communes]

OBJECTIVE

The COVID-19 pandemic and the resulting social and health crisis impacted the well-being of the population. Health-related quality of life (HRQoL) could be affected, mainly in conditions of social vulnerability. The objective was to analyze the HRQoL and the psychometric properties of the EQ-5D instrument in adult Chilean population from vulnerable communes of the Metropolitan Region.

METHOD

Cross-sectional study carried out during quarantine period April to June 2021. Five hundred adults residing in Chilean communes were selected and completed a structured questionnaire by video-call, including the EQ-5D instrument. Descriptive analyzes and confirmatory factor analyzes of the traditional reflective model were performed.

RESULTS

The age of the sample was 36.36±12.41 years, the majority reported having a secondary education level and being employed. Regarding the EQ-5D instrument, the most affected dimensions were pain/discomfort and anxiety/depression. The global health status was 73.0±19.71 points. The model showed an adequate fit: χ2=6.992, p=0.221, CFI=0.996, TLI=0.993, RMSEA=0.028 (90% CI: 0.000-0.073) and SRMR=0.067. In addition, the items of the scale were good indicators of the construct of interest.

CONCLUSIONS

In a pandemic context, the population was mostly affected by pain/discomfort and anxiety/depression. The EQ-5D instrument is a useful tool to estimate CRSV in the Chilean population in the context of pandemic. In addition, the psychometric evidence supports the dimensionality of the construct and the potential utility of decomposing its analysis.

Health and well-being of the Portuguese citizens: impacts of the COVID-19

BACKGROUND

COVID-19 pandemic placed unprecedented pressure on societies and healthcare systems around the world. Over the last years, measures imposed in almost all countries dealing with the pandemic sent the entire world into an extensive crisis and thus into a deep global recession. Since the outbreak began, many European countries have faced three/four waves of pandemic. Portugal has mainly dealt with three waves (March/April'2020; October/November'2020; January/February'2021), the third being the deadliest one. The purpose of this article is to provide evidence on the impact of the COVID-19 on health-related quality of life (HRQol) and well-being (W-B) of Portuguese citizens. It aims to (i) characterize these outcomes during the COVID-19 pandemic; (ii) compare them to pre-COVID-19 Portuguese population; and (iii) identify the social determinants that may affect these outcomes during the COVID-19 pandemic.

METHODS

This study used data from a survey that collected data on HRQoL, W-B, satisfaction with life, economic and labour impacts, access to healthcare, mental and physical health, amongst others. The survey was implemented by telephone to a representative random sample of 1,255 respondents from the general adult Portuguese population, stratified by sex, age group and region. Data was collected during the end of the second national lockdown. For comparison purposes, we have also used two other representative databases from the general Portuguese population: (i) data from before the pandemic (n = 1,006); and (ii) data from a survey conducted during the first lockdown, (n = 904).

RESULTS

Looking at health and access to healthcare, 4% of citizens had their surgeries postponed or cancelled because of COVID-19, more than a quarter had medical appointments or complementary exams postponed or cancelled, with 7% over 65 years old with surgeries cancelled or postponed and 32% medical appointments. COVID-19 pandemic also impacted negatively on the HRQoL of citizens, especially in the first lockdown. Half of the respondents reported feeling nervous, anxious, or on edge, about 45% of citizens felt sad or depressed. Sleeping problems were reported for almost 39% of citizens, and loneliness is reported by 29% of citizens. For about 70-85% of citizens, these feelings were more so than before the pandemic. Citizens with fair/strong economic stability were the most economically affected by the pandemic.

CONCLUSIONS

We provided evidence on the impact of COVID-19 on health and W-B of Portuguese citizens. Their health was worse than before the pandemic and the access to healthcare was highly affected.

Cost-effectiveness of therapeutics for COVID-19 patients: a rapid review and economic analysis

Background

Severe acute respiratory syndrome coronavirus 2 is the virus that causes coronavirus disease 2019. Over six million deaths worldwide have been associated with coronavirus disease 2019.

Objective

To assess the cost-effectiveness of treatments used for the treatment of coronavirus disease 2019 in hospital or used in the community in patients with coronavirus disease 2019 at high risk of hospitalisation.

Setting

Treatments provided in United Kingdom hospital and community settings.

Methods

Clinical effectiveness estimates were taken from the coronavirus disease-network meta-analyses initiative and the metaEvidence initiative. A mathematical model was constructed to explore how the interventions impacted on patient health, measured in quality-adjusted life-years gained. The costs associated with treatment, including those of hospital care, were also estimated and used to form a cost per quality-adjusted life-year gained value which was compared with thresholds published by the National Institute for Health and Care Excellence. Estimates of cost-effectiveness compared against current standard of care were produced in both the hospital and community settings at three different levels of efficacy: mean, low and high. Public list prices were used for interventions with neither confidential patient access schemes nor confidential list prices considered. Results incorporating confidential pricing data were provided to the National Institute for Health and Care Excellence appraisal committee.

Results

The treatments were estimated to be clinically effective although not all reached statistical significance. All treatments in the hospital setting, or community, were estimated to plausibly have a cost per quality-adjusted life-year gained value below National Institute for Health and Care Excellence's thresholds when compared with standard of care. However, almost all drugs could plausibly have cost per quality-adjusted life-years above National Institute for Health and Care Excellence's thresholds. However, there is considerable uncertainty in the results as the prevalent severe acute respiratory syndrome coronavirus 2 variant, vaccination status, history of being infected with severe acute respiratory syndrome coronavirus 2 and standard of care have all evolved since the pivotal studies were conducted which could have significant impact on the efficacy of each drug. For drugs used in high-risk patients in the community setting, the proportion of people at high risk who need hospital admission was a large driver of the cost per quality-adjusted life-year.

