PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

Abstract

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

Risk Predictors and Symptom Features of Long COVID Within a Broad Primary Care Patient Population Including Both Tested and Untested Patients

“…The utility of patient-reported outcome measures had been previously utilized to demonstrate the social and physical impact of persisting COVID-19 symptoms. 10 …”

“…5 Long COVID appears to be common, persistent, and debilitating, causing a wide range of physiological and cognitive disabilities irrespective of patient age and initial disease severity. 1,[6][7][8][9] The impact on social well-being 10 highlights the importance of addressing the persisting symptoms of COVID-19 infection. The common presentation of persisting symptoms includes fatigue, breathlessness, chest pain, and body aches.…”

“…However, current data on persisting symptoms of COVID-19 has been mostly derived from cases identified via positive test results. [7][8][9][10][11][14][15][16] While the exact numbers are not known, estimates suggested that the majority of COVID-19 cases went undetected, 17,18 likely due to limited testing capacity in the early phase of the pandemic. Furthermore, many studies on the long-term symptoms of COVID-19 have focused primarily on hospitalized patients.…”

Health-related quality of life and social determinants of health following COVID-19 infection in a predominantly Latino population

“…To date, there has been limited research examining HRQoL among COVID-19 survivors beyond a short time after diagnosis and among ethnically diverse samples. In 1 of the largest studies of COVID-19 survivors (n = 819), Ganesh and colleagues assessed the impact of COVID-19 infection on HRQoL of COVID-19 survivors drawn from the Mayo Clinic [21] . Overall, respondents reported significantly worse scores (greater than 1 SD) as compared with the expected population mean with respect to social roles, pain, fatigue, physical function, and sleep.…”

“…In addition, only a limited number of studies have examined multiple domains of health-related quality of life (HRQoL) in COVID-19 survivors. [14 , 20 , 21 , 25 – 27]…”