Wang, Jiunn, Goodfellow, Henry, Walker, Sarah, Blandford, Ann, Pfeffer, Paul, Hurst, John R., Sunkersing, David, Bradbury, Katherine, Robson, Chris, Henley, William and Gomes, Manuel (2024) Trajectories of functional limitations, health-related quality of life and societal costs in individuals with Long COVID: a population based longitudinal cohort study. BMJ Open, 14 (11), e088538, [e088538]. (doi:10.1136/bmjopen-2024-088538).
Abstract
Objectives: to examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.
Design: longitudinal single-arm service evaluation utilising real-time user data.
Setting: 35 Long COVID clinics in the UK.
Participants: 4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation, and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.
Main outcome measures: generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Secondary outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.
Results: the mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% confidence interval (CI) 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was -0.86 (95% CI -1.32, -0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared to 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.
Conclusions: individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.
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