Limitations

No studies were identified that were conducted in current conditions. This may be a large limitation as the severe acute respiratory syndrome coronavirus 2 variant changes. No head-to-head studies of interventions were identified.

Conclusions

The results produced could be informative to decision-makers, although conclusions regarding the most clinical - and cost-effectiveness of each intervention should be tentative due to the evolving nature of the decision problem and, in this report, the use of list prices only. Comparisons between interventions should also be treated with caution due to potentially large heterogeneity between studies.

Future work

Research assessing the relative clinical effectiveness of interventions within head-to-head studies in current conditions would be beneficial. Contemporary information related to the probability of hospital admission and death for patients at high risk in the community would improve the precision of the estimates generated.

Funding

This project was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR135564) and will be published in full in Health Technology Assessment; Vol. 27, No. 14. See the NIHR Journals Library website for further project information.

Predictors of fear control related to COVID-19 among older population: an investigation on COVID-19 risk perception and health related quality of life during the pandemic

BACKGROUND

The aim of this study was to examine the role of demographic characteristics, general health and health related quality of life on the fear control. Also, the aim of study was to explore how older people percept the COVID-19 pandemic by using the component of the expanded parallel process model (EPPM), and how the possible perception may contribute to probable behavior responses to prevention and control of COVID-19.

METHODS

The present study is a cross-sectional study that was conducted in Tabriz, a city in north of Iran from February to April 2021, the period that correspond with the fourth wave of COVID-19. To collect information, the Covid-19 risk perception questionnaire (based on EPPM model including efficacy, defensive responses, and perceived threat) and health related quality of life (HQOL) Short Form-36 questionnaire were used. Discriminate value was calculated to estimate fear control and danger control. Univariate and multivariable logistic regression were calculated to examine the effect of demographic characteristics, general health and health-related quality of life on the fear control.

RESULTS

The mean age of the 350 participants was 67.9 (6.4) years. A total of 83.1% of participants were engaged in danger control processes and 16.9% in fear control processes. According to the multivariable results, significant predictors for fear control were: gender 1.57 (95% CI 1.05-2.34, 0.025), education 7.38 (1.42-38.35, p = 0.017), economic status 1.31 (0.4-0.63, p = 0.029), and significant protective factors for fear control were: body pain 0.97 (0.94-0.99, p = 0.041), general health 0.96 (0.93-0.98, p = 0.032), physical health 0.94 (0.90-0.98) and total quality of life 0.024 (0.89-0.98).

CONCLUSIONS

Strong associations of fear control were found with being female, being illiterate, and having a good economic status and also body pain, general health, physical health and total HQOL were significantly associated with danger control. Since, most of elderly populations have adequately higher perceptions of efficacy to counteract their threat perceptions to continue motivating these older people to engage in COVID-19 self-protective behaviors, it is necessary to emphasis on the susceptibility of target population and the severity of the COVID-19 threats.

Post COVID-19 condition and health-related quality of life: a longitudinal cohort study in the Belgian adult population

BACKGROUND

Since the onset of the COVID-19 pandemic, most research has focused on the acute phase of COVID-19, yet some people experience symptoms beyond, referred to as post COVID-19 conditions (PCC). However, evidence on PCC and its impacts on health-related quality of life (HRQoL) is still scarce. This study aimed to assess the impact of COVID-19 and PCC on HRQoL.

METHODS

This is a longitudinal cohort study of the Belgian adult population with recent SARS-CoV-2 infection. In total, 5,727 people were followed up between the time of their infection and three months later. HRQoL was measured with the EQ-5D-5L questionnaire before and during the infection and three months later. Linear mixed regression models were built to assess the longitudinal association between participants' characteristics and the evolution of their HRQoL.

RESULTS

This study found a significant decline in HRQoL during the SARS-CoV-2 infection in comparison to the situation before (β=-9.91, 95%CI=-10.13;-9.85), but no clinically important difference three months after the infection compared to the situation before, except among people reporting PCC (β=-11.15, 95%CI=-11.72;-10.51). The main symptoms of PCC with a significant negative impact on the different dimensions of HRQoL were fatigue/exhaustion (21%), headache (11%), memory problems (10%), shortness of breath (9%), and joint (7%) or muscle pain (6%). The dimension of HRQoL most negatively affected by several PCC symptoms was pain/discomfort.

CONCLUSIONS

With the growing number of people infected with SARS-CoV-2, PCC and its impact on HRQoL are becoming important public health issues. To allow people with PCC to recover and to limit its detrimental impact on HRQoL, it is essential to manage its various heterogeneous symptoms using a multidisciplinary approach.

Assessment of Qol among COVID-19 Patients in South India: A Tertiary Care Center Study: An Original Research

Introduction

The COVID-19 epidemic has brought about an unparalleled health disaster and fundamentally altered people's livelihoods. We intended to examine risk variables for "Health-Related Quality Of Life (HRQoL)" amid COVID-19 hospital discharged patients.

Materials and Techniques

For this cross-sectional study, 1000 discharged patients who tested positive at the tertiary care center before January 2022 were included. The HRQoL was measured using a 5-level EuroQoL survey. The complete health state was evaluated using an Indian value set. The correlation of HRQoL and the clinical, sociodemographic parameters were investigated using appropriate statistical tools. Finally, regression model was utilized to identify all factors that predict the HRQoL dimensions.

Results

It was found that 55% of patients said they had moderate or serious health issues. Forty percent of respondents said they had felt moderate-to-severe pain or discomfort, compared to 41% who said they had anxiety or sadness. The outcome of the logistic regression demonstrated the substantial influencers were "age, gender, occupation, location of care, heart conditions, and diabetes" on several HRQoL aspects.

