Long-Term Health-Related Quality of Life in Working-Age COVID-19 Survivors: A Cross-Sectional Study

Hiten Naik; James Wilton; Karen C Tran; Naveed Zafar Janjua; Adeera Levin; Wei Zhang

doi:10.1016/j.amjmed.2024.05.016

Long-Term Health-Related Quality of Life in Working-Age COVID-19 Survivors: A Cross-Sectional Study

Am J Med. 2024 May 23:S0002-9343(24)00338-3. doi: 10.1016/j.amjmed.2024.05.016. Online ahead of print.

Authors

Hiten Naik¹, James Wilton², Karen C Tran³, Naveed Zafar Janjua⁴, Adeera Levin³, Wei Zhang⁵

Affiliations

¹ Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Post-COVID-19 Interdisciplinary Clinical Care Network, Provincial Health Services Authority, Vancouver, British Columbia, Canada; Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: hiten.naik@ubc.ca.
² BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, Canada.
³ Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; Post-COVID-19 Interdisciplinary Clinical Care Network, Provincial Health Services Authority, Vancouver, British Columbia, Canada; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
⁴ Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada; BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, Canada; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
⁵ Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; Centre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.

PMID: 38795939
DOI: 10.1016/j.amjmed.2024.05.016

Abstract

Background: Most working-age (18-64) adults have been infected with SARS-CoV-2, and some may have developed post-COVID-19 condition (PCC). However, long-term health-related quality of life (HRQOL) following infection remains uncharacterized.

Methods: In this cross-sectional study, COVID-19 survivors from throughout British Columbia (BC), Canada, completed a questionnaire >2 years after infection. PCC status was self-reported, and HRQOL was assessed using the EuroQol 5-dimension 5-level (EQ-5D-5L) instrument. We compared HRQOL in those with current PCC, those with recovered PCC, and those without a history of PCC. Multivariable analyses were weighted to be representative of COVID-19 survivors in BC.

Results: Of the 1,135 analyzed participants, 19.2% had current PCC, and 27.6% had recovered PCC. Compared to those without a history of PCC, participants with recovered PCC had a similar mean EQ-5D health utility (adjusted difference -0.02 [95%CI -0.03, 0.00]), but those with current PCC had a lower health utility (adjusted difference -0.08 [95%CI -0.12, -0.05]). Participants with current PCC were also more likely to report problems with mobility (adjusted odds ratio (aOR) 6.00 [95%CI 2.88-12.52]), self-care (aOR 5.96 [95%CI 1.84-19.32]), usual activities (aOR 8.00 [95%CI 4.27-14.99]), pain/discomfort (aOR 4.28 [95%CI 2.46-7.48]), and anxiety/depression (aOR 3.45 [95%CI 1.90-6.27]).

Conclusions: In working-age adults who have survived >2 years following COVID-19, HRQOL is high among those who never had PCC or have recovered from PCC. However, individuals with ongoing symptoms have lower HRQOL and are more likely to have functional deficits. These findings underscore the importance of implementing targeted healthcare interventions to improve HRQOL in adults with long-term PCC.

Keywords: Activities of daily living; COVID-19; Cross-sectional study; Employment; Health-related quality of life; Post-acute COVID-19 syndrome; SARS-CoV-2.