(B) Quality of Life in Patients with Post-COVID-Syndrome: Combining Data from Electronic Health Records and Questionnaires

Publication Number: 635

Background: In some of the patients with a COVID-19 infection, symptoms persist for longer than three months (post-COVID syndrome (PCS)), but little is known about how this affects the quality of life (QoL). For a complete understanding of the effects of PCS on QoL, we combine patient experiences from questionnaires with clinical data from electronic health records (EHRs) of general practitioners (GPs).

Objectives: What is the quality of life of patients with post-COVID syndrome three and six months after a COVID-19 infection?

Methods: In 2021, Nivel, the Netherlands Institute for Health Services initiated the Nivel Corona Cohort. We selected patients with a COVID-19 registration (ICPC code R83.03) in their EHRs from Nivel Primary Care Database and invited them to participate via their GP. Patient recruitment occurred between January and September 2021. Participants receive four questionnaires with questions about the COVID-19 infection, persistent symptoms, lifestyle and QoL (SF-12, score from 0-100) from before the COVID-19 infection and three and six months later. After patients’ permission, we linked data from questionnaires to data from the EHR. The EHR data contains information about comorbidities (ICPC), contact with GPs and drug use (ATC). PCS was defined as the presence of at least one COVID-19-related complaint three months after the corona infection, and whether the patient experiences discomfort or is not fully recovered. We analyzed the association between QoL and gender and age and we compared the QoL of patients with and without PCS. In follow-up analyses, we will study which clinical factors from the EHR data, such as comorbidities and drug use, are associated with a lower QoL.

Results: 442 patients from 18 general practices participate in the Nivel Corona Cohort. 178 (40.3%) of these patients had PCS as defined above. Initial analyses show that both the mental and physical QoL of people with PCS was significantly lower three months after COVID-19 infection (mean 48.1 (SD 10.6) and 41.0 (SD 10,6), respectively), than in people without PCS (54.7 (SD 5.9) and 53.6 (SD 4.7), respectively). There was no significant difference in QoL between men and women after three months. The reduced physical and mental QoL also persisted in people with PCS six months after the COVID-19 infection. Women with PCS had a significantly lower physical QoL than men after 6 months (respectively 37.6 ( SD 10.0) and 42.3 (SD 8.4), p=0.01), but not a lower mental QoL. Older people with PCS had better mental QoL at three and six months than younger people, but there was no difference in physical QoL.

Conclusions: Persistent complaints after a COVID-19 infection, or PCS, have a long-term influence on the QoL. Linking data from EHRs and questionnaires provides more insight into which factors are related to this.