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Multicenter Study
. 2022 May;31(5):1401-1414.
doi: 10.1007/s11136-021-02998-9. Epub 2021 Sep 28.

Factors associated with impaired quality of life three months after being diagnosed with COVID-19

Verena Rass  1 , Bogdan-Andrei Ianosi  2 , Laura Zamarian  2 , Ronny Beer  2 , Sabina Sahanic  3 , Anna Lindner  2 , Mario Kofler  2 , Alois Josef Schiefecker  2 , Philipp Mahlknecht  2 , Beatrice Heim  2 , Victoria Limmert  2 , Thomas Sonnweber  3 , Alex Pizzini  3 , Piotr Tymoszuk  3 , Christoph Scherfler  2 , Atbin Djamshidian  2 , Stefan Kiechl  2 , Ivan Tancevski  3 , Klaus Seppi  2 , Bettina Pfausler  2 , Judith Loeffler-Ragg  3 , Raimund Helbok  2
Affiliations
Multicenter Study

Factors associated with impaired quality of life three months after being diagnosed with COVID-19

Verena Rass et al. Qual Life Res. 2022 May.

Abstract

Purpose: To assess patient characteristics associated with health-related quality of life (HR-QoL) and its mental and physical subcategories 3 months after diagnosis with COVID-19.

Methods: In this prospective multicentre cohort study, HR-QoL was assessed in 90 patients using the SF-36 questionnaire (36-item Short Form Health Survey), which consists of 8 health domains that can be divided into a mental and physical health component. Mental health symptoms including anxiety, depression, and post-traumatic stress disorders were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Post-traumatic Stress Disorder Checklist-5 (PCL-5) 3 months after COVID-19. Using descriptive statistics and multivariable regression analysis, we identified factors associated with impaired HR-QoL 3 months after COVID-19 diagnosis.

Results: Patients were 55 years of age (IQR, 49-63; 39% women) and were classified as severe (23%), moderate (57%), or mild (20%) according to acute disease severity. HR-QoL was impaired in 28/90 patients (31%). Younger age [per year, adjOR (95%CI) 0.94 (0.88-1.00), p = 0.049], longer hospitalization [per day, adjOR (95%CI) 1.07 (1.01-1.13), p = 0.015], impaired sleep [adjOR (95%CI) 5.54 (1.2-25.61), p = 0.028], and anxiety [adjOR (95%CI) 15.67 (3.03-80.99), p = 0.001) were independently associated with impaired HR-QoL. Twenty-nine percent (n = 26) scored below the normal range on the mental health component of the SF-36 and independent associations emerged for anxiety, depression, and self-reported numbness. Impairments in the physical health component of the SF-36 were reported by 12 (13%) patients and linked to hypogeusia and fatigue.

Conclusion: Every third patient reported a reduction in HR-QoL 3 months after COVID-19 diagnosis and impairments were more prominent in mental than physical well-being.

Keywords: COVID-19; Mental health; Neuro-COVID; Quality of life; SARS-CoV-2.

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Conflict of interest statement

KS reports grants from FWF Austrian Science Fund, grants from Michael J. Fox Foundation, grants from International Parkinson and Movement Disorder Society, personal fees from Teva, personal fees from UCB, personal fees from Lundbeck, personal fees from AOP Orphan Pharmaceuticals AG, personal fees from Abbvie, personal fees from Roche, and personal fees from Grünenthal; all outside the submitted work. PM reports grants from TWF (Tyrolean Science Fund), grants from Medtronic, personal fees from Boston Scientific, all outside the submitted work. The other authors have nothing to disclose. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Box blots for each domain of the SF-36 stratified by disease severity during the acute phase of the disease. We did not find a significant difference across severity groups (p > 0.05). The central line shows the 50th percentile, the upper and lower lines the 75th and 25th percentile, and the lines end at the 90th and 10th percentiles. The rectangles indicate the median value of the whole cohort
Fig. 2
Fig. 2
Box plots for each domain of the SF-36 stratified by mental health symptoms are displayed. Patients with mental health symptoms scored worse in all domains compared to patients without a mental health symptom (p < 0.05). The central line shows the 50th percentile, the upper and lower lines the 75th and 25th percentile, and the lines end at the 90th and 10th percentiles. The rectangles indicate the mean value
Fig. 3
Fig. 3
A higher mental health burden 3 months after COVID-19 was associated with a A lower mental component summary (MCS; p < 0.001) but not B with the physical component summary (PCS). A higher physical symptom burden 3 months after COVID-19 was associated with a lower C MCS (p < 0.001) and D PCS (p < 0.001)
Fig. 4
Fig. 4
Factors associated with impaired A SF-36 < 40, B mental component summary (MCS) < 40, and C physical component summary (PCS) < 40 with calculated adjusted odds ratios based on the logistic regression with the 95% confidence intervals are shown. HADS-A > 7 is indicative of the presence of anxiety, HADS-D > 7 of depression. In non-hospitalized patients, “0” days were used for calculation
See this image and copyright information in PMC

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