使用 OpenPROMPT 研究长 COVID 对与健康相关的生活质量的影响

Oliver Carlile, Andrew Briggs, Alasdair Henderson, Ben Butler-Cole, John Tazare, Laurie Tomlinson, Michael Marks, Mark Jit, Liang-Yu Lin, Chris Bates, John Parry, Sebastian Bacon, Iain Dillingham, William Dennison, Ruth Costello, Alex Walker, William J Hulme, Ben Goldacre, Amir Mehrkar, Brian MacKenna, The OpenSAFELY Collaborative, Emily Herrett, Rosalind Eggo
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摘要

背景长COVID是一个影响患者健康、医疗服务和劳动力的重大问题。为了优化未来针对 COVID-19 的干预措施设计,更好地规划和分配医疗资源,量化这种新型疾病的健康和经济负担至关重要。方法经英国国家医疗服务系统(NHS England)批准,我们开发了 OpenPROMPT,这是一项英国队列研究,旨在测量长期 COVID 对健康相关生活质量(HRQoL)的影响。OpenPROMPT 使用智能手机应用程序邀请患者对 "患者报告结果指标"(PROMs)做出回应,并在 2022 年 11 月至 2023 年 10 月期间进行招募。我们使用经过验证的带有英国价值集的 EuroQol EQ-5D 问卷,利用线性混合模型为患有和未患有长 COVID 的受访者计算出非效用得分(1-效用),并计算出长 COVID 的后续质量调整生命月数(QALMs)。在多变量回归中,长期 COVID 对 HRQoL 有一致的影响,与未报告长期 COVID 的人相比,报告生活质量下降的概率很高(OR:22,95% CI:12.35-39.29)。在所有调查回复中,报告残疾是预测 HRQoL 损失的最大因素(OR:60.2,95% CI:27.79-130.57)。结论我们发现长期COVID对生活质量产生了重大影响,给患者和医疗服务带来了沉重负担。我们强调需要继续支持和研究长期 COVID,因为 HRQoL 分数与多发性硬化症、心力衰竭和肾病患者相比并不乐观。
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The impact of Long COVID on Health-Related Quality-of-life using OpenPROMPT
Background Long COVID is a major problem affecting patient health, the health service, and the workforce. To optimise the design of future interventions against COVID-19, and to better plan and allocate health resources, it is critical to quantify the health and economic burden of this novel condition. Methods With the approval of NHS England, we developed OpenPROMPT, a UK cohort study measuring the impact of long COVID on health-related quality-of-life (HRQoL). OpenPROMPT invited responses to Patient Reported Outcome Measures (PROMs) using a smartphone application and recruited between November 2022 and October 2023. We used the validated EuroQol EQ-5D questionnaire with the UK Value Set to develop disutility scores (1-utility) for respondents with and without Long COVID using linear mixed models, and we calculated subsequent Quality-Adjusted Life-Months (QALMs) for long COVID. Results We used data from 6,070 participants where 24.7% self-reported long COVID. In multivariable regressions, long COVID had a consistent impact on HRQoL, showing a high probability of reporting loss in quality-of-life (OR: 22, 95% CI:12.35-39.29) compared with people who did not report long COVID. Reporting a disability was the largest predictor of losses of HRQoL (OR: 60.2, 95% CI: 27.79-130.57) across survey responses. Self-reported long COVID was associated with an 0.37 QALM loss. Conclusions We found substantial impacts on quality-of-life due to long COVID, representing a major burden on patients and the health service. We highlight the need for continued support and research for long COVID, as HRQoL scores compared unfavourably to patients with conditions such as multiple sclerosis, heart failure, and renal disease.
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