Long-Term Health-Related Quality of Life in Non-Hospitalized Coronavirus Disease 2019 (COVID-19) Cases With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in England: Longitudinal Analysis and Cross-Sectional Comparison With Controls. (5th March 2022)

• Record Type: Journal Article
• Authors: Sandmann, Frank G; Tessier, Elise; Lacy, Joanne; Kall, Meaghan; Van Leeuwen, Edwin; Charlett, Andre; Eggo, Rosalind M; Dabrera, Gavin; Edmunds, W John; Ramsay, Mary; Campbell, Helen; Amirthalingam, Gayatri; Jit, Mark
• Is Part Of: Clinical infectious diseases. Volume 75:Number 1(2022)
• Page Start: e962
• Page End: e973
• Publication Date: 2022-03-05
• Subjects: SARS -- CoV -- 2 -- COVID -- 19 -- long COVID -- health -- related quality of life -- QALYs; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac151
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: We aimed to quantify the unknown losses in health-related quality of life of coronavirus disease 2019 (COVID-19) cases using quality-adjusted lifedays (QALDs) and the recommended EQ-5D instrument in England. Methods: Prospective cohort study of nonhospitalized, polymerase chain reaction (PCR)-confirmed severe acute respiratory syndrome coronavirus 2–positive (SARS-CoV-2–positive) cases aged 12–85 years and followed up for 6 months from 1 December 2020, with cross-sectional comparison to SARS-CoV-2–negative controls. Main outcomes were QALD losses; physical symptoms; and COVID-19-related private expenditures. We analyzed results using multivariable regressions with post hoc weighting by age and sex, and conditional logistic regressions for the association of each symptom and EQ-5D limitation on cases and controls. Results: Of 548 cases (mean age 41.1 years; 61.5% female), 16.8% reported physical symptoms at month 6 (most frequently extreme tiredness, headache, loss of taste and/or smell, and shortness of breath). Cases reported more limitations with doing usual activities than controls. Almost half of cases spent a mean of £18.1 on nonprescription drugs (median: £10.0), and 52.7% missed work or school for a mean of 12 days (median: 10). On average, all cases lost 13.7 (95% confidence interval [CI]: 9.7, 17.7) QALDs, whereas those reporting symptoms at month 6 lost 32.9 (95% CI: 24.5, 37.6) QALDs. Losses also increased with older age. Cumulatively, the health loss from morbidity contributes at least 18% of the total COVID-19-related disease burden in the England. Conclusions: One in 6 cases report ongoing symptoms at 6 months, and 10% report prolonged loss of function compared to pre-COVID-19 baselines. A marked health burden was observed among older COVID-19 cases and those with persistent physical symptoms. Abstract : Losses of health-related quality of life in non-hospitalized coronavirus disease 2019 (COVID-19) cases increase with age and for cases with persistent symptoms. At a population level, the health loss from morbidity contributes at least 18% of the total COVID-19-related disease burden in England.