Researchers evaluate health-related quality-of-life data obtained retrospectively from COVID-19 patients

In a recently posted study medRxiv* Preprint Server Researchers retrospectively evaluated the EQ-5D-5L data collection among coronavirus disease 2019 (COVID-19) patients.

Study: retrospective collection assessment of the EQ-5D-5L in US patients with COVID-19. Image credit: poptika / shutterstock


Studies have highlighted the effect of SARS-CoV-2 infection on amplifying previous clinical outcomes. To fully understand the impact of COVID-19, it is necessary to assess the impact on quality of life (QoL). The EuroQoL Group is widely employed to generate utilities for the 5 Dimensions and 5 Levels (EQ-5D-5L) assessment of health-related QoL (HRQoL) and the calculation of quality-adjusted life years (QALYs).

In Infectious Disease Patient-Reported Outcomes (PRO) research, the EQ-5D-5L data collection is used to identify, both retrospectively and prospectively, baseline health status pre-infection as well as morbid health status during infection has gone. However, previous investigations have not retrospectively validated EQ-5D-5L data collection.

about study

In the current study, the researchers employed PRO information obtained in the COVID-19 studies, which assessed the validity of retrospective EQ-5D-5L data collection in the setting of pre-COVID-19 infection status.

In the PRO research of COVID-19 patients, participants were enrolled adult outpatients in the United States with at least one self-reported symptom and a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Reverse transcription polymerase chain reaction (RT-PCR) test. A prior study included an analytical cohort limited to unvaccinated or BNT162b2-vaccinated people. All patients recruited were included to evaluate the validity of the retrospective data-collection process.

The EQ-5D-5L assessed QoL in five different dimensions, including mobility, routine activities, self-care, discomfort/pain, and depression/anxiety, and five levels, including none, mild, moderate, severe, and extreme. Contains issues/disabilities. The five domains were converted to a utility index (UI) by means of US-based weighting. On the day of recruitment, approximately three days after the SARS-CoV-2 test was positive, individuals answered the EQ-5D-5L questionnaire twice to evaluate HRQoL pre-SARS-CoV-2 in the past tense. Revised version of all prepared questions were included. A version created in the present tense to assess baseline and current HRQoL.


About 10.2% of the 676 participants were at least 65 years of age or older, 73.2% were female, and 71.9% were white. Eligible participants reported 8.6% for chronic lung disease or asthma, 4.7% for diabetes, and 11.2% for high blood pressure. A worse visual analog scale (VAS) score in each EQ-5D5L domain from a retrospectively obtained pre-COVID-19 baseline as well as a higher level of disease severity for a standard collection on day 3 after testing positive for COVID-19 was related.

For pre-SARS-CoV-2 infection dynamics, the team noted that those who did not report an average EQ-VAS score was 88.5, mild was 74.9, moderate was 57.7, and severe issue was 50.0. No participant reported an inability to move. No significant difference existed between mean EQ-VAS scores with respect to none, mild and moderate/severe problems.

Participants in this study were predominantly female, Caucasian, and had fewer chronic conditions than the general US population. Both pre-SARS-CoV-2 infection baseline average UI was 0.924% while the average VAS was 87.4%. In addition, fewer issues were observed in all five domains, with prevalence rates of 7.1%, 6.7%, 7.9%, 27.3%, and 43.5% with respect to the current study group versus 28.4%, 6.5%, 24.7%, 51.0%. were. , and 38.4% related to mobility, general activity, self-care, discomfort/pain, and depression/anxiety, respectively.

In models predicting EQ-VAS using the retrospective assessment variable called RETRO, UI, and their interaction, the measured coefficient associated with the UI-by-retro interaction was -4.2. This showed that retrospective estimation did not significantly affect the extent of correlation between UI and EQ-VAS.

Comparing the EQ-5D-5L to US population norms, the team used a matching-adjusted indirect comparison (MAIC) approach to match the proportions of age group, gender, hypertension and diabetes in the current sample to US norms Can go The weighted pre-COVID-19 baseline average for UI declined to 87.0, while the VAS declined to 0.922. Both were well above US population norms. With the inclusion of the fraction of individuals with mobility challenges, the sample size was reduced to 291.

The baseline weighted mean of UI before COVID-19 was 0.866, which did not differ significantly from the US population mean of 0.851. The mean weight of the VAS was 84.6, which was higher than the US average of 80.4.

Three days after COVID-19 test positivity, the UI was 0.808%, and the VAS was 73.33%. Cohen’s d value for UI was 0.68, and VAS was 1.01, suggesting a moderate to large effect on UI and a higher effect on VAS compared to the baseline assessment. The Cohen’s d values ​​in UI and VAS were 0.21 and 0.44, respectively, indicating a slight to moderate effect on UI and a minimal to moderate effect on VAS relative to US population norms. However, only 17.2% of the COVID-19 group experienced mobility problems, compared to 25.2% of the US population. After adjustment for age, sex, percentage of hypertension and diabetes, 19.0% of the population reported walking difficulties, which was much lower than 25.2%. It was determined that the UI and VAS effect sizes (ES) were 0.15 and 0.39, respectively.


Study findings showed that the retrospectively obtained pre-COVID-19 EQ-5D-5L was acceptable in relation to US population norms. It also lines up well enough in comparison to the standard EQ-5D-5L collection for COVID-19. Collecting pre-COVID-19 EQ-5D-5L data allows direct examination of the impact of COVID-19 on health-related QoL. Future research that specifically compares traditional prospective assessment prior to COVID-19 with retrospective assessment of the EQ-5D-5L is encouraged.

*Important Information

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, guide clinical practice/health related behavior, or be treated as established information.


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