Conclusion

The COVID-19 dramatically worsens the patients' physical and mental health conditions. Therefore, the government and policymakers must develop comprehensive ways to lessen the patients' mental and physical health problems.

Post-acute (long) COVID-19 quality of life: validation of the German version of (PAC19QoL) instrument

Purpose

The aim of our study was to validate a German translation of the post-acute (long) COVID-19 quality of life (PAC-19QoL) instrument among German patients with long COVID-19 syndrome.

Patients and methods

The PAC-19QoL instrument was translated into the German language and administrated to patients with long COVID-19 syndrome. Cronbach's alpha coefficient was used to analyze the internal consistency of the instrument. Construction validity was evaluated by using Pearson's correlation coefficient and Spearman's rank correlation. Scores of patients and controls were compared using the Mann-Whitney U-test.

Results

A total of 45 asymptomatic and 41 symptomatic participants were included. In total, 41 patients with long COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach's alpha >0.7. There was a significant correlation between all domains on the test (p < 0.001), with the highest correlation between total (r = 0.994) and domain 1 (r = 0.991). Spearman's rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings.

Conclusion

The German version of the instrument is valid and reliable and can be a suitable tool for research and daily clinical practice among patients with long COVID-19 syndrome.

Health-Related Quality of Life for Jordanian-Recovered Individuals During Post-COVID-19 Era: A Cross-Sectional Study

Aim

This study aims to determine health-related quality of life (HRQoL) that includes the physical and mental health of recovered patients of COVID-19 and examines the significant impact of variables such as period of infection, sample demographics characteristics, hospitalization past, and chronic disease past and the other variables on HRQoL of COVID-19-recovered patients.

Methods

An exploratory, community-based, cross-sectional research layout was adopted, using an electronic self-reporting survey disseminated online to recovered COVID-19 patients in Jordan. Targeted COVID-19 patients were individuals who were 18 years old or above. They had a documented background of COVID-19 illness, as stated in the following inclusion requirements: Those who had not been formally proven to have been afflicted by COVID-19 were excluded.

Results

The mean of the physical well-being of study participants during COVID-19 was M=68.00 (SD=6.95), representing medium physical well-being status. The mean of psychological well-being of study participants during COVID-19 was M=60.20 (SD=8.85), representing medium physical health. Multiple regression showed that female recovered patients who are not working, with a low level of income, married women, and who getting COVID-19 more than once are having lower health-related quality of life compared to other recovered patients.

Conclusion

The HRQoL of COVID-19 patients was significantly impacted, independent of the period since hospitalization or rehabilitation. Policymakers and health workers should research strong ways to enhance the HRQoL of COVID-19 patients as soon as possible. Elderly patients and those who have been infected more than one time and being hospitalized have a greater probability of decreased HRQoL after infection.

Quality of life in patients treated for COVID-19-associated mucormycosis at a tertiary care hospital

OBJECTIVES

Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management of CAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution.

METHODS

This cross-sectional study of 57 patients with CAM was conducted over 6 months using a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and <7 were considered to indicate poor QOL and poor improvement, respectively. The correlations of QOL and SRI scores were evaluated using Spearman rho values.

RESULTS

In total, 27 patients (47.4%; 95% confidence interval [CI], 34.9%-60.1%) and 26 patients (45.6%; 95% CI, 33.4%-58.4%) had poor QOL and poor SRI scores, respectively. The overall median (interquartile range) QOL score was 52 (41-63). Headache (adjusted B, -12.3), localized facial puffiness (adjusted B , -16.4), facial discoloration (adjusted B, -23.4), loosening of teeth (adjusted B, -18.7), and facial palsy (adjusted B, -38.5) wer e significantly associated with the QOL score in patients with CAM.

CONCLUSION

Approximately 1 in 2 patients with CAM had poor QOL and poor improvement. Various CAM symptoms were associated with QOL in these patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.

Health-related quality of life and associated factors among COVID-19 individuals managed with indian traditional medicine: A cross-sectional study from south India

Introduction

Coronavirus disease-2019 (COVID-19) had a multidimensional impact on human life. It affects the health-related quality of life (HRQoL) which is a perceived measure of physical and mental health. We estimated the EuroQol utility value for COVID-19 and the associated factors for those managed at Siddha COVID care centres in Tamil Nadu.

Methods

A cross-sectional study was conducted by a telephonic interview of 2000 randomly selected COVID-19 adults tested positive during June 2020 to Jan 2021. We collected sociodemographic, clinical and EQ-5D-5L profile. Mean EQ-5D-5L summary utility values and EQ-VAS scores were estimated. Multivariate regression was used to examine the factors associated with EQ-5D-5L. Study protocol was approved by the Institutional ethics committee of Government Siddha Medical College, Chennai (GSMC-CH-3401/ME-2/050/2021). The committee waived the written informed consent considering the pandemic situation of emerging infectious diseases.

Results

We interviewed 1047 participants. Of the total 68% were males with the median age (IQR) of 38 (29-51) years. The mean EQ-5D-5L utility score and EQ-VAS scores are 0.98 ± 0.05 and 92.14 ± 0.39 respectively. COVID-19 asymptomatic group reported a mean utility score of 0.99 ± 0.03 which is relatively more than the symptomatic group (0.97 ± 0.06),. EQ-VAS score was also reported high among the asymptomatic (95.45 ± 5.95) than the symptomatic (91.40 ± 8.69COVID-19.

Conclusion

The severity of illness and the comorbidity are significantly associated with a low HRQoL of COVID-19 patients.

