Jiunn Wang, Henry Goodfellow, Sarah Walker, Ann Blandford, Paul Pfeffer, John R Hurst, David Sunkersing, Katherine Bradbury, Chris Robson, William Henley, Manuel Gomes
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Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.</p><p><strong>Results: </strong>The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was -0.86 (95% CI -1.32, -0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.</p><p><strong>Conclusions: </strong>Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"14 11","pages":"e088538"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study.\",\"authors\":\"Jiunn Wang, Henry Goodfellow, Sarah Walker, Ann Blandford, Paul Pfeffer, John R Hurst, David Sunkersing, Katherine Bradbury, Chris Robson, William Henley, Manuel Gomes\",\"doi\":\"10.1136/bmjopen-2024-088538\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.</p><p><strong>Design: </strong>A population-based longitudinal cohort study using real-time user data.</p><p><strong>Setting: </strong>35 specialised long COVID clinics in the UK.</p><p><strong>Participants: </strong>4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.</p><p><strong>Main outcome measures: </strong>Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. 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引用次数: 0
摘要
目的：研究COVID长期门诊患者的功能限制、疲劳、健康相关生活质量（HRQL）和社会成本：研究转诊至COVID长期门诊的患者在功能限制、疲劳、健康相关生活质量（HRQL）和社会成本方面的轨迹：设计：基于人群的纵向队列研究，使用实时用户数据：环境：英国 35 家长程慢性阻塞性肺病专科门诊：在2020年8月4日至2022年8月5日期间，4087名在初级或二级医疗机构被诊断为长期COVID的成年人被认为适合康复，并在 "与Covid共存康复（LWCR）"项目中注册：使用工作和社会适应量表（WSAS）拟合广义线性混合模型，以估计功能限制的轨迹；得分≥20分表示中度严重限制。其他结果包括使用慢性疾病治疗功能评估-疲劳（FACIT-F）反向评分（得分≥22分表示功能受损）进行的疲劳评估、使用EQ-5D-5L进行的HRQL评估，以及与COVID相关的长期社会成本（包括医疗成本和生产力损失）：在 LWCR 注册 6 个月后，WSAS 平均得分为 19.1（95% CI 18.6，19.6），46% 的参与者（95% CI 40.3%，52.4%）报告 WSAS 得分超过 20（中度严重或更严重的损伤）。6 个月期间，WSAS 评分的平均变化为-0.86（95% CI -1.32, -0.41）。6 个月时，FACIT-F 平均反向评分为 29.1（95% CI 22.7，35.5），而基线评分为 32.0（95% CI 31.7，32.3）。EQ-5D-5L 平均得分在基线（0.63，95% CI 0.62，0.64）和 6 个月（0.64，95% CI 0.59，0.69）之间保持相对稳定。6个月时，每位患者每月与长COVID相关的社会成本为931英镑，主要是与工作日损失相关的成本：结论：英国转诊到长期COVID诊所的患者在登记参加LWCR项目后的6个月内，在功能限制、疲劳、HRQL和工作能力方面均有小幅改善。
Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study.
Objectives: To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.
Design: A population-based longitudinal cohort study using real-time user data.
Setting: 35 specialised long COVID clinics in the UK.
Participants: 4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.
Main outcome measures: Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.
Results: The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was -0.86 (95% CI -1.32, -0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.
Conclusions: Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.
期刊介绍：
BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.
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