Long COVID burden in primary care: quality of life, fatigue, sleep and function

Background

Long COVID is associated with persistent physical, psychological and functional impairment, but its overall burden in primary care remains insufficiently quantified. We compared health-related quality of life, fatigue, sleep, mood and exercise capacity between long COVID cases and recovered controls.

Methods

We performed a cross-sectional analysis of the ARALONGCOV cohort in Aragon, Spain. Participants were classified as long COVID cases or recovered controls. We analysed questionnaire and functional data available in each domain, including SF-12, Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), PHQ-9 and 6-minute walk distance.

Results

Long COVID cases showed markedly worse outcomes than controls across all domains. Median SF-12 score was 32.1 in long COVID versus 87.5 in controls. Median FSS score was 57 versus 6, median PSQI 12 versus 6, median PHQ-9 12 versus 1, and median 6-minute walk distance 440 m versus 541.5 m. All between-group differences were highly significant (all p < 0.001). Across measures, long COVID participants showed a consistent pattern of reduced quality of life, higher fatigue, poorer sleep, greater depressive symptom burden and lower functional exercise capacity.

Conclusions

In primary care, long COVID was associated with substantial multidimensional impairment compared with recovered controls. Assessment should not rely on symptom persistence alone, but also include quality of life, fatigue, mood, sleep and physical function to identify patients requiring closer follow-up and multidisciplinary support.

Key messages

• Long COVID in primary care was associated with major impairment in quality of life, fatigue, sleep, mood and exercise capacity.

• Assessment should move beyond symptom persistence alone and include multidimensional functional burden.