COVID-19 Pandemic
The impact of SARS-CoV-2 on fatigue and quality of life: prevalence of post COVID-19 condition in a Dutch population-based serosurveillance cohort in the first year of the pandemic. Cheyenne van Hagen* Cheyenne van Hagen Elizabeth N. Mutubuki Siméon de Bruijn Eric R.A. Vos Gerco den Hartog Fiona R.M. van der Klis Cees C. van den Wijngaard Hester E. de Melker Albert Jan van Hoek
We studied Post COVID-19 Condition (PCC) by investigating health-related quality of life (HRQoL) and fatigue in the general Dutch population in the early phase of the pandemic, including symptomatic and asymptomatic infections.
Participants aged ≥15 years were selected from the February 2021 round of the nationwide seroepidemiological PIENTER Corona cohort study. We assessed associations between the time since serologically-identified SARS-CoV-2 infection and four outcome measures: health utility (Short-Form 6 Dimensions), mental health and physical health (Short Form Health Survey 12) and fatigue (Checklist Individual Strength subscale fatigue). Per outcome, cutoff points were selected at each 5% increment (5-75%) along the cumulative distribution of those uninfected. At each cutoff, multivariable logistic regression models (score below cutoff yes/no) were fitted adjusted for infection history, age, sex, education level, comorbidities, COVID-19 vaccination, and restriction intensity.
At the cutoff of the lowest 15th percentile among uninfected, an example of the lower ends of cumulative distributions, significant differences between uninfected (n=4,614) and infected ≤4 months ago (n=368) were observed for health utility (OR [95%CI]: 1.6 [1.2-2.2]), physical health (1.7 [1.3-2.3]) and fatigue (1.6 [1.2-2.0]), but not for mental health (1.2 [0.9-1.6]) (Figure 1). There were no significant differences between uninfected and infected >4 months ago (n=345) for all outcomes at any cutoff, with post-hoc analysis showing a power to detect prevalence differences as low as 7.5%.
In the first year of the pandemic, individuals with a SARS-CoV-2 infection ≤4 months ago reported poor health utility and physical health, and more severe fatigue compared to those uninfected. Interestingly, differences in HRQoL and fatigue remained below the detection limit for those infected >4 months ago, suggesting a lower population PCC prevalence than currently found in literature for this period.
