Life quality poorer in COVID-19 survivors with ongoing symptoms

In adults who have survived the COVID-19 pandemic, health-related quality of life (HRQoL) is high among those who had either recovered from post-COVID-19 condition (PCC) or had never been afflicted with PCC, according to a study.

“However, individuals with ongoing symptoms have lower HRQoL and are more likely to have functional deficits,” the researchers said.

A total of 1,135 working adults were included in the analysis. Of these, 19.2 percent had current PCC, and 27.6 percent had recovered from PCC. [Am J Med 2025;138:850-861.E8]

Participants with recovered PCC showed a similar mean EuroQol 5-dimension 5-level (EQ-5D-5L) health utility to those without a PCC history (adjusted difference, ‒0.02, 95 percent confidence interval [CI], ‒0.03 to 0.00), while adults with current PCC exhibited a lower health utility (adjusted difference, ‒0.08, 95 percent CI, ‒0.12 to ‒0.05).

Individuals with current PCC also had a higher likelihood of experiencing problems with mobility (adjusted odds ratio [aOR], 6.00, 95 percent CI, 2.8‒12.52), self-care (aOR, 5.96, 95 percent CI, 1.84‒19.32), usual activities (aOR, 8.00, 95 percent CI, 4.27‒14.99), pain/discomfort (aOR, 4.28, 95 percent CI, 2.46‒7.48), and anxiety/depression (aOR, 3.45, 95 percent CI, 1.90‒6.27).

Functional deficit

“There were more striking relative differences in the proportion of participants with functional deficits,” the researchers said.

“Specifically, participants with current PCC had approximately sixfold greater odds of experiencing problems with mobility, eightfold greater odds of experiencing problems with usual care, and sixfold greater odds of experiencing problems with usual activities,” they added.

Previous studies have also reported the effects of PCC on functioning. [Lancet Reg Health Eur 2023;31:100671; Sci Rep 2023;13:19907; Am J Phys Med Rehabil 2022;101:48-52]

These findings suggest that such impairments could last for a long time and that PCC could become a chronic illness. [Science 2024;383:830-832; Sci Am 2022;326:56]

Additionally, the results of the current study support those from longitudinal studies, which showed how recovery rates decline over time, and some individuals never fully recover, even though most COVID-19 survivors improved their symptoms within 3‒6 months. [Nat Commun 2022;13:18-20; Nat Commun 2023;14:6588; BMJ 2023;381:e074425]

“Our findings are relevant to clinical care and health service delivery,” the researchers said. “When supporting patients with PCC, clinicians can use these data to set expectations regarding recovery.”

Health systems must also consider resourcing PCC-specific clinics to provide care to those with long-term symptoms, since not all patients will recover within 2 years, according to the researchers.

“Given the relative prevalence of functional impairment observed in this population, our findings also highlight the value of staffing these clinics with physiotherapists, occupational therapists, and other rehabilitation professionals,” they added. [NEJM Catal 2023;4:1-18; BMJ 2023;382:1791; Lancet Respir Med 2021;9:1328-1341]

The present cross-sectional study involved COVID-19 survivors from British Columbia, Canada, who completed a questionnaire >2 years after infection. PCC status was self-reported, while HRQoL was assessed using the EQ-5D-5L instrument.

The researchers then compared HRQoL among adults with current PCC, those with recovered PCC, and those with no PCC history. They weighted multivariable analyses to be representative of COVID-19 survivors in British Columbia.