Self-reported Anxiety, Depression, and Health-Related Quality of Life during Two Years Following Hospitalization for COVID-19: A longitudinal study

Introduction:Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Health-related quality of life (HRQoL) has been observed to decline after COVID-19 hospitalization, with anxiety and depression contributing to reduced HRQoL and emphasizing the need for research on long-term outcomes.The aim of the study was to longitudinally explore self-reported symptoms of anxiety, depression, and associated factors of HRQoL during 2 years after hospital-treated COVID-19, and to compare differences based on age, sex, and initial disease severity.Methods: Participants were included from the Life in the Time of COVID study in Gothenburg, comprising individuals hospitalized with COVID-19 during the first and second waves of the pandemic in Sweden. This prospective study includes follow-ups at 3 months, 1 year, and 2 years after discharge, using patient-reported outcomes assessing symptoms of anxiety, depression, HRQoL, and clinical data.Results:The study comprised 125 participants, of whom 111 were eligible for longitudinal analysis. Two years after COVID-19, individuals with initial moderate infection reported higher levels of anxiety ( p  = 0.031) and pain/discomfort ( p  = 0.039) than did those with severe infection. Symptoms of anxiety did not change significantly over the study period. Depressive symptoms increased significantly worse between 3 and 12 months after COVID-19 (Z = − 2.957, p  = 0.003). Older age was significantly associated with lower HRQoL (B = − 0.003, 95% CI [–0.004, − 0.001], p  = .010).Conclusions:Symptoms of anxiety remained generally within the normal range throughout the two-year follow-up after hospital-treated COVID-19. Symptoms of depression were lower at 3 months after hospitalization but subsequently stabilized at a higher, yet still normal, level. At two years after COVID-19, lower HRQoL was associated with older age, highlighting the importance of addressing age-related vulnerabilities in long-term follow-up care.