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Multicenter Study
. 2022 Jul;16(4):680-689.
doi: 10.1111/irv.12980. Epub 2022 Mar 28.

Associations between persistent symptoms after mild COVID-19 and long-term health status, quality of life, and psychological distress

Jin H Han  1   2 , Kelsey N Womack  1 , Mark W Tenforde  3 , D Clark Files  4 , Kevin W Gibbs  4 , Nathan I Shapiro  5 , Matthew E Prekker  6 , Heidi L Erickson  6 , Jay S Steingrub  7 , Nida Qadir  8 , Akram Khan  9 , Catherine L Hough  9 , Nicholas J Johnson  10 , E Wesley Ely  1   2 , Todd W Rice  1 , Jonathan D Casey  1 , Christopher J Lindsell  1 , Michelle N Gong  11 , Vasisht Srinivasan  10 , Nathaniel M Lewis  3 , Manish M Patel  3 , Wesley H Self  1 ; Influenza and Other Viruses in the Acutely Ill (IVY) Network
Affiliations
Multicenter Study

Associations between persistent symptoms after mild COVID-19 and long-term health status, quality of life, and psychological distress

Jin H Han et al. Influenza Other Respir Viruses. 2022 Jul.

Abstract

Background: We sought to assess whether persistent COVID-19 symptoms beyond 6 months (Long-COVID) among patients with mild COVID-19 is associated with poorer health status, quality of life, and psychological distress.

Methods: This was a multicenter prospective cohort study that included adult outpatients with acute COVID-19 from eight sites during 2-week sampling periods from April 1 and July 28, 2020. Participants were contacted 6-11 months after their first positive SARS-CoV-2 to complete a survey, which collected information on the severity of eight COVID-19 symptoms using a 4-point scale ranging from 0 (not present) to 3 (severe) at 1 month before COVID-19 (pre-illness) and at follow-up; the difference for each was calculated as an attributable persistent symptom severity score. A total attributable persistent COVID-19 symptom burden score was calculated by summing the attributable persistent severity scores for all eight symptoms. Outcomes measured at long-term follow-up comprised overall health status (EuroQol visual analogue scale), quality of life (EQ-5D-5L), and psychological distress (Patient Health Questionnaire-4). The association between the total attributable persistent COVID-19 burden score and each outcome was analyzed using multivariable proportional odds regression.

Results: Of the 2092 outpatients with COVID-19, 436 (21%) responded to the survey. The median (IQR) attributable persistent COVID-19 symptom burden score was 2 (0, 4); higher scores were associated with lower overall health status (aOR 0.63; 95% CI: 0.57-0.69), lower quality of life (aOR: 0.65; 95%CI: 0.59-0.72), and higher psychological distress (aOR: 1.40; 95%CI, 1.28-1.54) after adjusting for age, race, ethnicity, education, and income.

Conclusions: In participants with mild acute COVID-19, the burden of persistent symptoms was significantly associated with poorer long-term health status, poorer quality of life, and psychological distress.

Keywords: COVID-19; COVID-19 outcomes; long-COVID; post-COVID conditions; post-acute sequalae of COVID-19 (PASC).

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Figures

FIGURE 1
FIGURE 1
Flow diagram of patient participation. RT‐PCR, reverse transcription polymerase chain reaction
FIGURE 2
FIGURE 2
Symptom trajectories from 1 month before COVID‐19 (pre‐illness baseline), during peak acute COVID‐19 (worst during illness), and at long‐term follow‐up (6–11 months after the positive SARS‐CoV‐2 test) for 8 COVID‐19 symptoms. Patients rated their symptoms using a 4‐level Likert scale ranging from 0 (no symptoms) to 3 (severe symptoms). At each time point, a summary of symptom severity among all participants is plotted with a box plot, with the median score represented by the horizontal line, the interquartile range (25th percentile to 75th percentile) represented by the box, the full range represented by the outer brackets, and the mean represented by the star. A dashed line connects the median from each time point to highlight changes in the central tendency over time
See this image and copyright information in PMC

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