P-1934. Differences between the Reporting of Post-COVID-19 Symptoms and the Associated Health-Related Quality of Life during and after COVID-19 Infection - results of the Cross-Sectoral Platform of the German National Pandemic Cohort Network
Authors: Hopff Sina M , Appel Katharina , Bröhl Isabel , Nürnberger Carolin , Wagner Patricia , Scherer Margarete , Allwang Christine , Blaschke Sabine , Dashti Hiwa , de Angelis Clara , Hamelmann Eckard , Hamprecht Axel , Hansch Stefan , Hanses Frank , Heuschmann Peter , Illig Thomas , Kaasch Achim J , Käding Nadja , Kobbe Robin , Krefting Dagmar , Lehnert Kristin , Lemhöfer Christina , Lücke Thomas , Nunes de Miranda Susana M , Raquib Shimita , Reese Jens-Peter , Römmele Christoph , Schmidt Julia , Schulze Petra , Tebbe Johannes J , Vehreschild Maria J GT , Wyen Christoph , Vehreschild Janne J 
Published: January 2025

Abstract

Background
Post-COVID-19 syndrome (PCS) prevalences range from 10% up to 45%, caused by heterogeneous definitions, different study designs and survey methods, and sometimes misattribution of unrelated comorbidities to PCS. First correlations between PCS and health-related quality of life (HrQoL) are described. This study analyzes the course and differences between PCS-related symptoms and the associated HrQoL in a large multicenter cohort.Table 1:Development of Health-related Quality of Life (HrQoL) in COVID-19 patients compared to the healthy population
Comparisons of the frequency distribution of the individual EQ-5D-5L dimensions of the NAPKON cohort at the time of COVID-19 diagnosis (baseline), end of the acute phase, as well as the 3- (3MFU) and 12-month follow-up (12MFU) with those of a general German population according to Grochtdreis et. al (DOI: 10.1007/s10198-019-01054-1). Significance levels were computed using Person’s chi square test with p &lt; 0.05 = significant.

Methods
Prospectively collected data from COVID-19 patients enrolled in the Cross-Sectoral Platform of the German National Pandemic Cohort Network (NAPKON) were used to describe HrQoL by EQ-5D-5L. Interviews were conducted at the time of COVID-19 diagnosis, the end of acute phase, and during the 3- (3MFU) and 12-month follow-ups (12MFU). Results were compared with pre-pandemic German population data. Group comparisons were assessed using Pearson’s chi square test. EQ-5D-5L index scores were stratified by the severity of PCS according to a PCS score (DOI: 10.1016/j.eclinm.2022.101549) and correlations were assessed by Pearson’s correlation coefficient (p &lt; 0.05 significant, respectively).Figure 1:Development of EQ-5D-5L expressions over the observation period(a) The development of means of the 5 EQ-5D-5L dimensions pain, anxiety, mobility, usual activities (activity), and self-care (care) of COVID-19 patients of the NAPKON cohort are demonstrated over the observation time (1 = no problems, 2 = slight problems, 3 = moderate problems, 4 = severe problems, 5 = unable to). (b) EQ-5D-5L Visual Analogue Scale (VAS) values are indicated at the time of COVID-19 diagnosis (baseline), end of the acute phase, as well as the 3- and 12-month follow-up (FU). In addition, the level of the EQ-5D-5L index score is visualized by a color scale.

Results
We analyzed 1,494 patients from 39 study sites (median age 55, range 18-94; 42% female). During the acute phase, COVID-19 patients reported more difficulties in self-care (p &lt; 0.001) and usual activities (p &lt; 0.001) than the healthy population. HrQoL of COVID-19 patients constantly improved towards the 3MFU and 12MFU hence there was no longer a difference compared to the general population (Table 1). The courses of individual dimensions were heterogeneous (Figure 1). However, at the 3MFU 61% and at the 12MFU 57% of the patients still had PCS-related symptoms with a significant correlation between the EQ-5D-5L index score and the reported severity of PCS (3MFU: r = -0.39, p &lt; 0.001; 12MFU: r = -0.48, p &lt; 0.001).

