Impact of COVID-19 and effects of BNT162b2 on patient-reported outcomes: quality of life, symptoms, and work productivity among US adult outpatients

• Published in: Journal of patient-reported outcomes Vol. 6; no. 1; pp. 123 - 13
• Main Authors: Di Fusco, Manuela, Sun, Xiaowu, Moran, Mary M., Coetzer, Henriette, Zamparo, Joann M., Puzniak, Laura, Alvarez, Mary B., Tabak, Ying P., Cappelleri, Joseph C.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 05-12-2022; Springer Nature B.V; SpringerOpen
• Subjects: Coronaviruses; COVID-19; COVID-19 and patient-reported outcomes; COVID-19 symptoms; COVID-19 vaccines; HRQoL; Immunization; Infections; Medicine; Medicine & Public Health; Productivity; Quality of life; Quality of Life Research; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; WPAI; United States > US; COVID-19; SARS-CoV-2; BNT162b2; COVID-19 symptoms; HRQoL; WPAI; Humanistic; Quality of life
• ISSN: 2509-8020; 2509-8020
• DOI: 10.1186/s41687-022-00528-w

Background
Although there is extensive literature on the clinical benefits of COVID-19 vaccination, data on humanistic effects are limited. This study evaluated the impact of SARS-CoV-2 infection on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Impairment (WPAI) prior to and one month following infection between individuals vaccinated with BNT162b2 and those unvaccinated.
Methods
Subjects with ≥ 1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between 01/31/2022 and 04/30/2022. Socio-demographics, clinical characteristics and vaccination status were evaluated. Self-reported symptoms, HRQoL, and WPAI outcomes were assessed using questionnaires and validated instruments (EQ-5D-5L, WPAI-GH) across acute COVID time points from pre-COVID to Week 4, and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for several covariates. Effect size (ES) of Cohen’s d was calculated to quantify the magnitude of outcome changes within and between vaccination groups.
Results
The study population included 430 subjects: 197 unvaccinated and 233 vaccinated with BNT162b2. Mean (SD) age was 42.4 years (14.3), 76.0% were female, 38.8% reported prior infection and 24.2% at least one comorbidity. Statistically significant differences in outcomes were observed compared with baseline and between groups. The EQ-Visual analogue scale scores and Utility Index dropped in both cohorts at Day 3 and increased by Week 4 but did not return to pre-COVID levels. The mean changes were statistically lower in the BNT162b2 cohort at Day 3 and Week 4. The BNT162b2 cohort reported lower prevalence and fewer symptoms at index date and Week 4. At Week 1, COVID-19 had a large impact on all WPAI-GH domains: the work productivity time loss among unvaccinated and vaccinated was 65.0% and 53.8%, and the mean activity impairment was 50.2% and 43.9%, respectively. Except for absenteeism at Week 4, the BNT162b2 cohort was associated with statistically significant less worsening in all WPAI-GH scores at both Week 1 and 4.
Conclusions
COVID-19 negatively impacted HRQoL and work productivity among mildly symptomatic outpatients. Compared with unvaccinated, those vaccinated with BNT162b2 were less impacted by COVID-19 infection and recovered faster.