Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID-19 infection: A six- to seven-month prospective cohort.

Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9207302 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2702 (Electronic) Linking ISSN: 09621067 NLM ISO Abbreviation: J Clin Nurs

Original Publication: Oxford ; Boston : Blackwell Scientific Publications, c1992-

Quality of Life*/psychology ; COVID-19*; Humans ; Longitudinal Studies ; Prospective Studies ; Dyspnea ; Cognition ; Muscle Weakness

Aims: To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.
Background: Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.
Design: A longitudinal cohort study.
Methods: In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6-7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.
Results: HRQoL was impaired in almost 60% of the sample and remained impaired 6-7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%-56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6-7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%-55%) remained impaired. Impaired HRQoL at 6-7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8-18.1)), PTSD (OR = 6.0 (1.7-20.7)) and impaired HRQoL (OR = 11.7 (3.7-36.8)).
Conclusion: A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.
Relevance to Clinical Practice: Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients' HRQoL from being impaired at 6-7 months after their reported recovery.
(© 2022 John Wiley & Sons Ltd.)

Aarden, J. J., Van Der Schaaf, M., Van Der Esch, M., Reichardt, L. A., Van Seben, R., Bosch, J. A., Twisk, J. W. R., Buurman, B. M., & Engelbert, R. H. H. (2019). Muscle strength is longitudinally associated with mobility among older adults after acute hospitalization: The Hospital-ADL study. PLoS One, 14(7), e0219041. https://doi.org/10.1371/journal.pone.0219041.
Anastasio, F., Barbuto, S., Scarnecchia, E., Cosma, P., Fugagnoli, A., Rossi, G., Parravicini, M., & Parravicini, P. (2021). Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life. European Respiratory Journal, 58(3), 2004015. https://doi.org/10.1183/13993003.04015-2020.
Badia, X., Roset, M., Montserrat, S., Herdman, M., & Segura, A. (1999). The Spanish version of EuroQol: A description and its applications. European Quality of Life scale. Medicina Clinica, 112(Suppl), 79-85.
Bellan, M., Soddu, D., Balbo, P. E., Baricich, A., Zeppegno, P., Avanzi, G. C., Baldon, G., Bartolomei, G., Battaglia, M., Battistini, S., Binda, V., Borg, M., Cantaluppi, V., Castello, L. M., Clivati, E., Cisari, C., Costanzo, M., Croce, A., Cuneo, D., … Pirisi, M. (2021). Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Network Open, 4(1), e2036142. https://doi.org/10.1001/jamanetworkopen.2020.36142.
Belli, S., Balbi, B., Prince, I., Cattaneo, D., Masocco, F., Zaccaria, S., Bertalli, L., Cattini, F., Lomazzo, A., Dal Negro, F., Giardini, M., Franssen, F. M. E., Janssen, D. J. A., & Spruit, M. A. (2020). Low physical functioning and impaired performance of activities of daily life in COVID-19 patients who survived hospitalisation. The European Respiratory Journal, 56(4), 2002096. https://doi.org/10.1183/13993003.02096-2020.
Bonazza, F., Borghi, L., di San Marco, E. C., Piscopo, K., Bai, F., d’Arminio Monforte, A., & Vegni, E. (2020). Psychological outcomes after hospitalization for COVID-19: Data from a multidisciplinary follow-up screening program for recovered patients. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(3), 247-255. https://doi.org/10.4081/ripppo.2020.491.
Carfì, A., Bernabei, R., & Landi, F. (2020). Persistent symptoms in patients after acute COVID-19. JAMA - Journal of the American Medical Association, 324(6), 603-605. https://doi.org/10.1001/jama.2020.12603.
