Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID‐19 infection: A six‐ to seven‐month prospective cohort

Abstract

Aims

To investigate the health‐related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID‐19 patients at long‐term, and to identify factors to predict a poor HRQoL in this follow‐up.

Background

Studies have focused on persistent symptoms of hospitalised COVID‐19 patients in the medium term. Thus, long‐term studies of nonhospitalised patients are urgently required.

Design

A longitudinal cohort study.

Methods

In 102 nonhospitalised COVID‐19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow‐up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.

Results

HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post‐traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7‐months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)).

Conclusion

A high proportion of nonhospitalised patients with COVID‐19 experience an impaired HRQoL, cognitive and psychological function at long‐term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID‐19 who will have impaired quality of life at long‐term.

Relevance to clinical practice

Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post‐COVID‐19 patients could be necessary to prevent the patients’ HRQoL from being impaired at 6–7 months after their reported recovery.