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. 2021 Feb 3;19(1):40.
doi: 10.1186/s12955-021-01691-2.

Construct validity of the Post-COVID-19 Functional Status Scale in adult subjects with COVID-19

Felipe V C Machado  1   2   3   4 , Roy Meys  5   6   7 , Jeannet M Delbressine  5 , Anouk W Vaes  5 , Yvonne M J Goërtz  5   6   7 , Maarten van Herck  5   6   7   8 , Sarah Houben-Wilke  5 , Gudula J A M Boon  9 , Stefano Barco  10   11 , Chris Burtin  8 , Alex van 't Hul  12 , Rein Posthuma  5   6   7 , Frits M E Franssen  5   6   7 , Yvonne Spies  13 , Herman Vijlbrief  13 , Fabio Pitta  14 , Spencer A Rezek  15 , Daisy J A Janssen  5   16 , Bob Siegerink  17   18 , Frederikus A Klok  9   10 , Martijn A Spruit  5   6   7   8
Affiliations

Construct validity of the Post-COVID-19 Functional Status Scale in adult subjects with COVID-19

Felipe V C Machado et al. Health Qual Life Outcomes. .

Abstract

Background: An increasing number of subjects are recovering from COVID-19, raising the need for tools to adequately assess the course of the disease and its impact on functional status. We aimed to assess the construct validity of the Post-COVID-19 Functional Status (PCFS) Scale among adult subjects with confirmed and presumed COVID-19.

Methods: Adult subjects with confirmed and presumed COVID-19, who were members of an online panel and two Facebook groups for subjects with COVID-19 with persistent symptoms, completed an online survey after the onset of infection-related symptoms. The number and intensity of symptoms were evaluated with the Utrecht Symptom Diary, health-related quality of life (HrQoL) with the 5-level EQ-5D questionnaire, impairment in work and activities with the Work Productivity and Activity Impairment questionnaire and functional status with the PCFS Scale.

Results: 1939 subjects were included in the analyses (85% women, 95% non-hospitalized during infection) about 3 months after the onset of infection-related symptoms. Subjects classified as experiencing 'slight', 'moderate' and 'severe' functional limitations presented a gradual increase in the number/intensity of symptoms, reduction of HrQoL and impairment in work and usual activities. No differences were found regarding the number and intensity of symptoms, HrQoL and impairment in work and usual activities between subjects classified as experiencing 'negligible' and 'no' functional limitations. We found weak-to-strong statistical associations between functional status and all domains of HrQoL (r: 0.233-0.661). Notably, the strongest association found was with the 'usual activities' domain of the 5-level EQ-5D questionnaire.

Conclusion: We demonstrated the construct validity of the PCFS Scale in highly-symptomatic adult subjects with confirmed and presumed COVID-19, 3 months after the onset of symptoms.

Keywords: Functional status; Quality of life; SARS-CoV-2; Symptoms.

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Conflict of interest statement

FMEF reports grants and personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees from GlaxoSmithKline, grants and personal fees from Novartis, and personal fees from TEVA, outside the submitted work. DJAJ has received speaker fees from AstraZeneca, Boehringer Ingelheim and Novartis, outside the submitted work. FAK has received research grants from Bayer, Bristol-Myers Squibb, Boehringer-Ingelheim, MSD, Daiichi-Sankyo, Actelion, the Dutch thrombosis association, the Netherlands Organisation for Health Research and Development and the Dutch Heart foundation, all outside this work. MAS reports grants from Netherlands Lung Foundation, grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, and grants from Stichting Astma Bestrijding, all outside the submitted work. All other authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Comparisons of symptoms intensity between subjects with COVID-19 stratified according to the level of impairment in functional status. Figure displays the median as central line, interquartile range as the limits of the box and 10 and 90 percentiles as whiskers. a P < 0.05 compared with Grade 0; b P < 0.05 compared with Grade 1; c P < 0.05 compared with Grade 2; d P < 0.05 compared with Grade 3
Fig. 2
Fig. 2
A Comparisons of HrQoL of life between subjects with COVID-19 stratified according to the level of impairment in functional status. a P < 0.05 compared with Grade 0; b P < 0.05 compared with Grade 1; c P < 0.05 compared with Grade 2; d P < 0.05 compared with Grade 3. Figure displays the median as central line, interquartile range as the limits of the box and 10 and 90 percentiles as whiskers. B Associations between level of impairment in functional status and different domains of HrQoL
Fig. 3
Fig. 3
Comparisons of work productivity and activity impairment between subjects with COVID-19 stratified according to the level of impairment in functional status. a P < 0.05 compared with Grade 0; b  P < 0.05 compared with Grade 1; c P < 0.05 compared with Grade 2; d P < 0.05 compared with Grade 3. Figure displays the median as central line, interquartile range as the limits of the box and 10 and 90 percentiles as whiskers
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