Chang, M. C., & Park, D. (2020). Incidence of post-traumatic stress disorder after coronavirus disease. Healthcare, 8(4), 373. https://doi.org/10.3390/healthcare8040373.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (Vol. 18, Issue 2, pp. 131-132). Lawrence Erlbaum Associates Inc.
Constandt, B., Thibaut, E., De Bosscher, V., Scheerder, J., Ricour, M., & Willem, A. (2020). Exercising in times of lockdown: An analysis of the impact of COVID-19 on levels and patterns of exercise among adults in Belgium. International Journal of Environmental Research and Public Health, 17(11), 1-10. https://doi.org/10.3390/ijerph17114144.
Delgado, C., Araneda, A., & Behrens, M. I. (2019). Validation of the Spanish-language version of the Montreal Cognitive Assessment test in adults older than 60 years. Neurologia, 34(6), 376-385. https://doi.org/10.1016/j.nrl.2017.01.013.
Disser, N. P., De Micheli, A. J., Schonk, M. M., Konnaris, M. A., Piacentini, A. N., Edon, D. L., Toresdahl, B. G., Rodeo, S. A., Casey, E. K., & Mendias, C. L. (2020). Musculoskeletal consequences of COVID-19. Journal of Bone and Joint Surgery, 102(14), 1197-1204. https://doi.org/10.2106/JBJS.20.00847.
Esakandari, H., Nabi-Afjadi, M., Fakkari-Afjadi, J., Farahmandian, N., Miresmaeili, S. M., & Bahreini, E. (2020). A comprehensive review of COVID-19 characteristics. Biological Procedures Online, 22(1), 19. https://doi.org/10.1186/s12575-020-00128-2.
EuroQol Research Foundation. (2018). EQ-5D-3L user guide. https://euroqol.org/publications/user-guides.
Fusco, O., Ferrini, A., Santoro, M., Lo Monaco, M. R., Gambassi, G., & Cesari, M. (2012). Physical function and perceived quality of life in older persons. Aging Clinical and Experimental Research, 24(1), 68-73. https://doi.org/10.1007/BF03325356.
Gibson, G. J., Whitelaw, W., Siafakas, N., Supinski, G. S., Fitting, J. W., Bellemare, F., Loring, S. H., Troyer, A. D., & Grassino, A. E. (2002). ATS/ERS Statement on respiratory muscle testing. American Journal of Respiratory and Critical Care Medicine, 166(4), 518-624. https://doi.org/10.1164/rccm.166.4.518.
González, J., Benítez, I. D., Carmona, P., Santisteve, S., Monge, A., Moncusí-Moix, A., Gort-Paniello, C., Pinilla, L., Carratalá, A., Zuil, M., Ferrer, R., Ceccato, A., Fernández, L., Motos, A., Riera, J., Menéndez, R., Garcia-Gasulla, D., Peñuelas, O., Bermejo-Martin, J. F., … Barbé, F. (2021). pulmonary function and radiological features in survivors of critical COVID-19: A 3-month prospective cohort. Chest, 160(1), 187-198. https://doi.org/10.1016/j.chest.2021.02.062.
Hernandez, G., Garin, O., Dima, A. L., Pont, A., Pastor, M. M., Alonso, J., Van Ganse, E., Laforest, L., De Bruin, M., Mayoral, K., Serra-Sutton, V., & Ferrer, M. (2019). EuroQol (EQ-5D-5L) validity in assessing the quality of life in adults with asthma: Cross-sectional study. Journal of Medical Internet Research, 21(1), e10178. https://doi.org/10.2196/10178.
Herrero, M. J., Blanch, J., Peri, J. M., De Pablo, J., Pintor, L., & Bulbena, A. (2003). A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. General Hospital Psychiatry, 25(4), 277-283. https://doi.org/10.1016/S0163-8343(03)00043-4.
Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., Kang, L., Guo, L. I., Liu, M., Zhou, X., Luo, J., Huang, Z., Tu, S., Zhao, Y., Chen, L. I., Xu, D., Li, Y., Li, C., Peng, L. U., … Cao, B. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: A cohort study. The Lancet, 397(10270), 220-232. https://doi.org/10.1016/S0140-6736(20)32656-8.
Huang, Y., Tan, C., Wu, J., Chen, M., Wang, Z., Luo, L., Zhou, X., Liu, X., Huang, X., Yuan, S., Chen, C., Gao, F., Huang, J., Shan, H., & Liu, J. (2020). Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase. Respiratory Research, 21(1), 163. https://doi.org/10.1186/s12931-020-01429-6.
König, H. H., Bernert, S., Angermeyer, M. C., Matschinger, H., Martinez, M., Vilagut, G., Haro, J. M., De Girolamo, G., De Graaf, R., Kovess, V., & Alonso, J. (2009). Comparison of population health status in six European countries results of a representative survey using the EQ-5D questionnaire. Medical Care, 47(2), 255-261. https://doi.org/10.1097/MLR.0b013e318184759e.
