Evaluation of health-related quality of life using EQ-5D in China during the COVID-19 pandemic

Big Five Personality Traits and Predicting Mental Health among Iranian Older Adults

Aging has been a major issue for experts, policymakers, and even the general public in recent years. There is a growing body of evidence highlighting the role of personality traits in the health of older adults, but this evidence is still in its infancy. This study aimed to investigate the role of the big five personality traits in predicting the mental health among older adults. In this cross-sectional study, 150 community-residing older adults were selected and completed the Ten Item Personality Inventory, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Short-Form Health Survey. According to the results, extraversion and openness to experience can explain 11% of the variances of hope, extraversion and conscientiousness account for 16% of the variances in perceived social support, and all the big five personality traits together predict 34% of the variances in the health-related quality of life. Given the role of personality traits in predicting the mental health of older adults, counselors and psychologists working with these people can pay attention to the personality traits of older adults in designing their psychological, educational, and research programs to achieve more desirable outcomes.

Quality of Life in COVID-19 Outpatients: A Long-Term Follow-Up Study

Background: The long-term issues faced by COVID-19 survivors remain unclear. Symptoms may persist for several months, even in non-hospitalized patients, probably impacting the quality of life. Objective: To assess the health-related quality of life of outpatients one year after SARS-CoV-2 infection. Design, Settings, and Participants: This prospective multicentre study, conducted in France from February 2020 to February 2022, compared 150 COVID-19 cases (PCR+ and/or CT scan+) and 260 controls (PCR-) selected from a database of four COVID centres. Main outcomes: Health-related quality of life assessed using the EQ-5D-5L scale. Results: COVID-19 outpatients (n = 96) had significantly lower health-related quality of life than controls (n = 81) one year after SARS-CoV-2 infection: the EQ-5D-5L index averaged 0.87 in cases and 0.95 in controls (p = 0.002); the EQ- VAS averaged 78 in cases and 86.7 in controls (p < 0.001). This alteration in quality of life was more intense in the areas of pain or discomfort and daily activities. Conclusions: This study is the first to show an alteration in the quality of life of COVID-19 outpatients after one year. Appropriate guidance and community rehabilitation programs are required for outpatients with persistent symptoms of COVID-19. Research must continue to confirm these results in larger cohorts.

Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study

This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.

Health-Related Quality of Life and Associated Factors Among Covid-19 Survivors. Experience from Ethiopian Treatment Centers

Background

The pandemic of the novel coronavirus (Covid-19), which is extremely stressful and has an adverse effect on people's health-related quality of life (HRQoL), poses a serious threat to global public health. As a result, this study evaluated the health-related quality of life and associated factors among Covid-19 patients who were discharged from Ethiopian treatment centers.

Methods

We conducted a multi-center, cross-sectional study among 493 Covid-19 survivors who had been discharged from treatment centers between 1st January 2020, and 20th October 2021. We collected respondents' data using validated Amharic version EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients. Differences in HRQOL scores between patient subgroups were tested by Mann-Whitney U or Kruskal-Wallis test, and the multivariable betaMix regression was used to investigate factors associated with HRQOL scores.

Results

The EQ-5D and VAS median score for Covid-19 survivors was 0.940 (IQR: 0.783-0.966) and 87 (IQR: 70-91) respectively. Overall, married individuals, old-aged, individuals who had low educational status, high monthly income, comorbidities, admitted to the Intensive care Unit, received intranasal oxygen care, and prolonged hospitalization had lower utility scores and EQ-VAS scores compared to their counterparts. In multivariate betaMix regression, respondents' health status at admission, old age, chronic obstructive pulmonary disease, asthma, and hospital length of stay were significantly associated with the lower EQ-5D-Index value and EQ-VAS score.

