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. 2025 Apr;34(4):1103-1111.
doi: 10.1007/s11136-024-03882-y. Epub 2025 Jan 8.

Long‑term physical and mental Health-Related Quality of Life in Italian patients post COVID-19 hospitalisation

Marco Viola  1   2   3 , Carlotta Sacerdote  4 , Giovannino Ciccone  4 , Edoardo Donarelli  5 , Manolis Kogevinas  6 , Assunta Rasulo  4 , Anna Toscano  5 , Eva Pagano  4 , Rosalba Rosato  5
Affiliations

Long‑term physical and mental Health-Related Quality of Life in Italian patients post COVID-19 hospitalisation

Marco Viola et al. Qual Life Res. 2025 Apr.

Abstract

Purpose: Prior evidence suggests that patients' Health Related Quality of Life (HRQoL) worsens after COVID-19. This study aimed to investigate HRQoL in Italian patients post-hospitalization for COVID-19, focusing on changes in physical and mental HRQoL over time since COVID-19 diagnosis.

Methods: A cohort of patients hospitalized for COVID-19 at Molinette Hospital in Turin, Italy, was contacted post-discharge to assess HRQoL using the SF-36 questionnaire. Patients completed the questionnaire only once at a different time since diagnosis. This design allowed for the analysis of responses up to three years after diagnosis. Measured scores were compared with normative data from the Italian population using z-scores. HRQoL differences by gender, comorbidities, and self-perception of health status before and after COVID-19 were tested. The effect of time since diagnosis on physical (PCS) and mental (MCS) SF-36 scores was analysed using multiple linear models and stratified analyses.

Results: A total of 601 patients completed the questionnaire. HRQoL was significantly lower compared to the normative Italian population. Men and individuals without comorbidities had better HRQoL, and self-perceptions of health status before and after COVID-19 influenced HRQoL. Time since diagnosis was associated with improved PCS, but MCS remained unaffected. Mental health declined in patients using anxiolytics post-COVID-19, and increasing age negatively affected physical health.

Conclusion: Our findings highlight the impact of time since diagnosis on HRQoL post-COVID-19 in an Italian population and suggest the need for further investigation into the pandemic's effects on HRQoL. Physicians should implement measures to improve mental HRQoL post-COVID-19.

Keywords: Long-term; Physical and mental consequences; Post COVID-19 hospitalisation; Quality of life; SF-36; Time since diagnosis.

Plain language summary

The relationship between COVID-19 and both physical and mental health is a highly debated topic. COVID-19 impairs mental health and reduces the ability to engage in normal physical activities. However, the long-term consequences (12–36 months) of COVID-19 remain relatively unexplored, particularly in the Italian population. In this study, we examined a sample of Italian patients after hospitalisation for COVID-19 to assess changes in their physical and mental Quality of Life over time since their diagnosis. Our findings indicate that COVID-19 significantly worsened Quality of Life scores for these patients after hospitalisation compared to current normative scores for the Italian population. Over time, physical Quality of Life tends to improve in these patients, but mental Quality of Life does not show a similar trend. These results suggest the need to re-evaluate the impact of the COVID-19 pandemic on Quality of Life in Italy and emphasize the importance of addressing mental health to enhance the Quality of Life for those affected by COVID-19.

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Conflict of interest statement

Declarations. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Molinette Hospital - Città della Scienza e della Salute (Turin, Italy) (code 157/2022). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: Patients signed informed consent regarding publishing their data. Competing interests: The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Patients flow chart
Fig. 2
Fig. 2
Predicted response means for PCS score and standard errors on time between diagnosis and compilation of the questionnaire, by self-perception. The lines refer to a subject with age between 18 and 54 years, female, without comorbidities, without intensive care, with a low level of NEWS2, with an educational level lower than high school diploma and without use of anxiolytics post COVID-19
Fig. 3
Fig. 3
Predicted response means for MCS score and standard errors on time between diagnosis and compilation of the questionnaire, by self-perception. The lines refer to a subject with age between 18 and 54 years, female, without comorbidities, without intensive care, with a low level of NEWS2, with an educational level before high school diploma and without use of anxiolytics post COVID-19
See this image and copyright information in PMC

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