Lamprecht, B. (2020). Is there a post-COVID syndrome? Pneumologe, 17(6), 398-405. https://doi.org/10.1007/s10405-020-00347-0.
Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R., Azman, A. S., Reich, N. G., & Lessler, J. (2020). The incubation period of coronavirus disease 2019 (CoVID-19) from publicly reported confirmed cases: Estimation and application. Annals of Internal Medicine, 172(9), 577-582. https://doi.org/10.7326/M20-0504.
Long, J. S. (1997). Regression models for categorical and limited dependent variables. SAGE Publications.
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology, 77(6), 683-690. https://doi.org/10.1001/jamaneurol.2020.1127.
Mateo Lázaro, M. L., Penacho Lázaro, M. A., Berisa Losantos, F., & Plaza Bayo, A. (2008). New tables on hand strength in the adult population from Teruel. Nutricion Hospitalaria, 23(1), 35-40.
Mazza, M. G., De Lorenzo, R., Conte, C., Poletti, S., Vai, B., Bollettini, I., Melloni, E. M. T., Furlan, R., Ciceri, F., Rovere-Querini, P., & Benedetti, F. (2020). Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain, Behavior, and Immunity, 89, 594-600. https://doi.org/10.1016/j.bbi.2020.07.037.
Meys, R., Delbressine, J. M., Goërtz, Y. M. J., Vaes, A. W., Machado, F. V. C., Van Herck, M., Burtin, C., Posthuma, R., Spaetgens, B., Franssen, F. M. E., Spies, Y., Vijlbrief, H., van’t Hul, A. J., Janssen, D. J. A., Spruit, M. A., & Houben-Wilke, S. (2020). Generic and respiratory-specific quality of life in non-hospitalized patients with COVID-19. Journal of Clinical Medicine, 9(12), 3993. https://doi.org/10.3390/jcm9123993.
Miles, J. N. V., Marshall, G. N., & Schell, T. L. (2008). Spanish and English versions of the PTSD Checklist-Civilian Version (PCL-C): Testing for differential item functioning. Journal of Traumatic Stress, 21(4), 369-376. https://doi.org/10.1002/jts.20349.
Miller, M. R., Crapo, R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Enright, P., van der Grinten, C. P. M., Gustafsson, P., Jensen, R., Johnson, D. C., MacIntyre, N., McKay, R., Navajas, D., Pedersen, O. F., Pellegrino, R., Viegi, G., Wanger, J., & ATS/ERS Task Force. (2005). General considerations for lung function testing. The European Respiratory Journal, 26(1), 153-161. https://doi.org/10.1183/09031936.05.00034505.
Miskowiak, K. W., Johnsen, S., Sattler, S. M., Nielsen, S., Kunalan, K., Rungby, J., Lapperre, T., & Porsberg, C. M. (2021). Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 46, 39-48. https://doi.org/10.1016/j.euroneuro.2021.03.019.
Morales, P., Sanchis, J., Cordero, P. J., & Díez, J. L. (1997). Maximum static respiratory pressures in adults. Reference values for a Caucasian Mediterranean population. Archivos De Bronconeumologia, 33(5), 213-219. https://doi.org/10.1016/s0300-2896(15)30609-8.
Nunes, M. D. R., Jacob, E., Bomfim, E. O., Lopes-Junior, L. C., de Lima, R. A. G., Floria-Santos, M., & Nascimento, L. C. (2017). Fatigue and health related quality of life in children and adolescents with cancer. European Journal of Oncology Nursing, 29, 39-46. https://doi.org/10.1016/j.ejon.2017.05.001.
Núñez-Cortés, R., Rivera-Lillo, G., Arias-Campoverde, M., Soto-García, D., García-Palomera, R., & Torres-Castro, R. (2021). Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19. Chronic Respiratory Disease, 18. https://doi.org/10.1177/1479973121999205.
Pascarella, G., Strumia, A., Piliego, C., Bruno, F., Del Buono, R., Costa, F., Scarlata, S., & Agrò, F. E. (2020). COVID-19 diagnosis and management: A comprehensive review. Journal of Internal Medicine, 288(2), 192-206. https://doi.org/10.1111/joim.13091.
Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology, 49(12), 1373-1379. https://doi.org/10.1016/S0895-4356(96)00236-3.