Conclusion

We found that Covid-19 infection had a persisting impact on the physical and psychosocial health of Covid-19 survivors. Age, having asthma and chronic obstructive pulmonary disease, having a worsening health state upon admission, and a prolonged hospital length of stay were significantly associated with the lower EQ-5D and EQ-VAS score. Therefore, the cost-effective psychological treatment such as cognitive behaviour therapy should be encouraged after hospitalization to improve the post-Covid-19 depression and fatigue.

Quarantining: a mentally distressful but physically comfortable experience in South Korea

Objective

Quarantine is the first response to the COVID-19 pandemic. Restricting daily life can cause several problems. This study aimed to measure the impact of the COVID-19 quarantine on health-related quality of life (HRQoL) by comparing to the pre-pandemic.

Methods

HRQoL during COVID-19 quarantine was surveyed online using EQ-5D index and matched to that of the pre-pandemic-extracted from nationwide representative data of the Korea Community Health Survey- with propensity scores. A beta regression for the EQ-5D scores and a logistic analysis for individual dimensions of the EQ-5D index were performed to measure the impact of the COVID-19 quarantine on health utility.

Results

The overall scores of the EQ-5D index were significantly higher in the group under quarantine during the COVID-19 pandemic (0.971 SD 0.064) than those before the pandemic (0.964 SD 0.079, Diff. 0.007 SD 0.101, p = 0.043). The beta regression for the overall scores of EQ-5D revealed that quarantining during the COVID-19 pandemic increased by 52.7% compared to normal life before the outbreak(p = 0.045). Specifically, “Depression/Anxiety” deteriorated significantly during quarantining (OR = 0.62, 95% CI:0.48–0.80). However, “Pain/Discomfort” and “Mobility” significantly improved (OR = 5.37, 95% CI:3.71–7.78 and OR = 2.05, 95% CI:1.11–3.80, respectively).

Conclusion

Although the world is facing a challenging moment that it has never been through before, mandatory quarantine has served as an experience that provided mental distress but physical comfort in the Korean context.

Impact of the COVID-19 lockdown on patient-reported outcome measures in Dutch hip and knee arthroplasty patients

BACKGROUND AND PURPOSE

During the first COVID-19 lockdown elective surgery was greatly reduced. Prioritization of patients with greater need and expected benefit in terms of quality of life was advised. The lockdown also potentially affected follow-up outcomes. Therefore, our study compared patient-reported outcome measures (PROMs) retrieved during the lockdown of Dutch primary total hip and knee arthroplasty (THA, TKA) patients with previous years.

PATIENTS AND METHODS

We performed cross-sectional analyses using national data from the Dutch Orthopaedic Registry (LROI). All primary elective THA and TKA patients with preoperative or postoperative PROMs (EQ-5D-3L index, OHS/OKS) during the first COVID-19 lockdown between March and July 15, 2020 were included. Patients with PROMs during the same months in 2018 plus 2019 were used as control. Finally, 33,453 THA and 27,335 TKA patients were included. Patient characteristics were compared during versus before the lockdown. Subsequently, the lockdown effect on PROMs scores was analyzed with multivariable linear regression.

RESULTS

During the COVID-19 lockdown, THA and TKA patients had a lower age and BMI preoperatively, and more often had surgery in private clinics. Both preoperative PROMs in THA patients, but not in TKA patients, were worse (EQ-5D: Adjusted mean difference (AMD) -0.021, p < 0.001) during the lockdown compared with prior years. Both postoperative PROMs in THA and TKA patients were better during the lockdown (12-month EQ-5D in THA: AMD 0.010, p = 0.003; and in TKA: AMD 0.013, p < 0.001).

INTERPRETATION

During the COVID-19 lockdown, THA patients had slightly worse preoperative PROMs, suggesting selection of patients with greater urgency. Postoperative PROMs in both THA and TKA patients differed minimally. Overall, the observed differences were likely not clinically relevant.

