High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-19

The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infectio...

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Published in:	Frontiers in public health Vol. 11; p. 1104267
Main Authors:	Ahmad, Irma, Edin, Alicia, Granvik, Christoffer, Kumm Persson, Lowa, Tevell, Staffan, Månsson, Emeli, Magnuson, Anders, Marklund, Ingela, Persson, Ida-Lisa, Kauppi, Anna, Ahlm, Clas, Forsell, Mattias N E, Sundh, Josefin, Lange, Anna, Cajander, Sara, Normark, Johan
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 2023
Subjects:	Cohort Studies COVID-19 EQ-5D Humans long-COVID PACS Post COVID-19 condition (PCC) post-acute COVID syndrome (PACS) Post-Acute COVID-19 Syndrome Prevalence Prospective Studies Public Health Quality of Life SARS-CoV-2 Self Report COVID-19 EQ-5D post-acute COVID syndrome (PACS) SARS-CoV-2 PACS long-COVID Post COVID-19 condition (PCC)
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Summary:	The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infection, and explored risk factors for COVID-19 sequalae. This was a prospective, multicenter, cohort study including 434 patients. At 6 months, physical exercise capacity was assessed by a 1-minute sit-to-stand test (1MSTST) and persistent symptoms were reported and HRQoL was evaluated through the EuroQol 5-level 5-dimension (EQ-5D-5L) questionnaire. Patients with both persistent symptoms and reduced HRQoL were classified into a new definition of post-acute COVID syndrome, PACS+. Risk factors for developing persistent symptoms, reduced HRQoL and PACS+ were identified by multivariable Poisson regression. Persistent symptoms were experienced by 79% of hospitalized, and 59% of non-hospitalized patients at 6 months. Hospitalized patients had a higher prevalence of self-assessed reduced overall health (28 vs. 12%) and PACS+ (31 vs. 11%). PACS+ was associated with reduced exercise capacity but not with abnormal pulse/desaturation during 1MSTST. Hospitalization was the most important independent risk factor for developing persistent symptoms, reduced overall health and PACS+. Persistent symptoms and reduced HRQoL are common among COVID-19 survivors, but abnormal pulse and peripheral saturation during exercise could not distinguish patients with PACS+. Patients with severe infection requiring hospitalization were more likely to develop PACS+, hence these patients should be prioritized for clinical follow-up after COVID-19.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors have contributed equally to this work and share first/senior authorship Reviewed by: Marco Ruggiero, National Coalition of Independent Scholars, United States; Efrén Murillo-Zamora, Mexican Social Security Institute (IMSS), Mexico; Brandon Bautista-Becerril, Instituto Politécnico Nacional (IPN), Mexico This article was submitted to Infectious Diseases: Epidemiology and Prevention, a section of the journal Frontiers in Public Health Edited by: Ramcés Falfán-Valencia, Instituto Nacional de Enfermedades Respiratorias-México (INER), Mexico
ISSN:	2296-2565 2296-2565
DOI:	10.3389/fpubh.2023.1104267