Impact of COVID-19 on health-related quality of life (HRQOL) and functional status

Background

COVID-19 has caused a worldwide pandemic since December 2019.1 Its effects on patients’ health-related quality of life (HRQoL) and functional status has received less attention.2Our aim was to study the impact of COVID-19 on quality of life and functional status.

Methods

110 patients with COVID-19 infection were recruited after telephonic consent and a questionnaire was completed. HRQoL was assessed using the European Quality of Life 5 Dimension 3 Level (EQ-5D-3L) scale.3 The functional status was assessed using the Post-COVID-19 Functional Scale (PCFS) and the modified Medical Research Council Dyspnoea (mMRC) scale.

Results

Patients’ demographics are shown in Figure 1. Our main outcome, HRQoL showed a significant improvement from 0 to 3 months (Figure 2). The five domains of EQ-5D-3L; mobility 0.45 to 0.1, self?care 0.24 to 0.06, activity level 0.47 to 0.09, pain 0.48 to 0.07 and anxiety 0.55 to 0.09 showed an improvement in mean scores. The visual analog score (VAS) showed an improvement from 76.8% to 94.9% at 3 months (p <0.005). Secondary outcomes, PCFS and mMRC showed a significant improvement (Figure 2). We studied the effect of variables such as age, gender, severity of the disease, presence of comorbidities, obesity, vaccination status and need for ventilatory support on EQ5L, PCFS and mMRC. Females showed more improvement compared to males though not statistically significantly. Also, patients who contracted a severe disease, showed more improvement as compared to the moderate severity group. Obesity was a risk factor and obese patients showed less improvement as compared to normal Body Mass Index patients.

Conclusion

Despite the impact of COVID-19 infection on quality of life, there was a significant improvement at 3 months. We need to identify strategies to improve HRQoL and functional status to expedite recovery. Appropriate guidance and rehabilitation programs would be an area to explore.