Feasibility and acceptability of electronic EQ-5D-5L for routine measurement of HRQOL in patients with chronic musculoskeletal problems in Hong Kong primary care

BACKGROUND

Information on HRQOL can enhance patient diagnosis and management but it is rarely available in routine clinical practice. This mixed-method study evaluated the feasibility and acceptability of the electronic EQ-5D-5L measurement of HRQOL in patients with chronic musculoskeletal problems in primary care.

METHODS

In three primary care clinics, 665 patients with musculoskeletal problems completed the electronic EQ-5D-5L and Visual Analogue Scale (e-EQ-5D-5L/VAS), and a questionnaire on socio-demographics, perceived ease of use (PEOU), and perceived usefulness (PU) at baseline and two follow-ups. Patient completion and response rates, and time to complete the e-EQ-5D-5L/VAS were measured. During the same consultations, 49 doctors reviewed the e-EQ-5D-5L/VAS reports and completed a clinician questionnaire on PEOU, PU, and time spent to address each report. Individual interviews along with focus group discussions were conducted on patients, doctors, and research assistants for further exploration.

RESULTS

Mean completion time reduced from baseline to first and second follow-up (120.66, 83.99, and 105.22 s, respectively). Completion and response rates were high at each follow-up visit (> 99.8% and > 91.11%, respectively). Doctors needed less than 2 min to read the report but felt the time required to address the report was a significant barrier. Some patients had difficulties using e-platforms, in understanding or answering questions; but, PEOU improved with time (p < 0.001). Most patients found the e-platforms useful (> 85.3%). Clinicians agreed a great majority of the reports were easy to use (76.0-85.1%) and useful (69.2-72.0%), particularly aiding with a holistic view of the patient's musculoskeletal problem.

CONCLUSION

The e-EQ-5D-5L/VAS is a feasible and acceptable measurement of HRQOL of patients with chronic musculoskeletal problems in routine primary care in Hong Kong which can assist real-time management decisions.

TRIAL REGISTRATION

NCT03609762.

How do face masks impact communication amongst deaf/HoH people?

Face coverings have been key in reducing the spread of COVID-19. At the same time, they have hindered interpersonal communication, particularly for those who rely on speechreading to aid communication. The available research indicated that deaf/hard of hearing (HoH) people experienced great difficulty communicating with people wearing masks and negative effects on wellbeing. Here we extended these findings by exploring which factors predict deaf/HoH people’s communication difficulties, loss of information, and wellbeing. We also explored the factors predicting perceived usefulness of transparent face coverings and alternative ways of communicating. We report the findings from an accessible survey study, released in two written and three signed languages. Responses from 395 deaf/HoH UK and Spanish residents were collected online at a time when masks were mandatory. We investigated whether onset and level of deafness, knowledge of sign language, speechreading fluency, and country of residence predicted communication difficulties, wellbeing, and degree to which transparent face coverings were considered useful. Overall, deaf/HoH people and their relatives used masks most of the time despite greater communication difficulties. Late-onset deaf people were the group that experienced more difficulties in communication, and also reported lower wellbeing. However, both early- and late-onset deaf people reported missing more information and feeling more disconnected from society than HoH people. Finally, signers valued transparent face shields more positively than non-signers. The latter suggests that, while seeing the lips is positive to everyone, signers appreciate seeing the whole facial expression. Importantly, our data also revealed the importance of visual communication other than speechreading to facilitate face-to-face interactions.

Late-onset deaf people experienced more difficulties in communication and low wellbeing.

Severely/profoundly deaf people missed more information and felt disconnected from society.

Signers preferred completely transparent face coverings.

More frequent use of masks doesn’t necessarily imply more difficulty communicating.

Visual communication, pro-social behaviour, and societal structure might help easing communication.

