Impact of long-COVID on health-related quality of life in Japanese COVID-19 patients

  1. Shinya Tsuzuki
  2. Yusuke Miyazato
  3. Mari Terada
  4. Shinichiro Morioka
  5. Norio Ohmagari
  6. Philippe Beutels

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Abstract

Background

The empirical basis for a quantitative assessment of the disease burden imposed by long-COVID is currently scant. We aimed to inform the disease burden caused by long-COVID in Japan.

Methods

We conducted a cross sectional self-report questionnaire survey. The questionnaire was mailed to 526 eligible patients, who were recovered from acute COVID-19 in April 2021. Answers were classified into two groups; participants who have no symptom and those who have any ongoing prolonged symptoms that lasted longer than four weeks at the time of the survey. We estimated the average treatment effect (ATE) of ongoing prolonged symptoms on EQ-VAS and EQ-5D-3L questionnaire using inverse probability weighting. In addition to symptom prolongation, we investigated whether other factors (including demography, lifestyle, and acute severity) were associated with low EQ-VAS and EQ-5D-3L values, by multivariable linear regression.

Results

349 participants reported no symptoms and 108 reported any symptoms at the time of the survey. The participants who reported any symptoms showed a lower average value on the EQ-VAS (69.9 vs 82.8, respectively) and on the EQ-5D-3L (0.85 vs 0.96, respectively) than those reporting no symptoms considering the ATE of ongoing prolonged symptoms. The ATE of ongoing prolonged symptoms on EQ-VAS was − 12.9 [95% CI − 15.9 to − 9.8], and on the EQ-5D-3L it was − 0.11 [95% CI − 0.13 to − 0.09], implying prolonged symptoms have a negative impact on patients’ EQ-VAS and EQ-5D-3L score. In multivariable linear regression, only having prolonged symptoms was associated with lower scores (− 11.7 [95% CI − 15.0 to − 8.5] for EQ-VAS and − 0.10 [95% CI − 0.13 to − 0.08] for EQ-5D-3L).

Conclusions

Due to their long duration, long-COVID symptoms represent a substantial disease burden expressed in impact on health-related quality of life.

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  1. Version published to 10.1186/s12955-022-02033-6
  2. ScreenIT

    SciScore for 10.1101/2021.09.27.21264225: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIACUC: Ethics approval: According to local ethical guidelines, responses to questionnaire were regarded as patient consent.
    IRB: This study was reviewed and approved by the Ethics Committee of the Center Hospital of the NCGM (NCGM-G-004121-00).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations in our study. First, our results are based on the questionnaire survey then there are some recall biases in participants’ responses. Similarly, the potential participants were enrolled from the visitors of outpatient department at the national center hospital of infectious diseases in Japan, then the study population might be influenced by selection biases. In addition, we could not take “new variants” into consideration. The difference in severity, infectiousness, and so forth between such new variants and old ones were already reported [30–32], however, there is no solid evidence about the frequency and the severity of “long-COVID” symptoms in new variants. This should be the subject of future study. In addition, we should be careful about the representativeness of the data when we interpret the results because our survey includes a comparatively small number of participants from Japan. However, the response rate of our survey was extremely high (86.2%), and non-response bias may therefore be limited. Furthermore, we compared VAS and EQ-5D-3L values after adjusting participants’ background by propensity score matching.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.09.27.21264225v1 on medRxiv