Pain and Clinical Presentation: A Cross-Sectional Study of Patients with New-Onset Chronic Pain in Long-COVID-19 Syndrome

The aim of this study was to evaluate the characteristics of pain (i.e., pain intensity, pain interference, clinical presentation) in Long-COVID-19 patients and compare the location of pain between successfully recovered COVID-19 patients and healthy matched controls. A cross-sectional case-control study was carried out. Long-COVID-19 patients, age- and sex-matched patients with a history of COVID-19 who had successfully recovered, and healthy controls were included. Outcomes included were pain characteristics (Brief Pain Inventory and Short-Form McGill Pain Questionnaire) and clinical presentation (Widespread Pain Index and Euroqol-5 Dimensions 5 Levels Visual Analogue Scale). Sixty-nine patients with Long-COVID-19 syndrome, sixty-six successfully recovered COVID-19 patients, and sixty-seven healthy controls were evaluated. Patients with Long-COVID-19 syndrome showed greater pain intensity and interference. In addition, they showed worse quality of life and greater widespread pain, with the most frequent locations of pain being the neck, legs, and head. In conclusion, patients with Long-COVID-19 syndrome show a high prevalence of pain, characterized by widespread pain of moderate intensity and interference, with the most frequent locations being the neck, legs, and head, significantly affecting the quality of life of these patients.

Health-Related Quality of Life of COVID-19 Survivors Treated in Intensive Care Unit-Prospective Observational Study

Purpose: To investigate the quality of life (QoL) of survivors from severe forms of COVID-19 treated in the ICU. Methods: In this study, we investigated the QoL of patients with severe COVID-19 treated in the ICU from November 2021 to February 2022. In the study period, 288 patients were treated in ICU and 162 were alive at the time of analysis. Of those, 113 patients were included in this study. QoL was analyzed 4 months after ICU admission using the EQ-5D-5L questionnaire administered by telephone. Results: Of the 162 surviving patients, 46% reported moderate to severe problems in the anxiety/depression domain, 37% had moderate to severe problems in usual activities, and 29% in the mobility domain. Older patients had lower QoL in mobility, self-care and usual activities domains. Female patients had lower QoL in usual activities, while male patients had lower QoL in the self-care domain. Patients who spent longer time on invasive respiratory support and those with longer hospital lengths of stay had lower QoL in all domains. Conclusion: Severe COVID-19 reduces HRQoL in a significant number of survivors 4 months after ICU admission. Early recognition of patients at increased risk for reduced QoL could lead to early focused rehabilitation and improved QoL of these patients.

Evaluation and follow-up of pain, fatigue, and quality of life in COVID-19 patients

OBJECTIVES

We evaluated pain, fatigue, anxiety, depression, and quality of life in patients hospitalized for coronavirus disease 2019 (COVID-19) and observed them over a period of 3 months. We also investigated the relationship of these symptoms to age, sex, disease severity, and levels of anxiety and depression.

METHODS

The study included 100 confirmed COVID-19 patients (i.e., positive on a polymerase chain reaction test) between the ages of 18 and 75 years. Pain (visual analog scale [VAS]), fatigue (fatigue severity scale), anxiety, and depression (hospital anxiety and depression scales) were evaluated on the first day of hospitalization and at 1-month and 3-month follow-ups. The short form-12 questionnaire was used to measure quality of life at the 1-month and 3-month followups.

RESULTS

No differences were found in pain, fatigue, anxiety levels, depression levels, and quality of life according to disease severity. High VAS scores at hospital admission were related to continued pain at the 3-month follow-up (odds ratio [OR], 1.067; p<0.001). High VAS (OR, 1.072; p=0.003) and anxiety levels (OR, 1.360; p=0.007) were related to severe fatigue at the 3-month evaluation.

CONCLUSIONS

Pain, fatigue, anxiety, and depression appear to be long-term sequelae of COVID-19 and can affect quality of life. High VAS and anxiety levels were found to be associated with long-term fatigue.

Post-discharge quality of life of COVID-19 patients at 1-month follow-up: A cross-sectional study in the largest tertiary care hospital of Bangladesh

There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT-PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07-9.77). Female participants were 5.50 times (95% CI: 2.22-13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13-3.20), pain/discomfort (OR 1.82, 95% CI: 1.04-3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22-3.84). Comorbid patients were 1.75 times (95% CI: 1.07-2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31-8.18), usual-activity (OR 3.08, 95%CI: 1.21-7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09-6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35-8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients.

The trend in quality of life of Chinese population: analysis based on population health surveys from 2008 to 2020

BACKGROUND

Quality of life (QoL) is one of the most important indicators for evaluating an individual's overall health status. However, evidence exploring the trend in QoL of the Chinese population is still lacking. This study aimed to investigate the trend in QoL of the Chinese population measured by the EQ-5D from 2008 to 2020, as well as compare the changing trends in QoL categorized by populations with different socio-demographic characteristics.

METHODS

Data were obtained from the 2008, 2013, and 2020 waves of the Health Services Surveys conducted in Tianjin, China. Respondents completed the EQ-5D (EQ-5D-3L in 2008 and 2013 and EQ-5D-5L in 2020) through face-to-face interviews or self-administration. Responses of the EQ-5D-3L in 2008 and 2013 were mapped onto the EQ-5D-5L responses, and then converted to utility values using the Chinese value set. The trend in QoL was explored by comparing the percentage of any reported problems on each EQ-5D dimension and the corresponding utility values across the three waves. Subgroup analyses were performed to compare trends in utility values stratified by socio-demographic indicators. The effect of the time variable (year) on utility values was assessed by multiple linear regression analyses using the pooled data.

RESULTS

By analyzing and comparing the three waves of the data (N = 25,939 in the 2008 wave, N = 22,138 in 2013, and N = 19,177 in 2020), an upward trend was observed in the percentages of reporting problems on all five dimensions (p < 0.001), resulting in a decreasing trend in utility values (2008: 0.948, 2013: 0.942, 2020: 0.939, p < 0.001). Utility values declined more over time among the female, the elder, the recipients of medical assistance, the widowed, the unemployed, and respondents with primary or lower education. The effect of the year (Coef. for 2013 = - 0.009, p < 0.001; Coef. for 2020 = - 0.010, p < 0.001) confirmed the downward trend in the utility values.

