Impact of long COVID on the health-related quality of life of Japanese patients: A prospective nationwide cohort study, 2025, Yagi et al

Impact of long COVID on the health-related quality of life of Japanese patients: A prospective nationwide cohort study

Kazuma Yagi, Masahiro Kondo, Hideki Terai, Takanori Asakura, Ryusei Kimura, Ryo Takemura, Hiromu Tanaka, Keiko Ohgino, Katsunori Masaki, Ho Namkoong, Shotaro Chubachi, Jun Miyata, Ichiro Kawada, Tatsuya Kaido, Shuko Mashimo, Keigo Kobayashi, Toshiyuki Hirano, Ho Lee, Kai Sugihara, Nao Omori, Mayuko Watase, Takao Mochimaru, Ryosuke Satomi, Yasushi Makino, Takashi Inoue, Koichi Sayama, Yoshitaka Oyamada, Makoto Ishii, Yasunori Sato, Koichi Fukunaga

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Background
Various prolonged systemic symptoms, forming the long coronavirus disease (COVID), have been observed in patients who have recovered from the acute phase of COVID-19. Although previous studies have reported that COVID-19 impacts health-related quality of life (HRQoL), the associations of long COVID symptoms and clinical characteristics with HRQoL remain unclear. This study aimed to clarify these associations using nationwide Japanese epidemiological data.

Methods
A prospective nationwide cohort study was conducted on patients with COVID-19 between January 2020 and February 2021 at 26 participating medical institutions in Japan. Various long COVID symptoms and HRQoL scores at 3, 6, and 12 months following diagnosis were collected from 986 participants.

Generalized estimating equations (GEE) were used to explore the association between HRQoL scores evaluated using the short form-8 (SF-8), long COVID symptoms, and baseline clinical characteristics.

Results
Patients who had one long COVID symptom showed a significantly lower physical component summary score (PCS) and mental component summary score (MCS) compared with those without any symptoms at all time points after diagnosis. GEE revealed that long COVID symptoms, including dyspnea, fatigue, headache, and muscle weakness, were significantly associated with worse PCS, whereas poor concentration, sleep disorders, fatigue, and headache were significantly associated with worse MCS.

Severity-related baseline parameters for patients with COVID-19 were significantly associated with worse PCS scores, although these factors were not significantly associated with worse MCS scores.

Conclusions
Long COVID symptoms were associated with lower physical and mental HRQoL. Severe outcomes of COVID-19 impacted PCS but not MCS.

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