Association of long COVID with health-related quality-of-life outcomes

Malini M Gandhi; Carlee Moser; Judith S Currier; Justin Ritz; Joseph J Eron; Eric S Daar; David A Wohl; William A. Fischer II; Upinder Singh; Michael D Hughes; Davey M Smith; Teresa H Evering; Kara W Chew; ACTIV-2/A5401 Study Team

doi:10.1038/s41598-026-36189-8

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Association of long COVID with health-related quality-of-life outcomes

Journal article

Open access

Peer reviewed

Association of long COVID with health-related quality-of-life outcomes

Malini M Gandhi, Carlee Moser, Judith S Currier, Justin Ritz, Joseph J Eron, Eric S Daar, David A Wohl, William A. Fischer II, Upinder Singh, Michael D Hughes, …

Scientific reports, Vol.16(1), p.14229

03/19/2026

DOI: 10.1038/s41598-026-36189-8

PMCID: PMC13139396

PMID: 41857005

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Abstract

The association of long COVID with health-related quality-of-life (HrQOL) has not been well-characterized. Participants who received blinded placebo in the ACTIV-2/A5401 outpatient COVID-19 treatment trial were included in an analysis of the association of long COVID with HrQOL (both pre-specified exploratory trial endpoints) 9 months after acute COVID-19. Long COVID was defined as presence of self-assessed COVID-19 symptoms and HrQOL was assessed with EQ-5D-5L and SF-36v2 questionnaires. Associations were evaluated by Fisher's exact tests and Wilcoxon rank-sum tests. Of 546 participants, 13% had long COVID. Long COVID was associated with greater risk of reported problems in the EQ-5D-5L dimensions of mobility, usual activities, pain/discomfort, and anxiety/depression (risk ratios 3.45-6.00, all p < 0.001) and worse self-reported health scores (median 80 vs. 95, p < 0.001). Participants with long COVID also had worse SF-36v2 composite physical and mental component scores (both p < 0.001) and individual SF-36 domain scores (physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health; all p < 0.001). Associations were similar regardless of baseline (pre-COVID-19) medical history. Long COVID is associated with impaired HrQOL across multiple domains, highlighting the need to develop preventative and therapeutic interventions for this protean condition.

Quality of Life

Adult

Aged

Clinical Trials as Topic

COVID-19 - psychology

Depression

Female

Humans

Male

Middle Aged

Post-Acute COVID-19 Syndrome

SARS-CoV-2

Surveys and Questionnaires

Details

Title: Subtitle: Association of long COVID with health-related quality-of-life outcomes
Creators: Malini M Gandhi - Brigham and Women's Hospital
Carlee Moser - Harvard University
Judith S Currier - University of California, Los Angeles
Justin Ritz - Harvard University
Joseph J Eron - University of North Carolina at Chapel Hill
Eric S Daar - University of California, Los Angeles
David A Wohl - University of North Carolina at Chapel Hill
William A. Fischer II - University of North Carolina at Chapel Hill
Upinder Singh - University of Iowa
Michael D Hughes - Harvard University
Davey M Smith - University of California San Diego
Teresa H Evering - Weill Cornell Medicine
Kara W Chew - University of California, Los Angeles
ACTIV-2/A5401 Study Team
Resource Type: Journal article
Publication Details: Scientific reports, Vol.16(1), p.14229
DOI: 10.1038/s41598-026-36189-8
PMID: 41857005
PMCID: PMC13139396
NLM abbreviation: Sci Rep
ISSN: 2045-2322
eISSN: 2045-2322
Grant note: UM1 AI068636 / NIAID NIH HHS UM1 AI069534 / NIAID NIH HHS P30 AI152501 / NIAID NIH HHS UM1 AI069494 / NIAID NIH HHS UM1AI068634 / National Institute of Allergy and Infectious Diseases UM1 AI069424 / NIAID NIH HHS UM1 AI068634 / NIAID NIH HHS UM1 AI069419 / NIAID NIH HHS UM1AI068636 / National Institute of Allergy and Infectious Diseases
Language: English
Date published: 03/19/2026
Academic Unit: Internal Medicine
Record Identifier: 9985244657102771

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