Impact of Long/Post COVID on health-related quality of life and social participation in Germany: an online-based cross-sectional study

Dominik Schröder, Stephanie Heinemann, Gloria Heesen, Frank Müller, Alexandra Dopfer-Jablonka, Frank Klawonn

Keywords: COVID-19; Long COVID; Pandemic; Quality of Life; social participation

Background:
The specification of patient-centered outcomes like health-related Quality of Life (hrQoL) and social participation can give insights to medical care needs of the affected persons. Especially in the case of a new and widely spread disease such as Long COVID, characterization of the disease is crucial in terms of disease magagement, treatment and planning of new therapies.

Research questions:
How does the health-related quality of life and social participation characterize in individuals with Long COVID compared to individuals without Long COVID?

Method:
A cross-sectional online survey was conducted in Germany. All persons 18 years or older were eligible to participate. Participants were divided in three groups: Long COVID with a prior SARS-CoV-2 infection and new or persistent symptoms 28 days after infection, ExCOVID with a prior SARS-CoV-2 infection and without new or persistent symptoms after 28 days and NoCOVID when participants had no prior SARS-CoV-2 infection. EQ-5D-3L was used as hrQoL measure and the Index for the Assessment of Health Impairments (IMET) to reflect social participation. Descriptive and inferential statistics were performed.

Results:
A total of 3,188 participants were included in the analysis (1,421 Long COVID; 260 ExCOVID; 1,507 NoCOVID). Long COVID was associated with the lowest EQ-5D-3L index values (p<0.001), Visual Analogue Scale (VAS) scores (p<0.001), and IMET (p<0.001) scores followed by NoCOVID and ExCOVID. About 10% of Long COVID participants showed no health impairments in all EQ-5D dimensions while 51.1% of NoCOVID and 60% of ExCOVID participants showed no health impairments. Long COVID participants were affected in heterogeneous impairment dimensions. The appearance of Long COVID was associated with lower hrQoL compared to NoCOVID (p<0.001) after adjusting for sociodemographic factors, medical factors and social participation.

Conclusions:
This study highlights the additional health burden of persons with Long COVID on hrQoL and social participation compared to individuals without Long COVID in Germany.

Points for discussion:
Treatment of Long COVID as a general practitioner

Heterogeneity of Long COVID symptoms