CONCLUSIONS

The overall QoL of the Chinese population decreased over the period from 2008 to 2020. The QoL of the disadvantaged or vulnerable populations in terms of socioeconomic characteristics declined more over time.

Salud mental de cuidadores de niños con trastornos del neurodesarrollo durante la pandemia

Los cuidadores son especialmente propensos a verse más afectados psicológicamente durante las restricciones sociales y del sistema sanitario generadas por la pandemia por COVID-19. Los cuidadores de niños con trastornos del neurodesarrollo (es decir, autismo, discapacidad intelectual, déficit de atención, hiperactividad, discapacidad motora) tienen un papel más importante que los que acompañan niños sanos. Se diseñó un estudio cuantitativo transversal, utilizando técnicas estadísticas descriptivas, comparativas y correlacionales, para analizar la calidad de vida relacionada con la salud, el malestar emocional y la sobrecarga en cuatro subgrupos de cuidadores, clasificados según el diagnóstico del niño. Se incluyeron 132 cuidadores (86,4% mujeres). En el grupo 1 (discapacidad cognitiva) participaron 28 cuidadores; en el grupo 2 (TDAH) se incluyeron 51; en el grupo 3 (trastorno del espectro autista) participaron 33 cuidadores, y en el grupo 4 (discapacidad motora) se incluyeron 20. Los principales hallazgos de este estudio fueron: 1) alteraciones en el rol físico, el dolor corporal, la salud general y la vitalidad; 2) porcentajes muy bajos de sintomatología de depresión, ansiedad, estrés y sobrecarga; 3) diferencias en el funcionamiento social entre los grupos de discapacidad motora y TDAH, y en el estrés y la sobrecarga entre los grupos de autismo y discapacidad motora, y 4) correlaciones moderadas entre las dimensiones de dolor corporal y rol emocional y la depresión, la ansiedad, el estrés y la sobrecarga. Se concluyó que hay más afectación en variables asociadas con la salud física que con las de la salud mental.

Validation of the Slovakian Version of the "Post‑acute (Long) COVID‑19 Quality of Life Instrument" and Pilot Study

Purpose

The aim of our study was to validate a Slovakian translation of the PAC‑19QoL instrument among Slovakian patients with post COVID-19 syndrome.

Patients and Methods

The PAC-19QoL instrument was translated into the Slovakian language and administrated to patients with post COVID-19 syndrome. Cronbach's alpha coefficient was used to analyse the internal consistency of the instrument. Construction validity was evaluated by using Pearson's correlation coefficient and Spearman's rank correlation. Scores of patients and controls were compared using Mann-Whitney U-test.

Results

Forty-five asymptomatic and forty-one symptomatic participants were included. Forty-one patients with post COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach alpha greater than 0.7. There was a significant correlation between all domains on the test (p < 0.001), with the highest correlation of Total (r = 0.994) and Domain 1 (r = 0.991). Spearman's rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings.

Conclusion

The Slovakian version of the instrument is valid, reliable and can be a suitable tool for research and daily clinical practice among patients with post COVID-19 syndrome.

One-year follow-up of depression, anxiety, and quality of life of Peruvian patients who survived COVID-19

PURPOSE

To assess health-related quality of life (HRQoL) and its associated factors in patients who survived COVID-19 and to assess a prospective evaluation of the prevalence and severity of their depression and anxiety symptoms.

METHODS

We followed up a sample of hospitalized patients who survived COVID-19 at 3 and 12 months after discharge. We assessed HRQoL (Euroqol-5D-5L) through telephone interviews. Any problem in any dimension of Euroqol-5D-5L was considered as low HRQoL. The depression and anxiety symptoms were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 tools, respectively. We estimated the adjusted prevalence ratios (aPR) to low HRQoL using Poisson regression and the changes on their depression and anxiety symptoms during the follow-up.

RESULTS

We included 119 patients with a mean follow-up time of 363.6 days. 74% of the participants had low HRQoL at one year after hospital discharge and were associated with being ≥ 41 years old (aPR: 1.95), having a previous history of psychiatric diagnoses before COVID-19 infection (aPR: 1.47), having any COVID-19 symptom during the follow-up at one year (aPR: 1.84), and having a family member who had died from COVID-19 during the first wave (aPR: 1.24). In addition, the clinically relevant depression symptoms were frequent, and they increased from 3 (14.3%) to 12 months (18.5%).

CONCLUSION

One year after COVID-19 hospitalization discharge, patients had low HRQoL, and their depression symptoms increased. These findings acknowledge the need to provide services that adequately address mental health sequels and HRQoL to reduce the burden of the COVID-19.

