Effect of Dyspnea, Quality of Life, and Well-being in Postacute COVID-19 Patients: A Prospective Cohort Study

Abstract

ABSTRACT Context: The persistence of respiratory symptoms beyond 4 weeks otherwise known as postacute COVID-19 symptoms has been reported to significantly affect the clinical outcome, quality of life (QOL), and well-being of patients’ postinfection. Aims: The study aims to determine the pattern of postacute COVID-19 dyspnea symptoms, QOL, and well-being and its association at month 1 and 6 following COVID-19 infection. Settings and Design: A prospective cohort study of two COVID-19 hospitals in Malaysia was conducted. Subjects and Methods: Patients were followed up from admission, discharge, and 6 months after. A standard questionnaire assessed demographics, Modified Medical Research Council (mMRC) dyspnea score, QOL EQ-5D-5L scale (mobility, ability to self-care, ability to perform usual activity, pain, and anxiety), and the World Health Organization (WHO)-5 well-being index. Statistical Analysis Used: Wilcoxon signed-rank, Kruskal–Wallis, and Pearson correlation tests were used. Results: The mMRC, ED-5D-5L, and WHO-5 scores worsened during admission and slowly resolved over the 6 months (n = 388). mMRC scores positively correlated with EQ-5D-5L scores for mobility, self-care, ability to perform usual activity, pain, and anxiety (visit 1 and 6, P = 0.00) during the 1st and 6th months. Higher mMRC and EQ-5D-5L scores indicate worsening dyspnea and QOL. mMRC demonstrated a negative correlation with WHO-5 scores (visit 1: r = −0.30 and visit 6: r = −0.39, P = 0.00), which indicated worsening dyspnea and lower mental well-being. A higher WHO-5 well-being index was associated with lower EQ-5D-5L scores (visit 1 and 6, P = 0.00), demonstrating lowered patient’s well-being with worsening QOL. Conclusions: As such, appropriate health-care support and monitoring of patients, postdischarge is essential to optimize patient outcome.