Background & Aims

Post-acute sequelae of SARS-CoV-2 infection (PASC), better known as “Long COVID”, is a condition that occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually within three months of the onset of COVID-19, with symptoms lasting at least two months that cannot be explained by an alternative diagnosis1. Three of the more common Long COVID symptoms are physical pain, fatigue, and low sleep quality2-4. Estimates suggest that at least one in eight adult COVID cases may result in Long COVID5.
Chronic diseases such as Long COVID often have a detrimental effect on health-related Quality of Life (QoL), defined as the extent to which one’s usual or expected physical, emotional, and social wellbeing are affected by a medical condition or its treatment6.
The aim of this study was to explore Long COVID patient experiences as they pertain to pain, fatigue, sleep quality and their impact on QoL.

Methods

Survey firm Qualtrics was used to recruit and survey a sample of 792 English-speaking individuals in the U.S., ages 18-64, in October and November of 2022, who stated they have had COVID-19 at least once, have Long COVID, and currently have Long COVID symptoms.
Measures included demographics, quality of life (QoL, using items from the WHOQoL-BREF7), and three questions related to pain (“To what extent do you feel that physical pain prevents you from doing what you need to do?”, using a five-item Likert scale from “Not at all” to “An extreme amount”), energy/fatigue (“Do you have enough energy for everyday life?” using a five-item Likert scale from “Not at all” to “Completely”), and sleep quality (“How satisfied are you with your sleep?” using a five-item Likert scale from “Very dissatisfied” to “Very satisfied”). Quality of Life was measured using this question: “How would you rate your quality of life?” (using a five-item Likert scale from “Very poor” to “Very good”).

Results

78.7% (n=623) of respondents reported an extreme amount, very much, or a moderate amount of pain, 28.8% (n=228) reported having no/very little energy, and 30.4% (n=241) reported being (very) dissatisfied with sleep quality.
Mean QoL score for those who reported moderate/high pain was 3.54 vs. 3.80 for those who did not; 3.07 for those reporting lack of energy/fatigue vs. 3.81 for those who did not; 3.07 for those who reported dissatisfaction with sleep quality vs.3.83 for those who did not. Multiple linear regression showed that older respondents reported lower QoL (p=.032). Those who reported being moderately to very religious assessed their QoL as higher than those who said they were not at all or not very religious (p=.021), and those who were married/living together also assessed their QoL as higher than those who were single (p=.013). Those who reported high satisfaction with their sleep quality, enough energy, and lower pain were more likely to report higher QoL (all p<.001).

Conclusions

In the treatment of and encounters with Long COVID patients, healthcare providers should consider addressing any reported Long COVID-associated pain, fatigue, and insufficient sleep quality, especially for older patients and patients who are single, since improvement in these areas may increase self-reported QoL. While fatigue is often seen as the major factor to address in Long COVID patients, more than 75% of all respondents listed pain as a major issue, while only a little over 25% did so with lack of energy/fatigue, indicating that pain interference should be addressed as well.

References

1.World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. World Health Organization. Accessed August 2, 2022. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
2.van Kessel SA, Olde Hartman TC, Lucassen PL, van Jaarsveld CH. Post-acute and long-COVID-19 symptoms in patients with mild diseases: a systematic review. Family practice. 2022;39(1):159-167.
3.Subramanian A, Nirantharakumar K, Hughes S, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nature Medicine. 2022:1-9.
4.Nguyen NN, Hoang VT, Dao TL, Dudouet P, Eldin C, Gautret P. Clinical patterns of somatic symptoms in patients suffering from post-acute long COVID: a systematic review. European Journal of Clinical Microbiology & Infectious Diseases. 2022:1-31.
5.Ballering AV, Zon SKRv, Hartman TCo, Rosmalen JGM, Initiative LCR. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. The Lancet. 2022;400(10350):452-461. doi:doi.org/10.1016/s0140-6736(22)01214-4
6.Khanna D, Tsevat J. Health-related quality of life-an introduction. American Journal of Managed Care. 2007;13(9):S218.
7.WHOQOL Group. Development of the WHOQOL: Rationale and current status. International Journal of Mental Health. 1994;23(3):24-56.

Presenting Author

Thomas Chelimsky

Poster Authors

Jeanine Guidry

PhD

Tilburg University

Lead Author

Raouf Gharbo

DO

Virginia Commonwealth University School of Medicine

Lead Author

Linnea Laestadius

PhD

University of Wisconsin

Lead Author

Carrie Miller

PhD

Virginia Commonwealth University School of Medicine

Lead Author

Paul Perrin

University of Virginia

Lead Author

Gisela Chelimsky

Virginia Commonwealth University

Lead Author

Thomas Chelimsky

MD

Lead Author

Topics

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