Patient-Reported Outcome Measures, 1 Year After COVID-19: A Cohort Study of Symptomatic, Laboratory-Confirmed Cases in South Trinidad, 2020–2021

Aim: The study aims to describe patient-reported long-term health effects, 1 year post-acute COVID-19 infection, and predictors, according to illness severity. Methods: A cohort of adults who were symptomatic with laboratory-confirmed COVID-19 infection between March 2020–May 2021 were followed up for ≥12 months to evaluate persistent, newly occurring, or worsening symptoms. Multivariable-adjusted linear and logistic regression models estimated the odds ratios, β coefficients, and 95% CIs for associations between disease severity and long-term health consequences. Results: Seventy-five percent (324/431) of eligible participants were enrolled. The median age was 41 years (interquartile range: 34–52), with 51.23% being men, and 33.02% having comorbidities. One year later, 60.00% reported ≥1 persistent symptom; the most common were dyspnoea (52.16%), fatigue (42.59%), and muscle weakness (31.48%); 13.60% reported symptoms of anxiety or depression, as measured by the Patient Health Questionnaire-4 (PHQ-4). In the unadjusted analysis, participants with moderate/severe illness had a significantly increased risk of developing fatigue or muscle weakness (p=0.043), anxiety/depression (p<0.001), breathlessness (p<0.001), and reduced health-related quality of life (p<0.001). When adjusted for age, gender, and comorbidities, their risk of developing fatigue or muscle weakness, anxiety/depression, and breathlessness was nullified, except for health-related quality of life. Overall, the mean (SD) health index value score was 0.931 (0.13), comparable to the national norms of 0.950. For those with moderate/severe illness, the mean (SD) was 0.894 (0.16), with a statistically significant decrease compared to mild illness (p<0.001). Conclusion: After 1 year of post-acute COVID-19 infection, a significant proportion of survivors have persistent symptoms. The health index value for those with moderate/severe illness was below the population norms. Therefore, interventions should be prioritised for their long-term recovery.