The effect of the COVID-19 pandemic on the health-related quality of life in home-based patients with spinal cord injuries in Japan

CONTEXT

The COVID-19 pandemic has forced people to maintain social distance and to refrain from going out. As a result, home-based patients with spinal cord injuries (SCI) are not only less able to go out, but they may have difficulty in easily receiving long-term care services. There are concerns that their health-related quality of life (HRQOL) may have deteriorated. We aimed to clarify the effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI.In June 2020, when the COVID-19 pandemic was finally settling down in Japan, we conducted a mail survey of 266 patients with SCI regarding changes in the frequency of going out, the long-term care services, and their HRQOL due to the COVID-19 pandemic. They had all been discharged from our hospital (Rehabilitation medical center) by 2019, and were expected to be living at home. We received answers from 135 patients about their HRQOL.

FINDINGS

Respondent characteristics indicated that many of them were elderly (74.1% were over 60 years of age) and many had cervical SCI (70.5%). Worsened HRQOL since the impact of the COVID-19 pandemic was reported by 40% of respondents. The most commonly reported dimension was pain/discomfort. Significantly, many had been injured comparatively recently and had reduced frequency of going out and receiving home-visit nursing or rehabilitation services than patients whose HRQOL was unchanged.

CONCLUSION/ CLINICAL RELEVANCE

This study clarifies the negative effect of the COVID-19 pandemic on HRQOL in home-based patients with SCI. Many respondents had worsened HRQOL, in particular pain/discomfort. It was suggested that the decrease in the frequency of going out may be one of the factors that affected the deterioration of their HRQOL.

Vulnerable populations during COVID-19 response: Health-related quality of life among Chinese population and its influence due to socio-demographic factors and loneliness

Background

Infection control policy affected people's wellbeing during the COVID-19 pandemic, especially those vulnerable populations. This study aimed to compare the health-related quality of life (HRQoL) of the Hong Kong (HK) Chinese population under the pandemic with the normative profiles and explore its influencing factors, including socio-demographic characteristics, loneliness, and the interaction between them.

Methods

A cross-sectional questionnaire survey (301 online and 202 in-person) was conducted between June and December 2020 among the adult Chinese population during the 2nd wave of COVID-19 in HK. HRQoL was measured by a Hong Kong validated EQ-5D-5L instrument (EQ-5D-5L HK). Loneliness was measured by a single-item question regarding the frequency of the participants reporting feeling lonely and their subjective social status was measured by the MacArthur Scale of Subjective Social Status. A series of Tobit regressions was conducted. The interaction terms between socio-demographics and loneliness were also examined to decide their association with HRQoL.

Results

A total of 503 responses were collected. The level of HRQoL of the respondents was significantly lower than the referred norms profile among the local general population. The findings identified that younger age, single, a higher subjective social status, and a lower level of loneliness were significantly associated with better HRQoL. Moreover, age and marital status were significant moderators in the relationship between loneliness and HRQoL.

Conclusion

The present study found that some population groups face additional vulnerabilities during the pandemic in terms of declined HRQoL. In addition, reducing loneliness can protect the HRQoL during the pandemic, especially among older people. This article provides useful information for policy-makers to design and promote effective services or provide education to improve the connection of people and recover from the global pandemic.

Health-Related Quality of Life and Its Socio-Demographic and Behavioural Correlates during the COVID-19 Pandemic in Estonia

The aim of the study was to analyse health-related quality of life (HRQoL) among the Estonian general population and its socio-demographic and behavioural correlates during the COVID-19 pandemic. Longitudinal data on 1781 individuals from an Estonian rapid-assessment survey on COVID-19 were used. HRQoL was assessed with the EQ-5D-3L in June 2020 (baseline) and in May 2021 (follow-up). The HRQoL index score and its socio-demographic and behavioural variations were analysed using paired t-tests and Tobit regression modelling. Statistically significant declines in mean EQ-5D index scores were observed for all socio-demographic and behavioural variables considered. Most of these changes were due to increased reporting of problems in the pain/discomfort and anxiety/depression health domains. Older age, being unemployed or economically non-active and having financial difficulties were significantly associated with lower HRQoL in both baseline and follow-up measurements. In the follow-up data, women had significantly lower HRQoL compared to men, whereas higher education proved to be the only protective factor regarding HRQoL. Unhealthy dietary habits and low physical activity had a negative impact on the HRQoL score in the follow-up data. These results indicate that the COVID-19 pandemic has had a substantial impact on HRQoL in the Estonian population.

