Andy
Senior Member (Voting rights)
Full title: Associations of socioeconomic status and health-related quality of life in patients with long COVID and patients with persistent physical symptoms: A comparison of two cohort studies at baseline
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Highlights
- Health-related quality of life (HRQOL) was reduced in both Long COVID and persistent physical symptom (PPS) patients.
- Low socioeconomic status (SES) indicators were associated with poorer HRQOL in both patient groups.
- Unemployment and a higher number of comorbidities were significant predictors of reduced HRQOL.
- An accumulation of SES disadvantages corresponded to progressively lower HRQOL scores.
- Socioeconomic inequalities should be addressed to improve care equity for patients with PPS and Long COVID.
Abstract
Background and aim
Emerging evidence suggest a significant association between Long COVID (LC) and other persistent physical symptoms (PPS) with lower socioeconomic status (SES). We investigated the relationship between SES and health-related quality of life (HRQOL), as measured by the 15D and the EUROHIS-QOL-8 instruments, among patients with LC and those experiencing other PPS-related conditions.Methods
Factors related to clinical and socioeconomic aspects that affect HRQOL were evaluated using 15D, a validated 15-item self-reported questionnaire. Two parallel cohorts at Helsinki University Hospital were analyzed: the Helsinki LC cohort (n = 422; 2021–2023) and the Helsinki Sympa cohort (n = 599; 2020–2024), consisting of patients with PPS. Additionally, we performed an intersectional MAIHDA analysis of biopsychosocial predictors of quality of life.Results
The cohorts were demographically similar, with 70.6 % and 66.4 % female participants and mean ages of 44.8 years (SD = 11.3) and 38.8 years (SD = 11.0) in the LC and Sympa cohorts, respectively. By EUROHIS-QOL-8, 34 % of LC and 41 % of Sympa respondents rated their overall QOL as very bad or bad (scale options 1–2 out of 5). Mean 15D scores were 0.76 (SD = 0.11) in the LC cohort and 0.74 (SD = 0.11) in the Sympa cohort (scale: 0–1). Working status, comorbidities, and tertiary education emerged as key determinants in the information-criteria–based model, highlighting the cumulative burden of overlapping social and clinical disadvantages. No significant multiplicative effects were found within our cohorts.Conclusions
Patients in both cohorts reported reduced HRQOL, and the influence of socioeconomic factors on QOL were highly similar. Comorbidities, only basic school education, and being out of work were associated with the lowest HRQOL scores. The accumulation of socioeconomic disadvantage may function as a barrier to treatment, and healthcare professionals should recognize these challenges and ensure that patients receive adequate support.Paywall