The long-term impact of COVID-19 severity on health-related quality of life

A recent study of residents of Amsterdam, the Netherlands, describes that people with mild coronavirus disease 2019 (COVID-19) have better health-related quality of life after one year of onset. disease than those with moderate or severe COVID-19. The study was published in the journal BMC Medicinee.

Study: Health-related quality of life in people with baseline mild, moderate, and severe or critical COVID-19 at 1 and 12 months after infection: a prospective cohort study. Image Credit: fizkes/Shutterstock


The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has severely affected the physical and mental health of those affected around the world. A significant proportion of people affected by COVID-19 have been found to have long-term health consequences, even one year after initial diagnosis.

Studies investigating health-related quality of life in patients with COVID-19 have primarily observed poor physical, mental, and social functioning in participants after the onset of illness. In contrast, a few studies have documented satisfactory physical and functional recovery in participants. However, these studies were conducted on hospitalized patients with severe COVID-19.

In the current study, scientists explored the impact of mild, moderate, and severe COVID-19 on patients’ physical, mental, and social functioning (health-related quality of life) after 1 and 12 months of onset. sickness. They also assessed the impact of pandemic-related control measures on health-related quality of life.

study design

The study was conducted on adults in Amsterdam, the Netherlands, who had laboratory-confirmed COVID-19 with a range of severity (mild, moderate, or severe). The 36-item health survey of the Short Form Medical Outcome Study was conducted to assess health-related quality of life at one month and 12 months after illness onset.

The survey included 36 items that focused specifically on eight different domains, including physical, social and emotional functioning, mental health, amount of energy and pain, and general perceptions of health.

Impact of COVID-19 severity on health-related quality of life

A total of 269 participants completed the health-related quality of life survey.

Considering disease severity, participants with mild COVID-19 showed significantly better health-related quality of life than those with moderate or severe COVID-19. However, the level of health status was significantly higher at 12 months than at the first month after illness onset.

Controlling for migration status, Dutch-origin participants had significantly better health quality in the areas of physical and social functioning and energy and pain levels than those with immigrant backgrounds from high-income or low-income countries. low/middle income. In the domains of general and mental health, participants from the Netherlands and those from low/middle-income countries had a significantly higher quality of life than participants from high-income countries.

Participants with three or more high-risk comorbidities had worse health-related quality of life than those with fewer than three comorbidities. Specifically, immunosuppression and psychiatric illnesses had the highest impact on physical functioning and general health, respectively.

Health-related quality of life assessed in participants at month one after disease onset revealed a significant deviation from population-level reference norms. The highest and lowest difference was observed for social functioning and bodily pain, respectively.

Regarding general health, participants with mild COVID-19 were within baseline standards. In contrast, participants with moderate or severe COVID-19 had significantly lower health quality.

Health-related quality of life assessed at month 12 revealed that participants with mild disease had physical, emotional, and social functioning, energy levels, and general health status similar to baseline standards. However, no improvements in health quality were observed for participants with moderate or severe COVID-19.

Impact of pandemic restrictions on health-related quality of life

Participants who responded to the survey during the period of pandemic-related restrictions reported fewer mental health disorders and less limitation in social and physical functioning than those who responded to the survey during the period without restrictions .

Significance of the study

The study demonstrates that people with mild COVID-19 are able to return to normal levels of physical, social and emotional functioning one year after initial diagnosis of the disease. However, people with moderate or severe COVID-19 initially experience deterioration in health-related quality of life even one year after illness onset.

People with an immigrant background or with a higher number of high-risk comorbidities are more likely to experience a deterioration in their health-related quality of life.

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