Peolsson, A., Hedlund, R., & Oberg, B. (2001). Intra- and inter-tester reliability and reference values for hand strength. Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine, 33(1), 36-41. https://doi.org/10.1080/165019701300006524.
Qi, R., Chen, W., Liu, S., Thompson, P. M., Zhang, L. J., Xia, F., Cheng, F., Hong, A., Surento, W., Luo, S., Sun, Z. Y., Zhou, C. S., Li, L., Jiang, X., & Lu, G. M. (2020). Psychological morbidities and fatigue in patients with confirmed COVID-19 during disease outbreak: Prevalence and associated biopsychosocial risk factors. MedRxiv. https://doi.org/10.1101/2020.05.08.20031666.
Qu, G., Zhen, Q. I., Wang, W., Fan, S., Wu, Q., Zhang, C., Li, B., Liu, G., Yu, Y., Li, Y., Yong, L., Lu, B., Ding, Z., Ge, H., Mao, Y., Chen, W., Xu, Q., Zhang, R., Cao, L. U., … Sun, Y. (2021). Health-related quality of life of COVID-19 patients after discharge: A multicenter follow-up study. Journal of Clinical Nursing, 30(11-12), 1742-1750. https://doi.org/10.1111/jocn.15733.
Raman, B., Cassar, M. P., Tunnicliffe, E. M., Filippini, N., Griffanti, L., Alfaro-Almagro, F., Okell, T., Sheerin, F., Xie, C., Mahmod, M., Mózes, F. E., Lewandowski, A. J., Ohuma, E. O., Holdsworth, D., Lamlum, H., Woodman, M. J., Krasopoulos, C., Mills, R., McConnell, F. A. K., … Neubauer, S. (2021). Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine, 31, 100683. https://doi.org/10.1016/j.eclinm.2020.100683.
Rass, V., Beer, R., Josef Schiefecker, A., Kofler, M., Lindner, A., Mahlknecht, P., Heim, B., Limmert, V., Sahanic, S., Pizzini, A., Sonnweber, T., Tancevski, I., Loeffler-Ragg, J., Scherfler, C., Zamarian, L., Bellmann-Weiler, R., Weiss, G., Djamshidian, A., Kiechl, S., … Helbok, R. (2021). Neurological outcome and quality of life three months after COVID-19: A prospective observational cohort study. European Journal of Neurology, 28(10), 3348-3359. https://doi.org/10.1111/ene.14803.
Ritchie, C., Hendrikz, J., Jull, G., Elliott, J., & Sterling, M. (2015). External validation of a clinical prediction rule to predict full recovery and ongoing moderate/severe disability following acute whiplash injury. Journal of Orthopaedic and Sports Physical Therapy, 45(4), 242-250. https://doi.org/10.2519/jospt.2015.5642.
Ritchie, C., Hendrikz, J., Kenardy, J., & Sterling, M. (2013). Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury. Pain, 154(10), 2198-2206. https://doi.org/10.1016/j.pain.2013.07.001.
Saraçli, Ö., Akca, A. S. D., Atasoy, N., Önder, Ö., Senormanci, Ö., Kaygisiz, I., & Atik, L. (2015). The relationship between quality of life and cognitive functions, anxiety and depression among hospitalized elderly patients. Clinical Psychopharmacology and Neuroscience, 13(2), 194-200. https://doi.org/10.9758/cpn.2015.13.2.194.
Singer, S., Kuhnt, S., Götze, H., Hauss, J., Hinz, A., Liebmann, A., Krauß, O., Lehmann, A., & Schwarz, R. (2009). Hospital anxiety and depression scale cutoff scores for cancer patients in acute care. British Journal of Cancer, 100(6), 908-912. https://doi.org/10.1038/sj.bjc.6604952.
Storm van's Gravesande, K., Blaschek, A., Calabrese, P., Rostásy, K., Huppke, P., Kessler J, J., Kalbe, E., & Mall, V. (2019). Fatigue and depression predict health-related quality of life in patients with pediatric-onset multiple sclerosis. Multiple Sclerosis and Related Disorders, 36, 101368. https://doi.org/10.1016/j.msard.2019.08.010.
Strassmann, A., Steurer-Stey, C., Lana, K. D., Zoller, M., Turk, A. J., Suter, P., & Puhan, M. A. (2013). Population-based reference values for the 1-min sit-to-stand test. International Journal of Public Health, 58(6), 949-953. https://doi.org/10.1007/s00038-013-0504-z.
Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science Science, 240(4857), 1285-1293. https://doi.org/10.1126/science.3287615.
