Correlates of poorer quality of life in long COVID in primary care

Background

Long COVID is heterogeneous, and it is unclear which patient-reported domains are most closely associated with health-related quality of life. We examined correlates of poorer quality of life within long COVID cases.

Methods

We analysed ARALONGCOV participants classified as long COVID cases in primary care in Aragon, Spain. The outcome was SF-12 score. Candidate correlates were fatigue severity (FSS), depressive symptoms (PHQ-9), sleep quality (PSQI) and current work status. Multivariable linear regression was performed in cases with complete data for all variables.

Results

The multivariable model included 121 long COVID cases and explained 74.6% of the variance in SF-12. Higher depressive symptom burden and greater fatigue severity were independently associated with lower health-related quality of life. Each one-point increase in PHQ-9 was associated with a 2.16-point lower SF-12 score (p < 0.001), and each one-point increase in FSS total score with a 0.36-point lower SF-12 score (p < 0.001). In contrast, PSQI and current active work status were not independently associated with SF-12 after adjustment. These findings suggest that mental health burden and fatigue contribute more strongly to perceived health status than employment situation or sleep quality once analysed jointly.

Conclusions

Within long COVID, poorer quality of life was most strongly linked to depressive symptoms and fatigue. Primary care assessment and management should therefore include structured evaluation of both domains, rather than focusing only on persistence of physical symptoms.

Key messages

• Within long COVID, poorer quality of life was most strongly associated with depressive symptoms and fatigue.

• Primary care follow-up should include structured assessment of both domains, not only persistent physical symptoms.