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Meta-Analysis
. 2022 Jan;94(1):253-262.
doi: 10.1002/jmv.27309. Epub 2021 Sep 7.

Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)-A systematic review and meta-analysis

Preeti Malik  1 , Karan Patel  2 , Candida Pinto  1 , Richa Jaiswal  3 , Raghavendra Tirupathi  4 , Shreejith Pillai  5 , Urvish Patel  1
Affiliations
Meta-Analysis

Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)-A systematic review and meta-analysis

Preeti Malik et al. J Med Virol. 2022 Jan.

Abstract

There is an established literature on the symptoms and complications of COVID-19 but the after-effects of COVID-19 are not well understood with few studies reporting persistent symptoms and quality of life. We aim to evaluate the pooled prevalence of poor quality of life in post-acute COVID-19 syndrome (PCS) and conducted meta-regression to evaluate the effects of persistent symptoms and intensive care unit (ICU) admission on the poor quality of life. We extracted data from observational studies describing persistent symptoms and quality of life in post-COVID-19 patients from March 10, 2020, to March 10, 2021, following PRISMA guidelines with a consensus of two independent reviewers. We calculated the pooled prevalence with 95% confidence interval (CI) and created forest plots using random-effects models. A total of 12 studies with 4828 PCS patients were included. We found that amongst PCS patients, the pooled prevalence of poor quality of life (EQ-VAS) was (59%; 95% CI: 42%-75%). Based on individual factors in the EQ-5D-5L questionnaire, the prevalence of mobility was (36, 10-67), personal care (8, 1-21), usual quality (28, 2-65), pain/discomfort (42, 28-55), and anxiety/depression (38, 19-58). The prevalence of persistent symptoms was fatigue (64, 54-73), dyspnea (39.5, 20-60), anosmia (20, 15-24), arthralgia (24.3, 14-36), headache (21, 3-47), sleep disturbances (47, 7-89), and mental health (14.5, 4-29). Meta-regression analysis showed the poor quality of life was significantly higher among post-COVID-19 patients with ICU admission (p = 0.004) and fatigue (p = 0.0015). Our study concludes that PCS is associated with poor quality of life, persistent symptoms including fatigue, dyspnea, anosmia, sleep disturbances, and worse mental health. This suggests that we need more research on PCS patients to understand the risk factors causing it and eventually leading to poor quality of life.

Keywords: health-related quality of life; long COVID-19; persistent symptoms; post-COVID syndrome; post-acute COVID-19 syndrome.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Flow diagram of literature search and study selection process of quality‐of‐life post‐COVID‐19
Figure 2
Figure 2
Forest plot of pooled prevalence of poor quality of life (EQ‐VAS) in post‐COVID‐19 patients. CI, confidence interval
Figure 3
Figure 3
Forest plot of pooled mean of poor quality of life (EQ‐VAS) in post‐COVID‐19 patients
Figure 4
Figure 4
(A) Forest plot of pooled prevalence of mobility in EQ‐5D‐5L questionnaire in post‐COVID‐19 patients. (B) Forest plot of pooled prevalence of self‐care in EQ‐5D‐5L questionnaire in post‐COVID‐19 patients. (C) Forest plot of pooled prevalence of usual activity in EQ‐5D‐5L questionnaire in post‐COVID‐19 patients. (D) Forest plot of pooled prevalence of pain/discomfort in EQ‐5D‐5L questionnaire in post‐COVID‐19 patients. (E) Forest plot of pooled prevalence of anxiety/depression in EQ‐5D‐5L questionnaire in post‐COVID‐19 patients
Figure 5
Figure 5
(A) Meta‐regression between the poor quality of life (log‐event) and fatigue in post‐COVID‐19 patients. (B) Meta‐regression between the poor quality of life (log‐event) and ICU admission in post‐COVID‐19 patients. ICU, intensive care unit
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