Health-Related Quality of Life and Depressive Symptomatology in High School Students during the Lockdown Period Due to SARS-CoV-2

The objectives of this study were to evaluate and compare the prevalence of health-related quality of life and depressive symptomatology in high school students during the lockdown period due to the SARS-CoV-2 pandemic. A cross-sectional survey was conducted with students attending the High School Education System of the University of Guadalajara, Jalisco, México. Through a Google Forms survey, students answered their perceptions of health-related quality of life and depressive symptomatology. The outcome variable was the presence of depressive symptoms, assessed using the Children’s Depression Inventory (CDI). Cronbach’s alpha coefficient was 0.8 in both surveys. A total of 1446 students participated (women, 64.9%; mean age of 16.1 ± 0.9 years). Among the students, 22% manifested clinical depressive symptoms (24.4 ± 5.0), and males showed lower scores on health-related quality of life and depressive symptoms (44.9 ± 11.9, p = 0.005) (12 ± 7.7, p = <0.001) compared to their female peers (45.2 ± 10.6, p = 0.005) (13.7 ± 7.5, p = <0.001), respectively. During the lockdown due to the SARS-CoV-2 pandemic, a high prevalence of depressive symptomatology was identified in our students with in addition to a low perception of health-related quality of life in dimensions, mood and emotions, and peers and social support.

Predictive factors of Quality of Life in older adults during the COVID-19 pandemic

BACKGROUND

Given the vulnerability of older people to COVID-19, it is important to consider their physical and mental wellbeing and quality of life (QoL) in the COVID-19 pandemic. Therefore, the present study was aimed to identify the QoL and its predictive factors among a sample of Iranian older adults during the COVID-19 pandemic.

METHODS

This descriptive and cross-sectional study was conducted on 500 older people residing in Qazvin, Iran, from May 22th to November 21rd, 2021. Multistage cluster sampling method was used for selecting the eligible older adults. Data were collected using the demographic checklist, fear of COVID-19 scale, and Elderly Quality of Life Questionnaire (LIPAD). The multivariate regression model was used for determining the predictive factors of QoL in older people.

RESULTS

The mean age of older participants was 69.17 ± 6.75 years old. The results of multivariate regression model showed that fear of COVID-19, age, marital status, level of education, living arrangement, and economic situation were the significant predictors of QoL in the older adults during the COVID-19 pandemic.

CONCLUSIONS

It is recommended to pay close attention to divorced, lonely, and illiterate older people and those with low economic situation during the COVID-19 pandemic.

Clinical characteristics and quality of life of persistent symptoms of COVID-19 syndrome in Indonesia

Introduction

Coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) manifests in a broad clinical spectrum. COVID-19 survivors report various symptoms up to several months after being infected. The purpose of this study was to determine the prevalence of persistent COVID-19 syndrome in Indonesia, the factors that influence the incidence, and the quality of life.

Methods

This was a cross-sectional study with an online questionnaire conducted in January 2021. Inclusion criteria were: adult Indonesian citizens who had recovered from COVID-19, and were confirmed negative by RT-PCR of nasal swabs or had undergone an isolation period for a minimum of 14 days. Data analysis was performed by the Chi-square test, followed by multivariate analysis with the backward likelihood ratio method.

Results

From a total of 385 respondents, 256 (66.5%) experienced persistent COVID-19 syndrome. The most prevalent symptoms were fatigue (29.4%), cough (15.5%), and muscle pain (11.2%). Of the five aspects of quality of life, the most commonly reported aspects were pain/discomfort and anxiety/depression. The risk of persistent COVID-19 syndrome was significantly higher in subjects with older age, comorbidities, higher clinical severity, previous treatment in hospital, presence of pneumonia, and those who had required oxygen therapy. In the multivariate analysis, the most influential factor for the incidence of persistent COVID-19 syndrome was pneumonia (aOR 2.31, 95% CI 1.29-4.11, p<0.002).

