Poor self-reported general health (SRGH) is substantially more common among US adults with long COVID than among those without persistent symptoms (26% vs 16%), data from Pennsylvania State University investigators suggest.
Long-COVID patients also had more unfavorable mental and physical health and lower daily efficiency when completing daily activities for more than 13 days a month, according to the findings, published this week in PLOS One.
Overall long-COVID prevalence of 23%
The researchers analyzed 2022 data from the Behavioral Risk Factor Surveillance System surveys completed by 108,237 COVID-19 survivors who did or didn't have persistent symptoms. Participants' health-related quality of life (HRQL) was assessed via SRGH, self-reported mental and physical health, and efficiency in completing activities of daily life.
Of all participants, 35% were aged 18 to 34 years, 46.5% were men, and 22.7% had long COVID, also known as post-COVID condition (PCC), defined as having lingering symptoms at least 3 months post-infection.
"COVID-19 continues to impose a significant burden on the survivors by post-COVID conditions (PCCs), even after a mild initial infection," the study authors wrote. "Investigating the impact of PCCs on health-related quality of life (HRQL) helps us better understand the burden of these conditions and plan effective rehabilitative strategies."
3 symptoms linked to 'not good' health
Relative to patients without persistent symptoms, those with long COVID more often characterized their SRGH as "not good" (25.7% vs 15.5%) and their mental and physical health and daily task efficiency as compromised for more than 13 days a month.
In a regression analysis adjusted for sociodemographic factors, underlying illnesses, and health-related behaviors, long COVID was independently associated with adverse SRGH (adjusted odds ratio, 1.39). Long-COVID patients with dizziness on standing (38%), mood changes (36.3%), and musculoskeletal pain (34.1%) were the most likely to report unfavorable HRQL.
A multivariate logistic regression analysis suggested that, in this group, early middle age, obesity, physical inactivity, diabetes, cardiovascular and pulmonary diseases, cancer, depression, smoking, single marital status, and lower educational attainment and low annual income were risk factors for suboptimal SRGH. Poor SRGH was least common among those who had loss of taste or smell (18.1%), post-exertional malaise (21.9%), or brain fog (22.3%).
Poor health highest in West Virginia patients
The only statistically significant differences in SRGH were between men and women without long COVID in the early middle-age-group (11.9% vs 14.7%, respectively) and long-COVID patients in the early adult age-group (16.4% vs 18.0%).
Healthcare providers and policymakers can prioritize more individualized rehabilitation services following SARS-CoV-2 infection for at risk COVID survivors.
West Virginia had the highest rate of suboptimal SRGH among all COVID survivors and long-COVID patients (23.9% and 34.5%, respectively). Among all COVID survivors, Nevada (23.2%), Mississippi (23%), and Puerto Rico (22.6%) also had high rates of unfavorable SRGH. COVID survivors in Washington, DC (90.5%) and long-COVID patients in the US Virgin Islands (90.3%) had the highest rates of good SRGH.
"Our study corroborates that survivors with PCCs may experience significant adverse impacts on their health and daily life activities," the researchers wrote. "Healthcare providers and policymakers can prioritize more individualized rehabilitation services following SARS-CoV-2 infection for at risk COVID survivors."
"These findings emphasize the need for future research on chronic follow-up, cross-specialty support, and multidisciplinary rehabilitation for COVID survivors, particularly those with PCCs," they concluded.
