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. 2021 Mar 22;21(1):199.
doi: 10.1186/s12877-021-02140-x.

Health-related quality of life, functional decline, and long-term mortality in older patients following hospitalisation due to COVID-19

M M Walle-Hansen  1 , A H Ranhoff  2   3 , M Mellingsæter  4 , M S Wang-Hansen  5 , M Myrstad  6   7
Affiliations

Health-related quality of life, functional decline, and long-term mortality in older patients following hospitalisation due to COVID-19

M M Walle-Hansen et al. BMC Geriatr. .

Abstract

Background: Older people are particularly vulnerable to severe COVID-19. Little is known about long-term consequences of COVID-19 on health-related quality of life (HR-QoL) and functional status in older people, and the impact of age in this context. We aimed to study age-related change in health-related quality of life, functional decline and mortality among older patients 6 months following hospitalisation due to COVID-19.

Methods: This was a cohort study including patients aged 60 years and older admitted to four general hospitals in South-Eastern Norway due to COVID-19, from March 1 up until July 1, 2020. Patients who were still alive were invited to attend a six-month follow-up. Change in HR-QoL and functional status compared to before the COVID-19 hospitalisation were assessed using the EuroQol 5-dimensional-5 levels questionnaire (EQ. 5D-5L). A change in visual analogue scale (VAS) score of 7 or more was considered clinically relevant.

Results: Out of 216 patients aged 60 years and older that were admitted to hospital due to COVID-19 during the study period, 171 were still alive 180 days after hospital admission, and 106 patients (62%) attended the six-month follow-up. Mean age was 74.3 years, 27 patients (26%) had experienced severe COVID-19. Fifty-seven participants (54%) reported a decrease in the EQ. 5D-5L VAS score after 6 months, with no significant difference between persons aged 75 years and older compared to younger. Seventy participants (66%) reported a negative change in any of the dimensions of the EQ. 5D-5L, with impaired ability to perform activities of daily life (35%), reduced mobility (33%) and having more pain or discomfort (33%) being the most commonly reported changes. Forty-six participants (43%) reported a negative change in cognitive function compared to before the COVID-19 hospitalisation. Six-month mortality was 21%, and increased with increasing age.

Conclusions: More than half of the patients reported a negative change in HR-QoL 6 months following hospitalisation due to COVID-19, and one out of three experienced a persistently impaired mobility and ability to carry out activities of daily living. The results suggest awareness of long-term functional decline in older COVID-19 patients.

Keywords: COVID-19; Geriatric medicine; Health-related quality of life; Pandemic.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Inclusion of participants to the study. a 19 patients did not wish to participate in the study, 8 patients we were unable to reach by phone, 1 patient died before the follow-up evaluation and 2 patients were excluded because of severe cognitive and physical impairment, after consensus between the first and last author. Due to capacity challenges during the first wave, the list of admitted patients was retrospectively found to be incomplete for one of the participating hospitals, and 35 patients were therefore not invited to participate in the study
Fig. 2
Fig. 2
Mean change in HR-QoL (0–100 scale) by age 6 months after COVID-19. Patients aged 60 years and older admitted to four Norwegian hospitals from March 1 to July 1, 2020 due to COVID-19, and still alive after 6 months, n = 106. For 6 participants, information on EQ. 5D VAS scale was incomplete: 4 participants missed both status before and 6 months after COVID-19, and 2 participants missed status after 6 months
Fig. 3
Fig. 3
a-e Change in EQ. 5D-5L dimensions after hospitalisation due to COVID-19 by age group. Patients aged 60 years and older admitted to four Norwegian hospitals from March 1 to July 1, 2020 due to COVID-19, and still alive after 6 months, n = 106
Fig. 4
Fig. 4
One hundred and eighty day survival after hospitalisation due to COVID-19 by age group. Patients aged 60 years and older admitted to four Norwegian hospitals from March 1 to July 1, 2020, due to COVID-19, n = 216
See this image and copyright information in PMC

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