Szende, A., Janssen, B., & Cabasés, J. (2014). Self-reported population health: An international perspective based on EQ-5D. Springer. https://doi.org/10.1007/978-94-007-7596-1.
Szentes, B. L., Schultz, K., Nowak, D., Schuler, M., & Schwarzkopf, L. (2020). How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? BMC Pulmonary Medicine, 20(1), 168. https://doi.org/10.1186/s12890-020-01205-8.
Taquet, M., Geddes, J. R., Husain, M., Luciano, S., & Harrison, P. J. (2021). 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry, 8(5), 416-427. https://doi.org/10.1016/S2215-0366(21)00084-5.
Tarsitani, L., Vassalini, P., Koukopoulos, A., Borrazzo, C., Alessi, F., Di Nicolantonio, C., Serra, R., Alessandri, F., Ceccarelli, G., Mastroianni, C. M., & d’Ettorre, G. (2021). Post-traumatic stress disorder among COVID-19 survivors at 3-month follow-up after hospital discharge. Journal of General Internal Medicine, 36(6), 1702-1707. https://doi.org/10.1007/s11606-021-06731-7.
Thiese, M. S., Ronna, B., & Ott, U. (2016). P value interpretations and considerations. Journal of Thoracic Disease, 8(9), E928-E931. https://doi.org/10.21037/jtd.2016.08.16.
Turner, D., Schünemann, H. J., Griffith, L. E., Beaton, D. E., Griffiths, A. M., Critch, J. N., & Guyatt, G. H. (2009). Using the entire cohort in the receiver operating characteristic analysis maximizes precision of the minimal important difference. Journal of Clinical Epidemiology, 62(4), 374-379. https://doi.org/10.1016/j.jclinepi.2008.07.009.
van der Sar - van der Brugge, S., Talman, S., Boonman - de Winter, L., de Mol, M., Hoefman, E., van Etten, R. W., & De Backer, I. C. (2021). Pulmonary function and health-related quality of life after COVID-19 pneumonia. Respiratory Medicine, 176, 106272. https://doi.org/10.1016/j.rmed.2020.106272.
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. Journal of Clinical Epidemiology, 61(4), 344-349. https://doi.org/10.1016/j.jclinepi.2007.11.008.
Walle-Hansen, M. M., Ranhoff, A. H., Mellingsaeter, M., Wang-Hansen, M. S., & Myrstad, M. (2021). Health-related quality of life, functional decline, and long-term mortality in older patients following hospitalisation due to COVID-19. BMC Geriatrics, 21(1), 199. https://doi.org/10.1186/s12877-021-02140-x.
Willi, S., Lüthold, R., Hunt, A., Hänggi, N. V., Sejdiu, D., Scaff, C., Bender, N., Staub, K., & Schlagenhauf, P. (2021). COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Medicine and Infectious Disease, 40, 101995. https://doi.org/10.1016/j.tmaid.2021.101995.
Wong, A. W., Shah, A. S., Johnston, J. C., Carlsten, C., & Ryerson, C. J. (2020). Patient-reported outcome measures after COVID-19: A prospective cohort study. European Respiratory Journal, 56(5), 2003276. https://doi.org/10.1183/13993003.03276-2020.
Yeager, D. E., Magruder, K. M., Knapp, R. G., Nicholas, J. S., & Frueh, B. C. (2007). Performance characteristics of the posttraumatic stress disorder checklist and SPAN in veterans affairs primary care settings. General Hospital Psychiatry, 29(4), 294-301. https://doi.org/10.1016/j.genhosppsych.2007.03.004.
Yuan, B., Li, W., Liu, H., Cai, X., Song, S., Zhao, J., Hu, X., Li, Z., Chen, Y., Zhang, K., Liu, Z., Peng, J., Wang, C., Wang, J., & An, Y. (2020). Correlation between immune response and self-reported depression during convalescence from COVID-19. Brain, Behavior, and Immunity, 88, 39-43. https://doi.org/10.1016/j.bbi.2020.05.062.
Zheng, Z., Yao, Z., Wu, K., & Zheng, J. (2020). Patient follow-up after discharge after COVID-19 pneumonia: Considerations for infectious control. Journal of Medical Virology, 92(11), 2412-2419. https://doi.org/10.1002/jmv.25994.

Keywords: COVID-19; health-related quality of life; long-term; physical function; psychological status; pulmonary function

Date Created: 20220510 Date Completed: 20240110 Latest Revision: 20240110

20240110

PMC9348063

10.1111/jocn.16352

35534994