The impact of testing positive versus negative for COVID-19 on health-related quality of life … Alberta …, 2026, Kirwin+

[SNT Gatchaman]

The impact of testing positive versus negative for COVID-19 on health-related quality of life: cross-sectional evidence from the Alberta post-COVID-19 follow-up survey

Spoiler: Authors

Kirwin, Erin; Adibnia, Elham; Wiggins, Megan; Sander, Beate; Xie, Feng; Ohinmaa, Arto; Johnson, Jeffrey A; Norris, Colleen; Rafferty, Ellen; MacDonald, Shannon E; Round, Jeff

PURPOSE
The novel Coronavirus Disease 2019 (COVID-19) can have lasting physical and psychological outcomes, though little is known about the long-term impact of COVID-19 on the health-related quality of life (HRQoL) of Canadians. The aim of this study is to estimate the impacts of testing positive for COVID-19 using the EQ-5D-5 L instrument.

METHODS
Our study is a secondary analysis of data collected in the Alberta POST-COVID-19 Follow-up Study, linking survey responses to administrative health data. The data included 11,705 individuals tested for COVID-19 in Alberta from October 2021 to September 2023. Survey data included test results, age, sex, and EQ-5D-5 L response. Linked administrative data included socioeconomic status, comorbidities, hospital, and intensive care unit admissions. We used linear regression to estimate differences in HRQoL pre- and post-COVID-19 testing and ordinal logistic regression to estimate the odds of worsening HRQoL in each of the EQ-5D domains.

RESULTS
COVID-19-positive individuals were younger (mean 48.5 vs. 53.4 years), more often female (64.4% vs. 62.6%), and tested more recently (mean 274 vs. 519 days since test) compared to COVID-19-negative respondents. We estimated reductions in EQ-5D-5 L index score ranging from 0.0464 (CI 0.0393-0.0536) to 0.0702 (CI 0.0626-0.0777) points for respondents testing positive, and up to 0.0276 (CI 0.0190-0.0362) points for respondents testing negative. Positive respondents were also more likely to report problems within each of the EQ-5D-5 L domains.

CONCLUSION
Previous COVID-19 infection has an important impact on HRQoL. These results can support health economic models and provide insight into optimal COVID-19 mitigation strategies.

PLAIN ENGLISH SUMMARY
This study was developed to better understand how testing positive for COVID-19 affects peoples overall health and well being. The key issue that this study address is if COVID-19 infection has a measurable and lasting effect peoples heath related quality of life.

This study used data from over 11,000 adults in Alberta to see how peoples overall health and well-being changed before and after testing positive for COVID-19. The survey was conducted between 2021 and 2023, and included individuals who tested positive or negative for COVID-19.

The study found that people who tested positive for COVID-19 reported a bigger drop in their health-related quality of life than those who tested negative. This decline impacted several areas of daily life such as mobility, ability to partake in usual activities, pain, and mental health. The largest differences were seen within the first three months of COVID-19 infection, but they continued over a year later for some individuals. The biggest effects were in mental health, where over 10% of people who tested positive worsening mental health, compared to only 3% of people testing negative. Overall people with long-term health conditions (comorbidities) other than COVID-19 or who lived in more deprived areas reported worse outcomes.

These findings suggest that testing positive for COVID-19 is linked to lasting impacts on physical and mental health, even after the initial illness has passed.

Web | DOI | PDF | Quality of Life Research | Open Access

 

[SNT Gatchaman]

Survey responses used in this analysis were collected from October 2021 to September 2023.

For all domain-specific aORs, the comparator group is those testing negative and reporting HRQoL within three months of testing. For those testing positive in the same time period, the odds of worsening problems in mobility are 2.8 times higher (Table 4). Mobility aORs decrease in the next two periods, rising again to 3.7 one year or more following the index test. The aORs for self care, usual activities, and pain/ discomfort follow similar patterns and orders of magnitude, and all estimates are statistically significant. In contrast, anxiety/ depression aORs are smaller and only significant in the 9–12 month period, ranging from 2.0 to 2.3 thereafter.

Our results indicate that testing positive for COVID-19 has clinically important and sustained negative impacts on HRQoL. This finding is important for policy makers, as they assess the value of programs that affect the spread of and outcomes related to COVID-19.

A bit late now. We all went with let-it-rip anyway, so policy makers will assess the value of such programs as <shrug-emoji>.

 

[rvallee]

A bit late now. We all went with let-it-rip anyway, so policy makers will assess the value of such programs as <shrug-emoji>.

I wonder how much of that is the normalization of clinical trials that do long-term follow-up after having the control group go through the treatment as a normal part of the actual intended trial. They actually go through the performative ritual of pretending that it's worth comparing them after that. Unbelievable.

I'm not saying it's a big factor, but I doubt it's zero, because eliminating control groups from the population as public health policy allowing to conveniently ignore all its consequences is just an extension of the same reasoning.