Conclusion
We found no significant impairment in HrQoL up to 12 months after COVID-19 diagnosis compared to the healthy population, despite continued patient reports on PCS-related symptoms. While severity of symptoms was correlated with HrQoL, the overall impact of PCS was lower than expected. We conclude that incorporating HrQoL assessments alongside symptom-based questionnaires is crucial for accurately measuring PCS impact on daily life.

Disclosures
Sina M. Hopff, MD, Tillotts: Travel costs Christine Allwang, Dr. med., Ärzte- und Ärztinnenverband Long COVID: Board Member|BMBF German Federal Ministry of Education and Research: Grant/Research Support Sabine Blaschke, Prof. Dr. med., BMBF NAPKON NUM 2.0 Grant No. 01KX2121: Grant/Research Support Stefan Hansch, n/a, ETFS and equities (not specific to the medical sector): Stocks/Bonds (Private Company)|Gilead: Travel grants; Attending workshop (training) Frank Hanses, n/a, Akademie für Infektionsmedizin: Honoraria|Bayr. Landesärztekammer: Honoraria|Bayr. Staatsministerium für Gesundheit und Pflege: Grant/Research Support|Correvio / Advanz: Honoraria|DGINA: Honoraria|Sobi, GSK: Board Member Peter Heuschmann, Prof. Dr. med., Bavarian State: Grant/Research Support|Charité – Universitätsmedizin Berlin (within Mondafis; supported by an unrestricted research grant to the Charité from Bayer): Grant/Research Support|European Union: Grant/Research Support|Federal Joint Committee (G-BA) within the Innovationfond: Grant/Research Support|German Cancer Aid: Grant/Research Support|German Heart Foundation: Grant/Research Support|German Ministry of Research and Education (within the NUM): Grant/Research Support|German Parkinson Society: Grant/Research Support|German Research Foundation: Grant/Research Support|Participation on DSMB in publicly funded studies (by German Research Foundation, German Ministry of Research, Foundations): Board Member|University Göttingen (within FIND-AF randomized; supported by an unrestricted research grant to the University Göttingen from Boehringer-Ingelheim): Grant/Research Support|University Hospital Heidelberg (within RASUNOA-prime; supported by an unrestricted research grant to the University Hospital Heidelberg from Bayer, BM: Grant/Research Support|University Hospital Würzburg: Grant/Research Support Achim J. Kaasch, Prof. Dr. med., Network of University Medicine (NUM), funded by the German Federal Ministry of Education and Research (BMBF) (FKZ: 01KX2121): Grant/Research Support Dagmar Krefting, Prof. Dr., BMBF (Federal Ministry of Education and Research ): Grant/Research Support Christina Lemhöfer, Dr. med., Federal Joint Committee (G-BA) within the Innovationfond: Grant/Research Support|German Society of Physical and Rehabilitation Medicine (Deutsche Gesellschaft für Physikalische und Rehabilitative Medizin e.V. (DGPRM)): Board Member|Network University Medicine (NUM)/ German Federal Ministry of Education and Research (BMBF): Speaker Physical and Rehabilitation Group|Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin’: Board Member Jens-Peter Reese, Univ.-Prof. Dr. med., Bavarian State (ministry for science and the arts), DigiOnko: Grant/Research Support|Federal Joint Committee (G-BA) within the Innovationfond, Peri-OP, StaerkeR: Grant/Research Support|German Center for Lung Research, within PASSION: Grant/Research Support|German Ministry of Health (BMG): Expert Testimony|German Ministry of Research and Education: Grant/Research Support|Landesaerztekammer Hessen: Honoraria Julia Schmidt, n/a, Contract of employment at the University of Wuerzburg: Grant/Research Support Maria JGT Vehreschild, Prof. Dr. med., 3M: