Hejazian Seyyed Sina, Vemuri Ajith, Vafaei Sadr Alireza, Shahjouei Shima, Bahrami Sasan, Shouhao Zhou, Abedi Vida, Zand Ramin
Department of Neurology, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, United States of America.
Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, United States of America.
PLoS One. 2025 May 5;20(5):e0320721. doi: 10.1371/journal.pone.0320721. eCollection 2025.
Even after a mild initial SARS-CoV-2 infection, a considerable proportion of patients experience long-lasting symptoms. However, there is scarce data on how post-COVID conditions (PCCs) are associated with health-related quality of life (HRQL) among COVID survivors. We aimed to study this association among adult COVID survivors in the United States.
The Behavioral Risk Factor Surveillance System 2022 data was utilized. The study population consisted of participants with a history of SARS-CoV-2 infection, categorized based on whether they had any PCCs. We evaluated the respondents' HRQL in the two groups according to 1) self-reported general health (SRGH), 2) self-reported mental health, 3) self-reported physical health, and 4) efficiency in daily activities.
A total of 108,237 COVID survivors were included (35% were 18-34 years old and 46.5% were male), among whom 22.7% had PCCs. Unfavorable SRGH was more common among COVID survivors with PCCs than those without PCCs (25.7% vs. 15.5%, p < 0.001). Also, rates of having unfavorable mental and physical health and compromised daily efficiency for more than 13 days a month were significantly higher among PCC-positive respondents (p < 0.001). In the regression analysis adjusted for sociodemographics, comorbidities, and behavioral determinants of health, the presence of PCCs appeared as independent associates of unfavorable SRGH (aOR: 1.39, CI95%: [1.28-1.52], p < 0.001). Among PCC-positive respondents, dizziness on standing, mood changes, and musculoskeletal pain accompanied the highest odds of unfavorable HRQL. Based on a multivariate logistic regression analysis, early middle age, obesity, physical inactivity, diabetes, cardiovascular and pulmonary diseases, cancer, depression, smoking, being single and less educated, and having low annual income were independent factors associated with increased odds of unfavorable SRGH among survivors with PCCs.
Our study corroborates that survivors with PCCs may experience significant adverse impacts on their health and daily life activities. Our results highlight the importance of further studies on PCCs' diagnosis, follow-up, and treatment.
即使是轻度的初始新型冠状病毒2感染后，仍有相当比例的患者会出现长期症状。然而，关于新冠后状况（PCCs）与新冠幸存者健康相关生活质量（HRQL）之间的关联的数据却很少。我们旨在研究美国成年新冠幸存者中的这种关联。
利用了2022年行为风险因素监测系统的数据。研究人群包括有新型冠状病毒2感染史的参与者，根据他们是否有任何PCCs进行分类。我们根据以下四个方面评估了两组受访者的HRQL：1）自我报告的总体健康状况（SRGH），2）自我报告的心理健康状况，3）自我报告的身体健康状况，以及4）日常活动效率。
总共纳入了108237名新冠幸存者（35%为18至34岁，46.5%为男性），其中22.7%有PCCs。有PCCs的新冠幸存者中，不良SRGH比没有PCCs的更为常见（25.7%对15.5%，p<0.001）。此外，PCC阳性受访者中，心理健康和身体健康不良以及每月超过13天日常效率受损的发生率显著更高（p<0.001）。在对社会人口统计学、合并症和健康行为决定因素进行调整的回归分析中，PCCs的存在似乎是不良SRGH的独立相关因素（调整后比值比：1.39，95%置信区间：[1.28 - 1.52]，p<0.001）。在PCC阳性受访者中，站立时头晕、情绪变化和肌肉骨骼疼痛与不良HRQL的几率最高相关。基于多因素逻辑回归分析，中年早期、肥胖、缺乏身体活动、糖尿病、心血管和肺部疾病、癌症、抑郁症、吸烟、单身、受教育程度低以及年收入低是与有PCCs的幸存者中不良SRGH几率增加相关的独立因素。
我们的研究证实，有PCCs的幸存者可能会对其健康和日常生活活动产生重大不利影响。我们的结果凸显了对PCCs的诊断、随访和治疗进行进一步研究的重要性。
