A long road to recovery? Reduced quality of life, impaired functional status and the lived experience of Long COVID patients, a cohort analysis

Abstract

Introduction: One in ten people will develop symptoms of Long COVID (LC) following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite widely reported symptomology, the impact upon quality of life (QoL) and functional status (FS) is not well documented. Accordingly, we conducted a cohort observation to determine the impact of LC on QoL and FS that also captured the lived experience.

Method: Fifty-six patients (n=41 female, mean age 51±10 years) with confirmed history of COVID-19 were recruited from LC clinics in the United Kingdom and completed a 16-week cohort observation (five face-to-face visits and bi-weekly telephone consultations). QoL was assessed via the EQ-5D-5L and FS via the post-COVID functional status scale (PCFS) and the six-minute walk test (6MWT). Symptom profile and lived experience was captured via self-report diaries and analysed via thematic analysis.

Results: QoL across all domains was 2.5±0.6 AU at baseline and unchanged at 16-weeks (2.4±0.9, P=0.12). PCFS was improved at 16-weeks (2.1 ±1.1 AU) when compared to baseline (2.7±0.4 AU, P=0.02) but highlighted impaired FS. 6MWT was 322±133 M at baseline and improved at 16 weeks (430±150 meters, P<0.01) but was lower than normative data for healthy age matched controls. Patients recorded 2,197 references to symptoms profile (66% coverage), highlighting broad and cyclical symptoms that impacted QoL (30% coverage) and physical and mental wellbeing.

Conclusion: LC patients exhibit severely impacted QoL and FS that demonstrates little change over 16 weeks. Research must inform treatment and support to address symptomology and restore QoL and FS.