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Respiratory infection
Original research
Impact of post-COVID-19 condition on health status and activities of daily living: the PRIME post-COVID study
  1. Maarten Van Herck1,2,3,
  2. Demi M E Pagen4,5,
  3. Céline J A van Bilsen4,5,
  4. Stephanie Brinkhues6,
  5. Kevin Konings7,
  6. Casper D J den Heijer4,5,
  7. Suhreta Mujakovic4,
  8. Henriëtte L G ter Waarbeek4,
  9. Chris Burtin3,
  10. Daisy J A Janssen1,8,
  11. Christian J P A Hoebe4,5,
  12. Martijn A Spruit1,2,
  13. Nicole H T M Dukers-Muijrers4,9
  1. 1 Department of Research and Education, Ciro, Horn, The Netherlands
  2. 2 Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands
  3. 3 REVAL, Rehabilitation Research Center, BIOMED – Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
  4. 4 Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
  5. 5 Department of Social Medicine, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
  6. 6 Department of Knowledge & Innovation, South Limburg Public Health Service, Heerlen, The Netherlands
  7. 7 Department of Process & Information Management, Communication & Automation, South Limburg Public Health Service, Heerlen, The Netherlands
  8. 8 Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
  9. 9 Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
  1. Correspondence to Maarten Van Herck, Department of Research and Education, Ciro, Horn, 6080, The Netherlands; maarten.vanherck{at}uhasselt.be

Abstract

Objective To assess health and activities of daily living (ADL) in SARS-CoV-2-positive adults with and without post-COVID-19 condition (PCC) and compare this with negative tested individuals. Furthermore, different PCC case definitions were compared with SARS-CoV-2-negative individuals.

Methods All adults tested PCR positive for SARS-CoV-2 at the Public Health Service South Limburg (Netherlands) between June 2020 and November 2021 (n=41 780) and matched PCR negative individuals (2:1, on age, sex, year-quarter test, municipality; n=19 875) were invited by email. Health (five-level EuroQol five-dimension (EQ5D) index and EuroQol visual analogue scale (EQVAS)) and ADL impairment were assessed. PCC classification was done using the WHO case definition and five other common definitions.

Results In total, 8409 individuals (6381 SARS-CoV-2 positive; 53±15 years; 57% female; 9 (7–11) months since test) were included. 39.4% of positives had PCC by the WHO case definition (EQVAS: 71±20; EQ5D index: 0.800±0.191; ADL impairment: 30 (10–70)%) and perceived worse health and more ADL impairment than negatives, that is, difference of −8.50 points (95% CI −9.71 to −7.29; p<0.001) for EQVAS, which decreased by 1.49 points (95% CI 0.86 to 2.12; p<0.001) in individuals with PCC for each comorbidity present, and differences of −0.065 points (95% CI −0.074 to −0.056; p<0.001) for EQ5D index, and +16.72% (95% CI 15.01 to 18.43; p<0.001) for ADL impairment. Health and ADL impairment were similar in negatives and positives without PCC. Replacing the WHO case definition with other PCC definitions yielded comparable results.

Conclusions Individuals with PCC have substantially worse health and more ADL impairment than negative controls, irrespective of the case definition. Authorities should inform the public about the associated burden of PCC and enable adequate support.

  • COVID-19

Data availability statement

Data are available upon reasonable request. Data cannot be shared publicly because the data contains potentially identifying patient information. Data are available on request from the head of the data-archiving South Limburg Public Health Service (contact via Helen.Sijstermans@ggdzl.nl) for researchers who meet the criteria for access to confidential data.

https://doi.org/10.1136/thorax-2023-220504

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    Data availability statement

    Data are available upon reasonable request. Data cannot be shared publicly because the data contains potentially identifying patient information. Data are available on request from the head of the data-archiving South Limburg Public Health Service (contact via Helen.Sijstermans@ggdzl.nl) for researchers who meet the criteria for access to confidential data.

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    Footnotes

    • X @vanherck_m

    • Presented at European Respiratory Society’s International Congress 2023

    • Contributors MVH, DMEP, CJAvB, SB, KK, CDJdH, SM, HLGtW, CJPAH, MAS and NHTMDM designed the study. DMEP, CJAvB and SB actively participated in data collection. MVH performed the data analysis, wrote the first draft of the manuscript, and is the guarantor of this work. DMEP, CJAvB, SB, KK, CDJdH, SM, CB, DJAJ, MAS and NHTMDM supervised data analysis. All authors were involved in data interpretation, revised the manuscript critically for important intellectual content, approved the final version and agreed to be accountable for all aspects of the manuscript. MAS and NHTMDM are joint last authors.

    • Funding This work was supported by the research fund of the Dutch National Institute for Public Health and environment (RIVM) for local Public Health Services (Grant numbers: 3910090442/3910105642/3910121041).

    • Competing interests None declared.

    • Patient and public involvement statement Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.