Factors associated with health-related quality of life 1 year after COVID-19: a cross-sectional study in Sweden

Aims: The main aim of the present study was to identify factors influencing health-related quality of life (HRQoL), as measured by EQ-5D-5L, in individuals 1 year after the acute phase of COVID-19. Methods: This cross-sectional study included 75 participants (51% females), 1 year after confirmed SARS-CoV-2 infection (76% hospitalised). Associations between HRQoL, measured by patient-reported outcome measures (PROMs): EQ-5D-5L, and factors of interest, including persistent symptoms, comorbidities, work ability index (WAI), lung function, six-minute walking test (6MWT), and dyspnoea-12 (D-12) questionnaire, were assessed by an analysis of variance (ANCOVA) model (adjusted by various factors of interest) with post hoc pairwise comparison. Results: In the ANCOVA, lower HRQoL was significantly associated with not having a university education (mean difference [MD] with 95% confidence interval [CI]: 0.115 [0.013–0.217]), a higher number of persistent symptoms (for 10 vs. 1–3 symptoms: −0.153 [−0.291, −0.015]), lower work ability (for poor vs. excellent: −0.283 [−0.445, −0.120]), any comorbidity (0.077 [0.015–0.138]), and affective distress in the D-12 (0.257 [0.096–0.417]). No significant sex differences in HRQoL and the level of care at the acute infection were shown. In descriptive analysis, lower HRQoL was significantly associated with age under 55, sick leave, more dyspnoea in D-12, and poorer work ability. Conclusions: Work ability, comorbidities, persistent symptoms, and affective distress were associated with lower HRQoL at 1-year follow-up after COVID-19. No significant differences in HRQoL were observed between sexes. Our study highlights the need to address HRQoL in post-COVID-19 rehabilitation and broader public health planning.