Honoraria|Ärztekammer Niedersachsen: Honoraria|ADKA: Honoraria|Akademie für Infektionsmedizin: Honoraria|Astellas: Honoraria|Berliner Dialy Seminar: Honoraria|Biontech: Grant/Research Support|CED Service: Honoraria|DiaLog Service: Honoraria|EUMEDICA: Advisor/Consultant|EUMEDICA: Honoraria|Falk Foundation: Honoraria|Ferring: Honoraria|Forum für medizinische Fortbildung Gmbh: Honoraria|GILEAD: Honoraria|Heel: Grant/Research Support|Helios Kliniken: Honoraria|Institute Merieux: Honoraria|Janssen: Honoraria|Kit Kongress: Honoraria|Klinikum Essen: Honoraria|Klinikum Leverkusen: Honoraria|Lahn-Dill-Kliniken: Honoraria|Landesärztekammer Hessen: Honoraria|Limbach Gruppe SE: Honoraria|MaaT: Advisor/Consultant|MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Honoraria|Roche: Advisor/Consultant|Roche: Grant/Research Support|SD Biosensor: Grant/Research Support|St. Johannes Hospital: Honoraria|St. Josef Hospital: Honoraria|SUMIT OXFORD Ltd.: Honoraria|Tillotts: Advisor/Consultant|Tillotts: Honoraria|Uniklinik Frankfurt: Honoraria|Uniklinik Köln: Honoraria|Uniklinik Karlsruhe: Honoraria|Universitätsklinikum Freiburg: Honoraria|Universitätsklinikum Heidelberg: Honoraria Janne J. Vehreschild, Prof. Dr. med., Ärztekammer Hessen: Honoraria|Ärztekammer Nordrhein: Honoraria|Academy for Infectious Medicine: Board Member|Academy for Infectious Medicine: Honoraria|APOGEPHA: Honoraria|Astellas Pharma: Board Member|Astellas Pharma: Grant/Research Support|Astellas Pharma: Honoraria|Back Bay Strategies: Honoraria|Basilea: Board Member|Basilea: Grant/Research Support|Basilea: Honoraria|Biontech: Board Member|Biontech: Honoraria|Deutsches Zentrum für Luft- und Raumfahrt (DLR): Grant/Research Support|European Union: Grant/Research Support|German Cancer Consortium (DKTK): Grant/Research Support|German Cancer Consortium (DKTK): Honoraria|German Cancer Consortium (DKTK): Support for attending meetings|German Centre for Infection Research (DZIF): Board Member|German Centre for Infection Research (DZIF): Grant/Research Support|German Centre for Infection Research (DZIF): Honoraria|German Centre for Infection Research (DZIF): Support for attending meetings|German Federal Ministry of Education and Research (BMBF): Grant/Research Support|German Federal Ministry of Health (BMG): Grant/Research Support|German Network University Medicine: Board Member|German Network University Medicine: Grant/Research Support|German Network University Medicine: Honoraria|German Network University Medicine: Support for attending meetings|German Society for Infectious Diseases (DGI): Board Member|German Society for Infectious Diseases (DGI): Honoraria|German Society for Infectious Diseases (DGI): Support for attending meetings|German Society for Internal Medicine (DGIM): Board Member|German Society for Internal Medicine (DGIM): Honoraria|German Society for Internal Medicine (DGIM): Support for attending meetings|Gilead: Board Member|Gilead: Grant/Research Support|Gilead: Honoraria|Janssen: Board Member|Janssen: Honoraria|Merck/MSD: Board Member|Merck/MSD: Grant/Research Support|Merck/MSD: Honoraria|Molecular Health: Honoraria|NordForsk: Honoraria|Pfizer: Board Member|Pfizer: Grant/Research Support|Pfizer: Honoraria|Rigshospitalet Copenhagen: Grant/Research Support|Shionogi: Honoraria|University Hospital Aachen: Honoraria|University Hospital Aachen: Support for attending meetings|University Hospital Freiburg/ Congress and Communication: Honoraria|University Hospital Oldenburg: Honoraria|University Manchester: Board Member|University Manchester: Honoraria|University Manchester: Support for attending meetings|University of Bristol: Grant/Research Support