The course and trajectories of quality of life among post-COVID-19 patients in the HUS long covid cohort study, 2026, Virrantaus et al.

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The course and trajectories of quality of life among post-COVID-19 patients in the HUS long covid cohort study
Virrantaus, Hélène Rotkirch; Sirén, Maria; Varonen, Mikko; Arokoski, Jari; Kanerva, Mari; Kvarnström, Kirsi; Malmivaara, Antti; Sainio †, Markku; Juutistenaho, Sanna; Sulg, Aleksandra; Vangelova-Korpinen, Velina; Vuokko, Aki; Venäläinen, Mikko S; Liira, Helena

Patients with post-COVID condition (PCC) frequently report reduced quality of life (QoL). This study assessed QoL and health-related QoL (HRQoL) with trajectories within a prospective PCC cohort.

The study included adult patients at a PCC clinic. Outcomes were collected at 0, 3, 6, and 12 months. The primary outcome was QoL by Visual Analogue Scale (VAS 0–10). Secondary outcomes included QoL by EUROHIS-QOL-8 and HRQoL by 15D, and patients’ symptom perceptions by Somatic Symptom Disorder - B Criteria Scale (SSD-12). Linear mixed models analyzed temporal changes, and trajectory analysis modeled recovery patterns.

At baseline, 442 patients participated, with 305 (69.0%) providing follow-up data. Most patients (92.7%) were non-hospitalized. Trajectory analysis of EUROHIS-QOL-8 identified two recovering trajectories (73.8%) and a stable group (26.2%). Stable trajectories were associated with more comorbidities and higher levels of worry-inducing symptom perceptions (mean SSD-12 score 26 out of 48), whereas marked recovery was linked to being employed and having lower SSD-12 (10–13). Mean QoL improved over 12 months from 5.2 to 6.5 on the 0–10 VAS scale and from 3.1 to 3.5 on the EUROHIS-QOL-8 scale of 1–5. HRQoL by 15D increased from 0.76 to 0.80 (scale 0–1).

In conclusion, patients with comorbidities and distressing illness beliefs are the most vulnerable group in rehabilitation and require specific attention.

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Another major strength lies in the combined use of both general QoL and HRQoL measures, and the inclusion of SSD-12 added a psychological dimension, revealing how illness beliefs and symptom-related thoughts relate to perceived recovery. This combination offers a more complete understanding of PCC’s biopsychosocial nature.

Addressing these perceptual factors and avoidance behavior could offer intervention opportunities, for example through cognitive-behavioral approaches and micro-choice-based interventions aimed at modifying illness beliefs, reducing symptom-related anxiety, and promoting adaptive responses to symptoms through small, incremental behavioral changes.

Psychological distress and illness beliefs are increasingly recognized as key factors in recovery, yet remain insufficiently studied.
 
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