Conclusions

The prevalence of the persistent COVID-19 syndrome in Indonesia was high, which affects the quality of life of COVID-19 survivors. Pneumonia was the main factor that influenced the incidence of persistent COVID-19 syndrome. Further research with a larger sample size and a longer study time is recommended to control COVID-19 and its impact on the health and quality of life of COVID-19 survivors.

Understanding the Needs and Priorities of People Living with Persistent Pain and Long-Term Musculoskeletal Conditions during the COVID-19 Pandemic-A Public Involvement Project

BACKGROUND

Critiques of public involvement (PI) are associated with failing to be inclusive of under-represented groups, and this leads to research that fails to include a diversity of perspectives.

AIM

The aim of this PI project was to understand the experiences and priorities of people from three seldom-heard groups whose musculoskeletal pain may have been exacerbated or treatment delayed due to COVID-19. Engaging representatives to report diverse experiences was important, given the goal of developing further research into personalised and integrated care and addressing population health concerns about access and self-management for people with musculoskeletal pain.

METHODS

The project was approved via Sheffield Hallam University Ethics but was exempt from further HRA approval. A literature review was conducted, followed by informal individual and group discussions involving professionals and people with lived experience of (a) fibromyalgia pain, (b) those waiting for elective surgery and (c) experts associated with the care home sector. Findings from the literature review were combined with the insights from the public involvement. Resulting narratives were developed to highlight the challenges associated with persistent pain and informed the creation of consensus statements on the priorities for service improvement and future research. The consensus statements were shared and refined with input from an expert steering group.

RESULTS

The narratives describe pain as a uniformly difficult experience to share with professionals; it is described as exhausting, frustrating and socially limiting. Pain leads to exclusion from routine daily activities and often resigns people to feeling and being unwell. In all cases, there are concerns about accessing and improving services and critical issues associated with optimising physical activity, functional wellbeing and managing polypharmacy. Exercise and/or mobilisation are important and commonly used self-management strategies, but opportunity and advice about safe methods are variable. Services should focus on personalised care, including self-management support and medication management, so that people's views and needs are heard and validated by health professionals.

CONCLUSIONS

More research is needed to explore the most effective pain management strategies, and public involvement is important to shape the most relevant research questions. Health and care systems evaluation is also needed to address the scale of the population health need. The pandemic appears to have highlighted pre-existing shortcomings in holistic pain management.

Factors Associated with the Level of Physical Activity in Middle-Aged Colombian People during Lockdown in Response to COVID-19: A Cross-Sectional Study

(1) Background: Due to the pandemic caused by COVID-19, mandatory confinement was declared, which generated a decrease in the practice of physical activity (PA). Based on this problem, it was proposed to study the associations between PA in relation to depressive symptoms, quality of sleep, and the quality of life of middle-aged people who work in the university context during compulsory confinement as a result of COVID-19. (2) Methods: A total of 336 middle-aged people (48 ± 6.67) participated in this analytical cross-sectional study. The variable levels of PA, quality of sleep, symptoms of depression, and quality of life were measured with the International Physical Activity Questionary (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scale (ZSDS), and the SF-12v2 questionnaire, respectively. (3) Results: A logistic regression model was used to analyze the relationships between the level of PA and depressive symptoms (OR = 2.053), total sleep duration (OR = 0.495), sleep disturbances (OR = 2.414), quality of sleep (OR = 2.471), use of sleep medication (OR = 0.348), daytime dysfunction (OR = 1.809), general health (OR = 0.949), and physical functioning (OR = 0.987). (4) Conclusions: In middle-aged people, during compulsory confinement, being insufficiently active is a risk for depressive symptoms and disturbances in sleep quality.

