In a recent study published in Epidemiology and Infection, researchers evaluated the association between SWB (subjective well-being) and post-COVID-19 (coronavirus disease 2019) symptoms.

Study: Associations Between Reported Post-COVID-19 Symptoms and Subjective Well-Being, Israel, July 2021 -April 2022. Image Credit: ANDREI_SITURN/Shutterstock

Background

Symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been reportedly persistent beyond the acute period of infection or arise within the post-acute phase after recovery. The worldwide burden of post-acute health implications of SARS-CoV-2 infections could possibly be probably enormous; nonetheless, the impact of post-acute COVID-19 symptoms on SWB is just not clear.

In regards to the study

In the current study, researchers determined the connection between common post-COVID-19 symptoms and SWB for assessing the results of symptoms experienced beyond the acute phase of COVID-19 in the long run.

The team analyzed documented symptoms and SWB from 2,295 individuals (of which 576 reported a history of SARS-CoV-2 infections) who were an element of an ongoing longitudinal cohort study conducted in Israel. They estimated changes in SWB related to documented symptoms after three to 6 months, after six to 12.0 months, and after 12 to 18 months post-COVID-19 amongst individuals reporting prior SARS-CoV-2 infections. The participants were different at every follow-up assessment.

The participants were recurrently (every three to 4 months) asked to reply questions concerning their physical, mental and psychosocial health and well-being using the ISARIC (international severe acute respiratory and emerging infection consortium) questionnaires. They documented symptoms experienced in the course of the acute COVID-19 period and inside seven days preceding filling out the survey.

The SWB division of the questionnaire was based on WHO-5 (five-item World Health Organization well-being index). The participating individuals were to fill out the SWB division regarding the previous two weeks and supply NRS (numeric rating scale) scores for fatigue experienced on the day gone by.

Invitations comprising the survey links were sent by SMS (short message system) to all individuals who underwent RT-PCR (reverse transcription polymerase chain response) SARS-CoV-2 testing between July 2021 and April 2022 in either of the governmental hospitals in Israel, including Galilee medical center, Baruch Padeh Poriya medical center, and Ziv medical center.

The survey was available in 4 commonly spoken languages in Israel: Arabic, Hebrew, Arabic, English, and Russian. Participants were invited to participate at three points: July 2021, November 2021, and March 2022. Generalized linear regression evaluation was performed, and data adjustments were made for the important demographic aspects.

Individuals documenting symptoms inside 3.0 months or beyond 18 months of COVID-19 or those providing incomplete data were excluded from the evaluation. Variables considered were participant sex, age, the status of COVID-19 vaccination, follow-up period, time of filling out the survey questionnaires, and symptoms documented when the questionnaires were filled out.

Results

Out of 95,604 individuals invited, 6,500 individuals filled out the questionnaires (seven percent). After excluding individuals with missing information and ineligible individuals, 2,295 individuals (two percent of invitees) were considered for the ultimate evaluation. Amongst 2,295 participants, 57% (n=1,319) were female, 92% (n=2,112) had been vaccinated, and 75% (n=1,719) had no prior COVID-19 history.

Out of 576 individuals previously infected with SARS-CoV-2, 32% (n=186) didn’t document any COVID-19 symptoms during filling out the questionnaires, and 68% (n=390) documented ≥1.0 symptoms experienced within the post-acute period during filling out the questionnaires. A median value of 260.0 days was obtained for the duration between COVID-19 and completing the questionnaires.

Individuals with post-COVID-19 symptoms showed a greater likelihood of being unvaccinated and feminine. Amongst 526 participants with prior COVID-19 history, the symptoms most steadily documented included fatigue (42%, n=243), muscular weakness (26%, n=153), pain in muscles (23%, n= 134), sleep difficulties (21%, n=121), and concentration difficulties/confusion (22%, n=126).

SWB scores by individuals with prior history of SARS-CoV-2 infections previously who reported no symptoms within the post-COVID-19 period were equivalent to those by individuals with no prior COVID-19 history (74% for each groups).

As compared to individuals who didn’t document any symptoms, individuals documenting unspecific symptoms resembling sleep difficulties, concentration difficulties/confusion, and fatigue showed probably the most significant SWB reductions of 12, 12, and eight.0 pp (percent points), respectively. The effect of individual post-acute COVID-19 symptoms developed on SWB differed at every time point.

While fatigue resulted in a statistically non-significant eight pp reduction in SWB amongst individuals documenting fatigue at three to 6 months post-COVID-19, amongst individuals documenting fatigue in the course of the 12-month to 18-month time point, the reduction in SWB related to fatigue was significant (13 pp).

Concentration difficulties considerably reduced the SWB scores when documented at three to 6 months or 12 to 18 months post-infection. Nevertheless, sleep difficulties significantly affected the SWB at three to 6 months and 6 to 12 months but not at 12 to 18 months post-infection.

Musculoskeletal symptoms resembling pain and weakness within the muscles didn’t show any significant association with SWB at any time point apart from an SWB reduction amongst individuals documenting pain within the muscles in the course of the six-month to 12-month follow-up period post-COVID-19. Amongst 553 SARS-CoV-2-infected individuals with complete NRS data, those documenting fatigue had significantly greater NRS scores (7.1, more fatigue) than those that didn’t (4.1).

Conclusion

Overall, the study findings showed that post-acute COVID-19 symptoms were related to a big reduction in SWB ≤18.0 months after initial infection.