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

Abstract

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.

Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review

“…With respect to COVID-19 severity, we found in our systematic review that investigations included very heterogeneous participants, from asymptomatic to patients with severe COVID-19 symptoms. It has been postulated that length of hospitalization and severity of COVID-19 symptoms are associated with reduced quality of life ( 77 ) so there is no doubt that, if possible, psychological interventions should be provided during and after discharge. However, patients with mild but chronic physical symptoms may also experience an impact on their quality of life, especially those with pulmonary affections ( 78 ) so we propose that all COVID-19 patients should be offered both preventive psychological interventions and psychological treatment.…”