Post-Acute Sequelae of COVID-19 (PASC) Symptoms Associated with Deteriorated Quality of Life in a Community Sample of Individuals Reporting Previous SARS-CoV-2 Infection

Abstract

Purpose: To understand the impact of post-acute sequelae of COVID-19 (PASC) on quality of life (QOL) in a Midwestern community sample. Design: Anonymous online cross-sectional community survey. Methods: Survey responses collected July 2023-October 2024 were examined from 1,564 individuals reporting prior COVID-19 positive test or diagnosis. Logistic regressions and sensitivity analyses using subset of data were conducted to identify symptoms significantly associated with perceived Current QOL (determined by “Taking everything in your life into account, please rate your current overall QOL”) and Deteriorated QOL (i.e., Current QOL rated lower than QOL prior to SARS CoV-2 infection). Findings: Current QOL was predicted by pre-infection QOL and more frequent experiences of work/school difficulties, challenges with shopping/cleaning/driving/meal-prep, anxiety, depression, fatigue/tiredness, light headedness/fainting/rapid heartbeat episodes, and diminished activity/exercise tolerance (C-statistic = 0.84). Compared to the full dataset’s primary analyses, sensitivity analysis revealed all identified predictors except three physical symptoms remained significant Current QOL predictors. Deteriorated QOL after SARS-CoV-2 infection was predicted by pre-infection QOL, and more frequent experiences of work/school difficulties, diminished activity/exercise tolerance, anxiety, depression, trouble completing daily activities, fatigue/tiredness, and slow mental processing (C-statistic = 0.85). In contrast, sensitivity analysis revealed frequency of SARS-CoV-2 infection, pre-infection QOL, and more frequent challenges with shopping/cleaning/driving/meal-prep were the only significant predictors of Deteriorated QOL. Conclusions: PASC negatively impacted QOL. Pre-infection QOL may influence perceived post-infection QOL. Clinical Evidence: Results make a compelling case for community nurses to identify PASC, rule-out underlying medical causes, and refer patients for interdisciplinary post-COVID rehabilitation to improve health outcomes and QOL.