Comparison of long-term health-related quality of life and symptoms between COVID-19 patients and test-negative controls during the Omicron-predominant period in Japan.

BACKGROUND

Persistent symptoms following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection affect health-related quality of life (HRQoL) and impose a substantial burden on society. While previous studies showed that both coronavirus disease 2019 (COVID-19) patients and patients with acute respiratory symptoms but negative for SARS-CoV-2 experienced persistent symptoms, evidence comparing the long-term HRQoL of COVID-19 patients with test-negative controls for SARS-CoV-2 remains limited. This study aimed to compare symptoms and HRQoL using EQ-5D-5L in both acute and chronic phases between COVID-19 patients and test-negative controls for SARS-CoV-2 during the Omicron-predominant period in Japan.

METHODS

Individuals aged ≥18 years tested for SARS-CoV-2 with COVID-19-like symptoms at a clinic in Tokyo, Japan, between January 2022 and January 2023, were invited an online survey. Individuals who tested positive and negative for SARS-CoV-2 were both included. Participants retrospectively recorded their physical and mental symptoms, and completed EQ-5D-5L questionnaires during the acute phase, and at months 1, 3, and 6, which were compared between COVID-19 patients and test-negative controls. Additionally, the mean EQ-5D-5L utility score was compared between male and female COVID-19 patients.

RESULTS

A total of 302 COVID-19 patients and 77 test-negative controls were included (median age: 42 years; 41.2% male; 13.2% with underlying medical conditions). At month 3, 19.9% (60/302) of COVID-19 patients and 9.1% (7/77) of test-negative controls reported ongoing symptoms. Mental symptoms and fatigue persisted for over three months among COVID-19 patients. The mean EQ-5D-5L utility score during the acute phase for COVID-19 patients was 0.615 (95% confidence interval [CI]: 0.586-0.645), and 0.874 (95% CI: 0.826-0.921) for test-negative controls, with a mean difference of -0.258 (95% CI: -0.324 to -0.193). COVID-19 patients consistently exhibited lower EQ-5D-5L utility scores than controls for over six months post-infection. Female COVID-19 patients showed lower EQ-5D-5L utility scores compared to male patients throughout the period (acute phase mean difference: -0.091; 95% CI: -0.151 to -0.031).

CONCLUSIONS

COVID-19 patients experienced more symptoms three months post-testing compared to test-negative controls, with lower EQ-5D-5L utility scores persisting for over six months. Female COVID-19 patients exhibited lower EQ-5D-5L utility scores than their male counterparts throughout the period.