Lockdown Due to COVID-19 and Its Consequences on Diet, Physical Activity, Lifestyle, and Other Aspects of Daily Life Worldwide: A Narrative Review

The novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the disease called coronavirus disease 2019 (COVID-19). Besides the important rates of mortality and morbidity directly attributed to the infection itself, many studies detected an important shift towards mostly unhealthy lifestyle patterns in previously healthy non-infected populations all around the world. Although most of the changes in lifestyle had or will have a negative impact on general population health status, some findings are encouraging. Notwithstanding that there was an obvious necessity for governments to apply national lockdowns, it is also necessary to identify and comprehend the consequences they have caused. A narrative literature review was performed, based on scientific articles and previous reviews. An accurate description of changes in eating habits and alcohol consumption, physical activity, mental health, daily routines, economic impacts, and broader effects on society is provided for each continent and different age groups through this review. The volume of selected scientific surveys encompasses approximately 400,000 persons.

Combining patient-specific, digital 3D models with tele-education for adolescents with CHD

INTRODUCTION

Adolescents with CHD require transition to specialised adult-centred care. Previous studies have shown that adolescents' knowledge of their medical condition is correlated with transition readiness. Three-dimensional printed models of CHD have been used to educate medical trainees and patients, although no studies have focused on adolescents with CHD. This study investigates the feasibility of combining patient-specific, digital 3D heart models with tele-education interventions to improve the medical knowledge of adolescents with CHD.

METHODS

Adolescent patients with CHD, aged between 13 and 18 years old, were enrolled and scheduled for a tele-education session. Patient-specific digital 3D heart models were created using images from clinically indicated cardiac magnetic resonance studies. The tele-education session was performed using commercially available, web-conferencing software (Zoom, Zoom Video Communications Inc.) and a customised software (Cardiac Review 3D, Indicated Inc.) incorporating an interactive display of the digital 3D heart model. Medical knowledge was assessed using pre- and post-session questionnaires that were scored by independent reviewers.

RESULTS

Twenty-two adolescents completed the study. The average age of patients was 16 years old (standard deviation 1.5 years) and 56% of patients identified as female. Patients had a variety of cardiac defects, including tetralogy of Fallot, transposition of great arteries, and coarctation of aorta. Post-intervention, adolescents' medical knowledge of their cardiac defects and cardiac surgeries improved compared to pre-intervention (p < 0.01).

CONCLUSIONS

Combining patient-specific, digital 3D heart models with tele-education sessions can improve adolescents' medical knowledge and may assist with transition to adult-centred care.

The impact of COVID-19 on the quality of life of southern Moroccan doctors : a gender-based approach

Objectif

Après que l'Organisation mondiale de la santé a qualifié la COVID-19 de pandémie mondiale, plusieurs pays ont adopté des mesures préventives pour limiter la propagation du virus. La qualité de vie de plusieurs populations a été affectée par ces mesures, notamment par le confinement et la distanciation sociale. La pandémie a augmenté la charge de travail des professionnels de santé, ce qui pourrait avoir altéré la qualité de vie des médecins. L'objectif de notre travail était d’évaluer la qualité de vie des médecins exerçant dans les provinces du sud du Maroc durant la pandémie de COVID-19 et de comparer la qualité de vie entre les médecins hommes et les médecins femmes.

Design de l’étude

Etude transversale descriptive.

Méthodes

Nous avons inclus 257 médecins travaillant dans les provinces du sud du Maroc. Nous avons utilisé un questionnaire en ligne auto-administré via Google Forms. Pour évaluer la qualité de vie, nous avons utilisé le WHOQOL-Bref, un questionnaire qui évalue la qualité de vie dans quatre domaines : physique, mental, social et environnemental. Le score limite entre meilleure et mauvaise qualité de vie était fixé à 60.

