Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID, 2024, Wang+

Discussion in 'Long Covid research' started by SNT Gatchaman, Nov 14, 2024.

  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study
    Jiunn Wang; Henry Goodfellow; Sarah Walker; Ann Blandford; Paul Pfeffer; John R Hurst; David Sunkersing; Katherine Bradbury; Chris Robson; William Henley; Manuel Gomes

    OBJECTIVES
    To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.

    DESIGN
    A population-based longitudinal cohort study using real-time user data.

    SETTING
    35 specialised long COVID clinics in the UK.

    PARTICIPANTS
    4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.

    MAIN OUTCOME MEASURES
    Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.

    RESULTS
    The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was −0.86 (95% CI −1.32, –0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.

    CONCLUSIONS
    Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.


    Link | PDF (BMJ Open) [Open Access]
     
  2. NelliePledge

    NelliePledge Moderator Staff Member

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    Use of functional as in ability to function rather than the dodgy psychosomatic makes a change. What they’re describing as “small improvement” after 6 months - let’s see after 12
     
    bobbler, Sean, MSEsperanza and 4 others like this.
  3. Hutan

    Hutan Moderator Staff Member

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    That's not a very impressive improvement over the 6 months, considering natural improvement.

    And that the people who dropped out may have been too sick or too disillusioned to turn up to the follow-up.
     
    Joan Crawford, bobbler, Sean and 8 others like this.
  4. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    In addition to what was already said above: Not only very little mean improvement but if I understood properly all scores still indicate impairment?

    Why did they use the reversed score? Is this common (if not -- why confuse things regarding comparability ?)

    Sorry, only was able to read the abstract: Does the paper also report the proportions of participants who scored worse? (Apart from the already mentioned problem not having the data from those who dropped out?)

    Why not worth to be mentioned in the conclusion? And again, the figures appear also to comprise worsened scores so would be interesting to have exact numbers on that (aka harms)?
     
    Joan Crawford, bobbler and Hutan like this.

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