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28-09-2021 Open Access

Factors associated with impaired quality of life three months after being diagnosed with COVID-19

Quality of Life Research
Verena Rass, Bogdan-Andrei Ianosi, Laura Zamarian, Ronny Beer, Sabina Sahanic, Anna Lindner, Mario Kofler, Alois Josef Schiefecker, Philipp Mahlknecht, Beatrice Heim, Victoria Limmert, Thomas Sonnweber, Alex Pizzini, Piotr Tymoszuk, Christoph Scherfler, Atbin Djamshidian, Stefan Kiechl, Ivan Tancevski, Klaus Seppi, Bettina Pfausler, Judith Loeffler-Ragg, Raimund Helbok
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Supplementary Information

The online version contains supplementary material available at https://​doi.​org/​10.​1007/​s11136-021-02998-9.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.



To assess patient characteristics associated with health-related quality of life (HR-QoL) and its mental and physical subcategories 3 months after diagnosis with COVID-19.


In this prospective multicentre cohort study, HR-QoL was assessed in 90 patients using the SF-36 questionnaire (36-item Short Form Health Survey), which consists of 8 health domains that can be divided into a mental and physical health component. Mental health symptoms including anxiety, depression, and post-traumatic stress disorders were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Post-traumatic Stress Disorder Checklist-5 (PCL-5) 3 months after COVID-19. Using descriptive statistics and multivariable regression analysis, we identified factors associated with impaired HR-QoL 3 months after COVID-19 diagnosis.


Patients were 55 years of age (IQR, 49–63; 39% women) and were classified as severe (23%), moderate (57%), or mild (20%) according to acute disease severity. HR-QoL was impaired in 28/90 patients (31%). Younger age [per year, adjOR (95%CI) 0.94 (0.88–1.00), p = 0.049], longer hospitalization [per day, adjOR (95%CI) 1.07 (1.01–1.13), p = 0.015], impaired sleep [adjOR (95%CI) 5.54 (1.2–25.61), p = 0.028], and anxiety [adjOR (95%CI) 15.67 (3.03–80.99), p = 0.001) were independently associated with impaired HR-QoL. Twenty-nine percent (n = 26) scored below the normal range on the mental health component of the SF-36 and independent associations emerged for anxiety, depression, and self-reported numbness. Impairments in the physical health component of the SF-36 were reported by 12 (13%) patients and linked to hypogeusia and fatigue.


Every third patient reported a reduction in HR-QoL 3 months after COVID-19 diagnosis and impairments were more prominent in mental than physical well-being.

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