The influencing factors of health-related quality of life of the general population of Iran during the COVID-19 Pandemic

COVID-19 is a global challenge that negatively affects the health-related quality of life (HRQoL) of the general population. The current study aimed to evaluate HRQoL and its associated factors among the Iranian general population during the COVID-19 pandemic. The data were collected in 2021 using the EuroQol 5-Dimension 3-Level (EQ-5D-3L) and EQ-5D Visual Analog Scale (EQ VAS) questionnaires through an online survey. Participants were recruited via social media from the Fars province. The multiple binary logistic regression model was used to identify factors influencing participants' HRQoL. Kolmogorov-Smirnov, the t-test, ANOVA, and the chi-square test were used. All tests were conducted at a significance level of 5% using Stata 14.2 and SPSS 16. A total of 1,198 participants were involved in this cross-sectional study. The mean age of participants was 33.3 (SD:10.2), and more than half were women (55.6%). The mean EQ-5D-3L index value and EQ-VAS of the respondents were 0.80 and 77.53, respectively. The maximum scores of the EQ-5D-3L and EQ-VAS in the present study were 1 and 100, respectively. The most frequently reported problems were anxiety/depression (A/D) (53.7%), followed by pain/discomfort (P/D) (44.2%). Logistic regression models showed that the odds of reporting problems on the A/D dimension increased significantly with supplementary insurance, including concern about getting COVID-19, hypertension, and asthma, by 35% (OR = 1.35; P = 0.03), 2% (OR = 1.02; P = 0.02), 83% (OR = 1.83; P = 0.02), and 6.52 times (OR = 6.52; P = 0.01), respectively. The odds of having problems on the A/D dimension were significantly lower among male respondents, those in the housewives + students category, and employed individuals by 54% (OR = 0.46; P = 0.04), 38% (OR = 0.62; P = 0.02) and 41% (OR = 0.59; P = 0.03), respectively. Moreover, the odds of reporting a problem on the P/D dimension decreased significantly in those belonging in a lower age group and with people who were not worried about getting COVID-19 by 71% (OR = 0.29; P = 0.03) and 65% (OR = 0.35; P = 0.01), respectively. The findings of this study could be helpful for policy-making and economic evaluations. A significant percentage of participants (53.7%) experienced psychological problems during the pandemic. Therefore, effective interventions to improve the quality of life of these vulnerable groups in society are essential.

Clinical characterization and factors associated with quality of life in Long COVID patients: Secondary data analysis from a randomized clinical trial

BACKGROUND

Long COVID patients suffer a negative impact on their quality of life, as well as their functioning, productivity or socialization. There is a need to better understand the individual experience and circumstances surrounding these patients.

OBJECTIVE

To characterize clinical picture of Long COVID patients and to identify factors associated with quality of life.

METHODS

A secondary data analysis from a randomized clinical trial (RCT) was carried out with 100 Long COVID patients treated by Primary Health Care and residents in the territory of Aragon (northeast of Spain). The main variable of the study was quality of life, evaluated using the SF-36 Questionnaire, in relation to socio-demographic and clinical variables. In addition, ten validated scales were used that contemplated their cognitive, affective, functional and social status, as well as personal constructs. Correlation statistics and linear regression model were calculated.

RESULTS

Long COVID patients suffer a decrease in their levels of physical and mental health. On the one hand, the higher number of persistent symptoms (b = -0.900, p = 0.008), worse physical functioning (b = 1.587, p = 0.002) and sleep quality (b = -0.538, p = 0.035) are predictors of worse quality of life, physical subscale. On the other hand, higher educational level (b = 13.167, p = 0.017), lower number of persistent symptoms (b = -0.621, p = 0.057) and higher affective affectation (b = -1.402, p<0.001) are predictors of worse quality of life, mental subscale.

CONCLUSION

It is necessary to design rehabilitation programs that consider both the physical and mental health of these patients, thus obtaining an improvement in their quality of life.

Health-related quality of life of children and adolescents with type 1 diabetes during the COVID-19 pandemic in Kuwait

Background

With the rapid transmission of COVID-19 globally, countries have implemented strict governmental measures and social distancing rules that aimed to minimize the spread of the virus. School closures, quarantine orders, and social isolation, coupled with a surge in family stress and lack of peer interactions, are probable causes of mental health complications and psychological symptoms faced by children. This study aims at comparing the HRQoL of children and adolescents with type 1 diabetes (T1D) and affected by COVID-19 infection (personal or familial) and those who were not affected by COVID-19.

Materials and methods

A random sample was selected from children and adolescents diagnosed with T1D at the six major governmental diabetes centers in Kuwait. To measure HRQoL, parent-proxy and self-reports from the Pediatric Quality of Life Inventory (PedsQL^TM) 3.0 Diabetes Module were used.

Results

A sample of 455 children and adolescents with T1D diabetes (44.6% male participants and 41.98% affected by COVID-19 infection) was studied. The total score of the HRQoL self-reports was significantly higher compared with parent-proxy reports (79.06 ± 15.19 vs. 73.79 ± 15.17, p < 0.01). Children reported significantly higher HRQoL scores in the "treatment I" domain and "worry" domain and lower scores in the "diabetes" symptoms domain, compared with their parents' reports (p < 0.01). In the COVID-19-affected group, a major difference was noticed between the total scores of children and parent-proxy reports (77.04 ± 15.81 vs. 72.80±14.90, p = 0.047). The affected children reported significantly lower scores in "diabetes" symptoms (59.50) (p < 0.01) and higher scores in the "treatment I" domain (81.43) than their parent-proxy reports (72.05) (p < 0.01).

Conclusion

This is the first report on the health-related quality of life of children with T1D in Kuwait during the COVID-19 era. Parents' or caregivers' experience of caring for their children was negative, as they worried, and reported poorer HRQoL compared with their children's perceptions. There is a need to empower healthcare professionals to support parents and caregivers of children with chronic diseases such as T1D in promoting self-management, enhancing physical and psychological wellbeing, treatment adherence, and continuous health education during pandemics of any kind.

Impact of COVID-19 and effects of BNT162b2 on patient-reported outcomes: quality of life, symptoms, and work productivity among US adult outpatients

BACKGROUND

Although there is extensive literature on the clinical benefits of COVID-19 vaccination, data on humanistic effects are limited. This study evaluated the impact of SARS-CoV-2 infection on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Impairment (WPAI) prior to and one month following infection between individuals vaccinated with BNT162b2 and those unvaccinated.

