J Clin Nurs. 2026 May 30. doi: 10.1111/jocn.70383. Online ahead of print.
ABSTRACT
AIMS: To evaluate the health-related quality of life (HRQOL) of adults with Long COVID 2 years and beyond after COVID-19 illness.
DESIGN: Cross-sectional study.
METHODS: Health status was assessed using the EQ-5D-5L instrument among 226 adults diagnosed in primary care with mild-to-moderate COVID-19 during the 2021 pandemic. Data were collected through a cross-sectional survey using a standardized questionnaire with a set of validated clinical outcomes for Long COVID. The sample consisted of adults aged ≥ 18 years who attended the specified ambulatory settings, tested positive for SARS-CoV-2, and agreed to be interviewed; the response rate was 70%. Health utility scores were compared between adults with and without Long COVID. Multivariate logistic regressions were applied to investigate the relationship between Long COVID and health-related quality of life outcomes.
DATA SOURCES: Primary data were collected from six public Family Health Care Units in João Pessoa, Brazil, between May 2023 and July 2024.
RESULTS: Adults with Long COVID had statistically significantly lower median utility scores (0.784, IQR: 0.633-0.902) than those without persistent symptoms (1.0, IQR: 0.877-1.0). Poorer HRQOL was more evident among women, older adults, non-White individuals, participants with pre-existing chronic diseases, and those with lower educational attainment. Long COVID was associated with impairments in anxiety/depression, pain/discomfort and usual activities.
CONCLUSION: Adults with Long COVID experienced poorer HRQOL 2 years or longer after mild-to-moderate infection compared with those without persistent symptoms, regardless of sex, age, ethnicity, education level or comorbidities. These findings support the implementation of targeted interventions and rehabilitation services in primary care for individuals experiencing long-term health problems following COVID-19 illness.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Identifying adults at greater risk of persistent health impairments following COVID-19 may help health professionals, caregivers and policymakers better address the aspects of patients’ lives that lack quality and develop a multidisciplinary approach in primary care to managing this condition.
IMPACT: What problem did the study address? ○ This study examined the association between persistent symptoms 2 years or longer after non-severe COVID-19 illness and health-related quality of life. What were the main findings? ○ Long COVID was associated with poorer health-related quality of life, particularly in the domains of anxiety/depression, pain/discomfort and usual activities. Where and on whom will the research have an impact? ○ The findings highlight the need for multidisciplinary management of long-term health problems among adult COVID-19 survivors in primary care.
REPORTING METHODS: The STROBE checklist was followed.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
PMID:42218573 | DOI:10.1111/jocn.70383
