Construct Validity and Responsiveness of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) in a Cohort of Italian Hospitalized COVID-19 Patients

Abstract

Post-COVID Syndrome (PCS) is characterized by physical, psychological and cognitive symptoms with a negative impact on daily activities. This study tested the responsiveness and construct validity of the original version of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) in a cohort of Italian hospitalized COVID-19 patients. This longitudinal study involved 79 hospitalized COVID-19 patients with rehabilitation needs, assessed after 12 and 26 weeks post-infection. Functional and patient-reported outcome measures were correlated with 10 items of the C19-YRS to test the construct validity, whereas distribution-based methods were used for the responsiveness over time. After 12 weeks since infection, 88.5% of patients reported fatigue, 83.3% breathlessness, 69.4% anxiety, 55.6% depression, and 44.9% pain. Moreover, 84.6% experienced reduced mobility, 75.7% had difficulties with usual activities, and 47.4% with personal care. Single items for each symptom had significant correlation (rho 0.25–0.60) with well-established scales for these symptoms. At 26 weeks, except for anxiety, all the PCS symptoms were still present but significantly reduced. The C19-YRS had moderate responsiveness for the most represented deficit reported. The C19-YRS was a valuable patient-reported outcome for screening, assessing severity, and monitoring the persistence of symptoms after 12 and 26 weeks from SARS-CoV2 infection in a cohort of Italian hospitalized patients.

The Thai version of the COVID-19 Yorkshire Rehabilitation Scale: a valid instrument for the psychometric assessment of the community members in Bangkok, Thailand

“…The C19-YRS has been widely used to screen the symptoms and severity of long-term COVID in patients that have been discharged from the hospital and those recovering in typical European communities [ 8 – 14 ] and west Asian nations [ 15 , 16 ]. Research into long-term COVID in Thailand has led to limited data; thus, further evidence to support long-term COVID management by MDT is warranted.…”

Psychometric analysis of the modified Covid-19 Yorkshire Rehabilitation Scale (C19-YRSm) in a prospective multicentre study

“…The original 22-item C19-YRS underwent psychometric evaluation including both classical and modern psychometric evaluation methods resulting in a 17-item modified tool, the C19-YRSm 18 . Both the original 22-item and the modified version have undergone a limited degree of subsequent validation 10,19 . The C19-YRS has been shown to have good construct validity but moderate responsiveness 10 .…”

“…Both the original 22-item and the modified version have undergone a limited degree of subsequent validation 10,19 . The C19-YRS has been shown to have good construct validity but moderate responsiveness 10 . The C19-YRSm has, by contrast, been demonstrated in a Croatian patient population to have good internal reliability and convergent validity 19 .…”

“…The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a condition-specific patient-reported outcome measure designed to capture the symptoms of LC, as well as assess severity and monitor the persistence of symptoms to inform and guide the rehabilitation of affected patients [7][8][9][10] . Since the initial validation of the instrument 7,11 , it has been widely used in a variety of LC contexts including symptom evaluation in primary care and community settings [12][13][14] , determining the need for LC rehabilitation interventions 8,9,15 , as well as epidemiological assessments of post-COVID symptoms 16,17 .…”

“…Both the original 22-item and the modified version have undergone a limited degree of subsequent validation 10,19 . The C19-YRS has been shown to have good construct validity but moderate responsiveness 10 .…”