METHODS

Subjects with ≥ 1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between 01/31/2022 and 04/30/2022. Socio-demographics, clinical characteristics and vaccination status were evaluated. Self-reported symptoms, HRQoL, and WPAI outcomes were assessed using questionnaires and validated instruments (EQ-5D-5L, WPAI-GH) across acute COVID time points from pre-COVID to Week 4, and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for several covariates. Effect size (ES) of Cohen's d was calculated to quantify the magnitude of outcome changes within and between vaccination groups.

RESULTS

The study population included 430 subjects: 197 unvaccinated and 233 vaccinated with BNT162b2. Mean (SD) age was 42.4 years (14.3), 76.0% were female, 38.8% reported prior infection and 24.2% at least one comorbidity. Statistically significant differences in outcomes were observed compared with baseline and between groups. The EQ-Visual analogue scale scores and Utility Index dropped in both cohorts at Day 3 and increased by Week 4 but did not return to pre-COVID levels. The mean changes were statistically lower in the BNT162b2 cohort at Day 3 and Week 4. The BNT162b2 cohort reported lower prevalence and fewer symptoms at index date and Week 4. At Week 1, COVID-19 had a large impact on all WPAI-GH domains: the work productivity time loss among unvaccinated and vaccinated was 65.0% and 53.8%, and the mean activity impairment was 50.2% and 43.9%, respectively. Except for absenteeism at Week 4, the BNT162b2 cohort was associated with statistically significant less worsening in all WPAI-GH scores at both Week 1 and 4.

CONCLUSIONS

COVID-19 negatively impacted HRQoL and work productivity among mildly symptomatic outpatients. Compared with unvaccinated, those vaccinated with BNT162b2 were less impacted by COVID-19 infection and recovered faster.

Evaluation of post-COVID health status using the EuroQol-5D-5L scale

SARS-CoV-2 has had a lasting effect on the overall health of recovered patients, called 'long COVID'. Currently, there is a lack of a validated standard questionnaire to assess post-COVID health status. A retrospective observational study involving the recovered COVID patients admitted to a secondary care hospital in India between June to December 2020 (n = 123), was conducted using the EuroQol-5D-5L scale at discharge, 4 weeks and 8 weeks post-discharge. A significant difference in anxiety/depression scores was found (χ2 = 65.6, p < 0.000) among the 3 categories of time (discharge, 4 weeks and 8 weeks). The anxiety/depression dimension scores showed a significant change (p < 0.0001) between discharge and 8 weeks, using paired t-test. Age had a significant relationship with the anxiety/depression dimension at 4 weeks (OR = 5.617, 95% CI = 1.0320-30.5746, p < 0.05). A significant difference was found using Kruskal-Wallis rank-sum test on mean index scores (χ2 = 60.0, p < 0.000) among the three categories of time (discharge, 4 weeks and 8 weeks). There was a statistically significant difference of time on EQ Index scores as determined by one-way repeated measures ANOVA (F(2,375) = 18.941, p = <0.00001). Our study found time to have a statistically significant impact on the mean index scores, level sum scores and dimension scores. Smoking was found to be significantly associated with usual activity scores at 4 weeks. The most remarkable changes occurred in the anxiety/depression dimension. Overall, there was a general trend of health improvement.

Long COVID-19 and Health-Related Quality of Life of Mild Cases in Korea: 3-Months Follow-up of a Single Community Treatment Center

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) survivors mount as the pandemic continues. To date, studies on persistent symptoms and their effects on health-related quality of life (HRQoL) in mild COVID-19 cases have been limited.

METHODS

A prospective online survey was conducted in COVID-19 patients who were admitted to Seongnam Community Treatment Center, an isolation center in South Korea, from November 23rd 2021 to January 2nd 2022. Patients above the age of 19 with no or mild symptoms were included in the study. Total of 147 patients returned to the follow-up survey 3 months after discharge. Baseline demographics, clinical characteristics, symptoms, and EuroQol-5 dimensions-5 levels (EQ-5D-5L) measures were investigated.

RESULTS

The median (interquartile range [IQR]) interval period between the initial and follow-up survey was 96.0 (93.0-98.0) days. The median (IQR) age of participants was 51.0 (43.0-61.0). During isolation, 131 (89.1%) patients manifested symptoms. On follow-up, 82 (55.8%) participants remained symptomatic. Common symptoms were constitutional (fatigue, myalgia), neurological (memory impairment, hyposmia, hypogeusia, dizziness), and neuropsychiatric (anxiety) symptoms. Participants with remaining neuropsychiatric symptoms reported the lowest EQ-5D-5L index values. Factors associated with persistent symptoms and diminished HRQoL were identified as female sex, metabolic disease, and anxiety during acute COVID-19 phase.

CONCLUSIONS

Cardiopulmonary symptoms improved over time but constitutional, neurological, neuropsychiatric symptoms remained. Patients with neuropsychiatric symptoms (anxiety and insomnia) reported the worst HRQoL. Female sex, metabolic disease, and anxiety during the acute COVID-19 phase were associated with long COVID. Observations of long-term symptoms of COVID-19 with decline in HRQoL and integrated research in COVID-19 survivors are warranted.

Quality of Life in COVID-19 Outpatients: A Long-Term Follow-Up Study

Background: The long-term issues faced by COVID-19 survivors remain unclear. Symptoms may persist for several months, even in non-hospitalized patients, probably impacting the quality of life. Objective: To assess the health-related quality of life of outpatients one year after SARS-CoV-2 infection. Design, Settings, and Participants: This prospective multicentre study, conducted in France from February 2020 to February 2022, compared 150 COVID-19 cases (PCR+ and/or CT scan+) and 260 controls (PCR-) selected from a database of four COVID centres. Main outcomes: Health-related quality of life assessed using the EQ-5D-5L scale. Results: COVID-19 outpatients (n = 96) had significantly lower health-related quality of life than controls (n = 81) one year after SARS-CoV-2 infection: the EQ-5D-5L index averaged 0.87 in cases and 0.95 in controls (p = 0.002); the EQ- VAS averaged 78 in cases and 86.7 in controls (p < 0.001). This alteration in quality of life was more intense in the areas of pain or discomfort and daily activities. Conclusions: This study is the first to show an alteration in the quality of life of COVID-19 outpatients after one year. Appropriate guidance and community rehabilitation programs are required for outpatients with persistent symptoms of COVID-19. Research must continue to confirm these results in larger cohorts.

