Long-Term Effect on Health-Related Quality of Life in Patients With COVID-19 Requiring Hospitalization Compared to Non-hospitalized COVID-19 Patients and Healthy Controls

Abstract

BackgroundIn this study, we aimed to evaluate the health-related quality of life (HRQL) in patients with severe coronavirus disease 2019 (COVID-19) six months after their hospitalization and compare it to that of nonhospitalized patients with mild COVID-19 and healthy controls. MethodologyParticipants were enrolled between September 2021 and April 2022 and included hospitalized COVID-19 patients at General Hospital of Athens "Hippocration" who had been discharged at least six months prior to enrollment, non-hospitalized patients with COVID-19, and healthy controls. Collected data included demographics, disease severity, medication history, and comorbidities. Participants completed a EuroQol 5 Dimensions 5Levels (EQ5D5L), a Short Form 36 version 2 (SF36v2), a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and a Post-COVID-19 Functional Status Scale (PCFSS) regarding HRQL before and six months after infection with severe acute respiratory syndrome coronavirus 2. In the case of healthy controls, two sets of questionnaires were completed at least six months apart. Statistical analysis was performed using the SPSS version 25 software (IBM Corp., Armonk, NY, USA). ResultsA total of 151 participants were enrolled. Hospitalized patients with COVID-19 demonstrated a statistically significant deterioration in most parameters of SF36v2 as well as both parameters of the EQ5D5L and FACIT-F questionnaires. Hospitalized patients exhibited worse results in SF36v2 and EQ5D5L when compared to both healthy controls as well as those with mild COVID-19 (p < 0.05). Hospitalized women, in particular, were shown to fare worse than other women in parameters associated with both mental/psychological and physical health (p < 0.05). Hospitalized patients between 41 and 60 years old demonstrated a statistically significant drop in the scores of all three main questionnaires compared to their previous health status (p < 0.05). Hospitalized patients between 61 and 80 years old exhibited a similar trend, but statistical significance was achieved in fewer parameters. HRQL decline was greater in both age groups compared to that of healthy and milder disease counterparts. There was a significant correlation between the results from the three main questionnaires. Similarly, PCFS scale values were shown to correlate with disease severity (hospitalization or not) and age. ConclusionsHRQL remained noticeably impacted six months after hospitalization due to COVID-19. The physical and mental/psychological stress of severe COVID-19 translated into lasting health deterioration, especially for women and those aged 41-60 years old. The use of questionnaires, such as those implemented in this study, might help in the early detection of patients who could benefit from rehabilitation programs. Psychological, as well as physical and social, support is crucial to alleviate the burden of post-COVID-19 symptomatology and expedite the recovery of this group of patients.

Quality of life at work and fatigue after hospitalization due to COVID‐19

“…Our study also revealed that deterioration in QoL at work was predicted by younger age, both during and after acute phase of the SARS‐CoV‐2 infection. Our results resembled the observation from a small cohort assessed with four different questionnaires before and 6 months after hospitalization due to COVID‐19 that revealed a decrease in QoL, especially in younger individuals, that was, between 41 and 60 years 24 . On the other hand, an online questionnaire survey of 385 Indonesian patients showed that the risk of persistent post‐COVID fatigue, affecting QoL in the aspect of pain and anxiety or depression, was increased in older people and those previously hospitalized 25 .…”

“…Our results resembled the observation from a small cohort assessed with four different questionnaires before and 6 months after hospitalization due to COVID-19 that revealed a decrease in QoL, especially in younger individuals, that was, between 41 and 60 years. 24 On the other hand, an online questionnaire survey of 385 Indonesian patients showed that the risk of persistent post-COVID fatigue, affecting QoL in the aspect of pain and anxiety or depression, was increased in older people and those previously hospitalized. 25 Thus, as it has been shown in a recent meta-analysis, both in younger and older COVID-19 survivors, symptoms of the CFS, such as fatigue, headache, and myalgia, are highly prevalent, and possibly associated with a poorer QoL.…”

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

“…Different studies have tried to identify what factors influence longterm quality of life outcomes in COVID-19. Female sex is the most frequently described determinant, in keeping with our findings (11,12,(17)(18)(19)(20)(21)(22). Likewise, obesity has been described as another relevant factor (21).…”

“…None of them were vaccinated against SARS-CoV-2 at the time of their admission; slightly less than half presented ARDS, and practically all of them were treated with corticosteroids. The worst quality of life outcomes were obtained in the domains of general health, vitality, and mental state, with similar results to those observed by Koullias et al (11), who administered a simpler version of the SF-36 at 6 months after admission for coronavirus disease 2019 (COVID-19). Our results are also consistent with theirs in terms of the acceptable scores obtained in the domains referring to physical issues.…”

Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19: a prospective multicenter study

“…Health-related quality of life (HrQoL) has been insufficiently investigated in critical COVID-19. The physical and mental component scores of SF-36v2®have shown long-lasting deterioration in hospitalised COVID-19, particularly in women and in those aged 41–60 years [ 25 , 26 ].…”