Self-Reported Everyday Functioning After COVID-19 Infection
Authors: Theodore J. Iwashyna, Valerie A. Smith, Sarah Seelye, Amy S. B. Bohnert, Edward J. Boyko, Denise M. Hynes, George N. Ioannou, Matthew L. Maciejewski, Ann M. O’Hare, Elizabeth M. Viglianti, Theodore S. Berkowitz, John Pura, James Womer, Lee A. Kamphuis, Max L. Monahan, C. Barrett Bowling, Andrew Admon, Kathleen Akgun, Stacy Anderson, Mihaela Aslan, David Au, Lisa Backus, Kristina Bajema, Aaron Baraff, Lisa Batten, Theodore Berkowitz, Taylor Bernstein, Kristin Berry Wyatt, Joseph Bogdan, Hayden Bosworth, Nathan Boucher, Nicholas Burwick, Aissa Cabrales, Jennifer Cano, Wen Chai, Jason Chen, Kei-Hoi Cheung, Kristina Crothers, Jeffrey Curtis, Marie Davis, Emily Del Monico, Aram Dobalian, Jacob Doll, Jason Dominitz, McKenna Eastment, Vincent Fan, Jacqueline Ferguson, Breanna Floyd, Alexandra Fox, Matthew Goetz, Diana Govier, Pamela Green, Susan Nicole Hastings, Katie Hauschildt, Eric Hawkins, Paul Hebert, Mark Helfand, Alex Hickok, Dana Horowitz, Catherine Hough, Elaine Hu, Kevin Ikuta, Barbara Jones, Makoto Jones, Lee Kamphuis, Brystana Kaufman, Sara Knight, Anna Korpak, Peggy Korpela, Kyle Kumbier, Kenneth Langa, Ryan Laundry, Stacy Lavin, Yuli Li, Jennifer Linquist, Holly McCready, Martha Michel, Amy Miles, Jessie Milne, Max Monahan, Daniel Morelli, Pradeep Mutalik, Jennifer Naylor, Meike Neiderhausen, Summer Newell, Shannon Nugent, Michael Ong, Thomas Osborne, Matthew Peterson, Alexander Peterson, Hallie Prescott, Nallakkandi Rajeevan, Ashok Reddy, Marylena Rouse, Mazhgan Rowneki, Som Saha, Sameer Saini, Javeed Shah, Troy Shahoumian, Aasma Shaukat, Megan Shepherd-Banigan, Whitney Showalter, Christopher Slatore, Nicholas Smith, Battista Smith, Pradeep Suri, Jeremy Sussman, Yumie Takata, Alan Teo, Eva Thomas, Laura Thomas, Anais Tuepker, Zachary Veigulis, Elizabeth Vig, Kelly Vranas, Xiao Qing Wang, Katrina Wicks, Kara Winchell, Edwin Wong, Chris Woods, Katherine Wysham, Lei Yan, Donna Zulman
Journal: JAMA Network Open (2024)

Importance Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection. Objective To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histories of COVID-19 infection. Design, Setting, and Participants This cohort study used data from the US Veterans Affairs (VA) and included 186 veterans who had COVID-19 between October 2020 and April 2021 (ie, COVID-19 cohort) and 186 matched comparators who did not have documented COVID-19 infections (ie, control cohort). This match balanced the risk of COVID-19 based on 39 variables measured in the 24 months before infection or match, using principles of target trial emulation. Data were analyzed from December 2022 to December 2023. Exposure First documented COVID-19. Main Outcome and Measures The differences in self-reported everyday functioning 18 months after COVID-19 infection were estimated and compared with their matched comparators. Within–matched pair logistic and linear regressions assessed differences in outcomes and were weighted to account for sampling and nonresponse. Results Among the 186 matched pairs of participants, their weighted mean age was 60.4 (95% CI, 57.5 to 63.2) years among veterans in the COVID-19 cohort (weighted sample, 91 459 of 101 133 [90.4%] male; 30 611 [30.3%] Black or African American veterans; 65 196 [64.4%] White veterans) and 61.1 (95% CI, 57.8 to 64.4) years among their comparators in the control cohort (91 459 [90.4%] male; 24 576 [24.3%] Black or African American veterans; 70 157 [69.4%] White veterans). A high proportion of veterans in the COVID-19 cohort (weighted percentage, 44.9% [95% CI, 34.2% to 56.2%]) reported that they could do less than what they felt they could do at the beginning of 2020 compared with the control cohort (weighted percentage, 35.3%; [95% CI, 25.6% to 46.4%]; within–matched pair adjusted odds ratio [OR], 1.52 [95% CI, 0.79 to 2.91]). There was no association of documented COVID-19 infection with fatigue, substantial pain, limitations in either activities of daily living and instrumental activities of daily living, severely curtailed life-space mobility, employment, or mean health-related quality of life on a utility scale. Conclusions and Relevance In this cohort study of veterans with and without documented COVID-19, many reported a substantial loss of everyday functioning during the pandemic regardless of whether or not they had a documented infection with COVID-19. Future work with larger samples is needed to validate the estimated associations.