It took many US COVID-19 survivors who sought treatment for their infection up to 9 months post-infection to return to their baseline sense of mental well-being, while 1 in 5 still had suboptimal quality of life at 1 year, the INSPIRE (Innovative Support for Patients with SARS-CoV-2 Infections Registry) Group reported yesterday in Open Forum Infectious Diseases.
For the prospective, multicenter registry study, the US investigators used Patient-Reported Outcomes Measurement Information System (PROMIS)-29 and PROMIS SF-8a questionnaire responses to compare health-related quality of life (HRQoL) among 1,096 adult COVID-19 survivors and 371 uninfected controls enrolled from December 2020 through August 2022 and followed every 3 months for 1 year.
Participants (68.5% women) answered questions on physical function, anxiety, depression, fatigue, social participation, sleep problems, pain interference, and cognitive function.
Physical well-being restored first
COVID-positive participants reported compromised mental well-being for up to 9 months after infection. Physical well-being returned after 3 months, but up to 20% of patients continued experiencing suboptimal overall HRQoL 1 year post-infection.
Four distinct well-being classes emerged at all study timepoints: optimal overall, poor mental, poor physical, and poor overall HRQoL. COVID-19 patients were more likely to return to the optimal HRQoL class than COVID-negative respondents. Notably, participants in the poor physical HRQoL and poor overall HRQoL classes had much more severe acute COVID-19 symptoms, higher rates of underlying conditions, and more symptoms at baseline.
Among those in the poor overall HRQoL category, 42.4% reported that they had long COVID at final follow-up, versus 24.2% among those in the poor physical HRQoL class, 17.8% in the poor mental HRQoL class, and 9.7% in the optimal class.
The odds of moving from poor to optimal overall well-being was comparable between COVID-positive and COVID-negative groups and remained low over time (range, 1.4% to 5.2%). The most substantial shift from poor physical to optimal HRQoL occurred by 3 months, while a transition from poor mental to optimal HRQoL occurred by 9 months.
Improved models of care needed
"In this large, geographically diverse study of individuals with 12 months of follow-up after COVID-19-like illness, a substantial proportion of participants continued to report poor HRQoL, whether or not the inciting acute symptoms were due to SARS-CoV-2 or another illness," the researchers wrote.
