Health-related quality of life among COVID-19 survivors 2-years post-acute infection in Tanzania

Coronavirus Disease 2019 (COVID-19) has impacted the lives of its survivors worldwide, affecting both short-term and long-term quality of life of survivors as well as countries’ economies. This study aimed to determine Health-Related Quality of Life (HRQoL) and its associated factors among COVID-19 survivors in selected tertiary hospitals in Tanzania. This was an ambispective study, COVID-19 survivors from five tertiary hospitals in Tanzania who presented between March 2021 and July 2021 were enrolled. The follow-up data (including the HRQoL assessment) were collected from November 2022 to May 2023 with median intervals ranging from 1.7 to 2.2 years. Poor HRQoL was defined as reporting problems in the five EQ-5D-5 L dimensions. Robust Poisson regression was used to estimate the prevalence ratio (PR) associated with poor HRQoL. A total of 712 participants were included in the analysis. The median age (IQR) of the participants was 60(48–69) years. More than half were male (380, 52%). The median (IQR) EQ-5D-5 L index score was 0.66 (0.55-1.00). Overall, 55% of participants reported poor HRQoL. Anxiety and pain were the most frequently reported problems. Factors associated with poor HRQoL included age ≤ 60 years (PR 1.26, 95% Confidence Interval (CI) 1.09–1.48, p = 0.013), smoking history (PR 1.41, 95% CI 1.05–1.91, p = 0.025), baseline ground glass appearance (GGO) (PR 1.22, 95% CI 1.03–1.45, p = 0.021), non-use of steroid at admission (PR 1.13, 95% CI 1.08–1.17, p = 0.042); and pulmonary hypertension (PR 1.63, 95% CI 1.43–1.85, p < 0.001) at follow-up. This study found poor HRQoL in 55% of COVID-19 survivors 2 years post-acute COVID-19 illness. Patients reported major problems with anxiety/depression, mobility, and pain/discomfort. Predictors of poor HRQoL included age ≥ 60years, no steroid use, smoking, baseline ground-glass opacities, and post-acute conditions like pulmonary hypertension. These findings underscore the need for interventions, such as steroid therapy during an acute illness, to improve quality of life in COVID-19 survivors.