Health-Related Quality of Life and Associated Factors Among Covid-19 Survivors. Experience from Ethiopian Treatment Centers

Background

The pandemic of the novel coronavirus (Covid-19), which is extremely stressful and has an adverse effect on people's health-related quality of life (HRQoL), poses a serious threat to global public health. As a result, this study evaluated the health-related quality of life and associated factors among Covid-19 patients who were discharged from Ethiopian treatment centers.

Methods

We conducted a multi-center, cross-sectional study among 493 Covid-19 survivors who had been discharged from treatment centers between 1st January 2020, and 20th October 2021. We collected respondents' data using validated Amharic version EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients. Differences in HRQOL scores between patient subgroups were tested by Mann-Whitney U or Kruskal-Wallis test, and the multivariable betaMix regression was used to investigate factors associated with HRQOL scores.

Results

The EQ-5D and VAS median score for Covid-19 survivors was 0.940 (IQR: 0.783-0.966) and 87 (IQR: 70-91) respectively. Overall, married individuals, old-aged, individuals who had low educational status, high monthly income, comorbidities, admitted to the Intensive care Unit, received intranasal oxygen care, and prolonged hospitalization had lower utility scores and EQ-VAS scores compared to their counterparts. In multivariate betaMix regression, respondents' health status at admission, old age, chronic obstructive pulmonary disease, asthma, and hospital length of stay were significantly associated with the lower EQ-5D-Index value and EQ-VAS score.

Conclusion

We found that Covid-19 infection had a persisting impact on the physical and psychosocial health of Covid-19 survivors. Age, having asthma and chronic obstructive pulmonary disease, having a worsening health state upon admission, and a prolonged hospital length of stay were significantly associated with the lower EQ-5D and EQ-VAS score. Therefore, the cost-effective psychological treatment such as cognitive behaviour therapy should be encouraged after hospitalization to improve the post-Covid-19 depression and fatigue.

Headache in Post-COVID-19 Patients: Its Characteristics and Relationship with the Quality of Life

Little is known on the characteristics of headaches associated with coronavirus disease 2019 (COVID-19) in Indonesia. The objective of this study was to describe the characteristics of headache in post-COVID-19 patients, and its impact on the patients' quality of life (QoL), as well as to determine the associated determinants of the poor QoL. A cross-sectional study was conducted in Banda Aceh, Indonesia. The demographic characteristics, clinical symptoms of COVID-19, characteristics of headache, and the QoL were collected and assessed. Headache was diagnosed and characterized using the International Classification of Headache Disorders, version 3 (ICHD-3). QoL was assessed using a Short Form 36 Health Survey (SF-36) tool. A logistic regression model was used to investigate the associated determinants of poor QoL in post-COVID-19 patients. A total of 215 post-COVID-19 patients were included in the final analysis, and 21.4% (46/215) of them had a poor QoL due to headache following COVID-19. Those who were unemployed and who contracted COVID-19 less than three months prior to the study had higher odds of having poor QoL compared to those who were employed and who contracted COVID-19 more than three months prior to the study. Low QoL was also related to headache that occurred less than one month after recovering from COVID-19 (compared to that which occurred longer than one month after); had a high frequency; had a combination sensation of pulsating, pressing, fiery, and stabbing pain; had a high severity score; and had additional symptoms accompanying the headache. In conclusion, headache related to COVID-19 is associated with low QoL among post-COVID-19 patients. A guideline on prevention measures of headache on COVID-19 patients, therefore, needs to be established to avoid long-term consequences.

Food Intake Changes and Their Impact on Quality of Life in Spanish Citizens with and without COVID-19 during Lockdown

The pervasive impact of the COVID-19 pandemic is just beginning to be analyzed. To date, only a handful of these studies have investigated the relationship between an individual’s quality of life (QoL) and their changes in food intake due to the virus (from the associated symptomatology of diagnosis to the universal impact of lockdown on individual lives, regardless of a person’s health status). Therefore, the purpose of this study is to identify changes in food intake resulting from the pandemic and the corresponding impact on QoL in the Spanish population. This study focuses its investigation on the 3-month time period within which lockdown was its most restrictive, March−May 2020. Survey questions ask participants to compare their eating habits, general health status, and QoL during these 3 months to times prior to the pandemic. We conducted an online survey amongst the Spanish population over 18 years old. Three surveys were administered: (1) the adult eating behavior questionnaire (EABQ), (2) EuroQoL-5D-5L, and (3) The determinants lifestyle changes during lockdown period (March to May 2020). A total of 86 participants were included, with a mean age of 34 years. In the analysis of QoL, significant differences were found according to age, sex, and the presence of a COVID-19 diagnosis. Likewise, in the analysis of food intake, significant differences were found by age (greater changes in the 18−29-years-old population) (p< 0.01) and by sex (women p < 0.03), as well as greater changes in those with a diagnosis of COVID-19. Furthermore, both food intake and COVID-19 diagnosis were variables that predicted QoL outcomes. In sum, forced home lockdown can cause changes in food intake, which can predict a lower QoL. It follows that the lockdown situation caused by the worldwide COVID-19 pandemic has affected the food intake and overall QoL of the Spanish population.