Health-related quality of life during the pandemic in Germany: a web-based longitudinal study

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

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

Background:

Health-related Quality of Life (hrQoL) is an important outcome when characterizing and comparing health over time. For new diseases as long COVID hrQoL can give insights in terms of primary care demand and treatment. Especially when investigated in a longitudinal study design.

Research questions:

How does hrQoL changes throughout the pandemic in individuals with lasting long COVID compared to participants without previous SARS-CoV-2 infection?
How does symptoms change in participants with long COVID?

Method:

An online survey was conducted in Germany investigating changes in hrQoL and symptoms using a longitudinal study design including two time points. All persons 18 years or older were eligible to participate. EQ-5D-3L and EQ-VAS were used as hrQoL outcome. 27 symptoms were rated by participants with long COVID on a 11-point Likert-scale (0 = no symptoms; 11 = worst symptoms). Covariates include sociodemographic, medical and pandemic-specific variables. Descriptive and inferential statistics were performed comparing changes in hrQoL between both time points and across groups according to their COVID-19 status.

Results:

Data from 1,113 participants was included in the analysis. The average time between baseline and follow-up was approximately 60 days. Between baseline and follow-up participants with Long COVID (n=699) worsened significantly in EQ-5D VAS scores (M = -2.14, SD = 18.13, p<0.001) and improved significantly in EQ-5D-3L index scores (M = 0.04, SD = 0.18, p<0.001). In participants with no previous SARS-CoV-2 infection (n=329) hrQoL did not change significantly. The health dimensions pain/discomfort and anxiety/depression improved the most in participant with long COVID. 20 out of 27 symptoms in participants with long COVID improved significantly regarding symptom severity and prevalence.

Conclusions:

Subjective hrQoL worsened while objective hrQoL improved in participants with long COVID. This discrepancy needs to be investigated further as subjective hrQoL determinate primary care demand. EQ-5D index score may not reflect all health dimensions related to long COVID.

Points for discussion:

Therapy and management of patients with long COVID in family practice

hrQoL as a basis for efficacy and cost-effectiveness studies

Subjective vs. objective health when treating patients