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. 2024 Jan;33(1):89-102.
doi: 10.1111/jocn.16352. Epub 2022 May 9.

Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID-19 infection: A six- to seven-month prospective cohort

Tamara Del Corral  1 , Noemí Menor-Rodríguez  2 , Sara Fernández-Vega  2 , Celia Díaz-Ramos  2 , Sandra Aguilar-Zafra  3   4 , Ibai López-de-Uralde-Villanueva  1
Affiliations

Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID-19 infection: A six- to seven-month prospective cohort

Tamara Del Corral et al. J Clin Nurs. 2024 Jan.

Abstract

Aims: To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.

Background: Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.

Design: A longitudinal cohort study.

Methods: In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6-7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.

Results: HRQoL was impaired in almost 60% of the sample and remained impaired 6-7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%-56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6-7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%-55%) remained impaired. Impaired HRQoL at 6-7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8-18.1)), PTSD (OR = 6.0 (1.7-20.7)) and impaired HRQoL (OR = 11.7 (3.7-36.8)).

Conclusion: A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.

Relevance to clinical practice: Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients' HRQoL from being impaired at 6-7 months after their reported recovery.

Keywords: COVID-19; health-related quality of life; long-term; physical function; psychological status; pulmonary function.

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Conflict of interest statement

The authors have stated that they had no interests which might be perceived as posing a conflict or bias.

Figures

FIGURE 1
FIGURE 1
Flow‐chart for recruitment of patients in post COVID‐19 long‐term follow‐up assessments
FIGURE 2
FIGURE 2
Change in EQ‐5D‐3L dimensions in participants with and without impaired health‐related quality of life
FIGURE 3
FIGURE 3
Results of bivariate logistic regression analysis showing factors associated with presence of impaired health‐related quality of life at 6–7 months after COVID‐19 diagnosis. CI, confidence interval; EQ, EuroQol; FEV1, forced expiratory volume at the first second; FVC, forced vital capacity; HADS, hospital anxiety and depression scale; MIP, maximal inspiratory pressure; MoCA, montreal cognitive assessment; OR, odds ratio; PCL‐C, post‐traumatic stress disorder checklist – Civilian version; VAS, visual analog scale
FIGURE 4
FIGURE 4
ROC analysis to determine the diagnostic accuracy of the model for identifying patients with quality of life impairment at 6–7 months after COVID‐19 diagnosis
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