Résultats

Tous les médecins avaient une qualité de vie médiocre dans tous les domaines. Les scores moyens et les déviations standards dans les domaines physique, mental, social et environnemental étaient respectivement (57,88 ± 17,12), (57,09 ± 20,13), (55,57 ± 23,66) et (47,99 ± 17,34). En comparant les deux sexes, les hommes avaient une meilleure qualité de vie par rapport aux femmes dans tous les domaines, avec une différence statistiquement significative (p-value ≤ 0.05). Dans le domaine environnemental, les hommes et les femmes avaient une qualité de vie altérée (moins de 60). Les médecins qui travaillaient directement dans le circuit COVID-19 avaient une pauvre qualité de vie dans tous les domaines. Même si les hommes travaillant dans le circuit COVID-19 avaient des scores inferieurs à 60, ils avaient une qualité de vie meilleure que les femmes à l'exception du domaine social.

Conclusion

La qualité de vie des médecins exerçant dans les provinces du sud du Maroc était diminuée dans tous les domaines. Les médecins travaillant dans le circuit COVID-19 avaient une pauvre qualité de vie, et les scores des femmes étaient plus bas que ceux des hommes.

Factors associated with a change in smoking habit during the first COVID-19 lockdown: an Italian cross-sectional study among ever-smokers

BACKGROUND

The COVID-19 pandemic and the lockdown period lasted from March to May 2020, resulted in a highly stressful situation yielding different negative health consequences, including the worsening of smoking habit.

METHODS

A web-based cross-sectional study on a convenient sample of 1013 Italian ever smokers aged 18 years or more was conducted. Data were derived from surveys compiled by three different groups of people: subjects belonging to Smoking Cessation Services, Healthcare Providers and Nursing Sciences' students. All institutions were from Northern Italy. The primary outcome self-reported worsening (relapse or increase) or improvement (quit or reduce) of smoking habit during lockdown period. Multiple unconditional (for worsening) and multinomial (for improving) logistic regressions were carried out.

RESULTS

Among 962 participants, 56.0% were ex-smokers. Overall, 13.2% of ex-smokers before lockdown reported relapsing and 32.7% of current smokers increasing cigarette intake. Among current smokers before lockdown, 10.1% quit smoking and 13.5% decreased cigarette intake. Out of 7 selected stressors related to COVID-19, four were significantly related to relapse (OR for the highest vs. the lowest tertile ranging between 2.24 and 3.62): fear of being infected and getting sick; fear of dying due to the virus; anxiety in listening to news of the epidemic; sense of powerlessness in protecting oneself from contagion. In addition to these stressors, even the other 3 stressors were related with increasing cigarette intensity (OR ranging between 1.90 and 4.18): sense of powerlessness in protecting loved ones from contagion; fear of losing loved ones due to virus; fear of infecting other.

CONCLUSION

The lockdown during the COVID-19 pandemic was associated with both self-reported relapse or increase smoking habit and also quitting or reduction of it.

Quality of life during COVID-19 pandemic: a community-based study in Dakahlia governorate, Egypt

BACKGROUND

The sudden transmission of the novel coronavirus along with instant measures taken in response to the Coronavirus Disease 2019 (COVID-19) pandemic caused many new challenges adversely disturbing quality of life (QoL). The objective of this study is to measure quality of life of the public during the COVID-19 pandemic and factors affecting it among adults.

METHODS

This is a community-based cross-sectional household study with analytic component conducted in an agricultural area in Dakahlia governorate, Egypt and included 500 individuals. Data were collected through a structured interview, and the collected data included socio-demographic characteristics as well as some data related to their habits and comorbidities, their experience with COVID-19 and data about QoL using the COV19-Impact on Quality of Life (COV19-QoL) scale Arabic version, after assessing Content validity and reliability.

RESULTS

The total QoL score (mean ± standard deviation) is 2.3 ± 0.6 and the score for QoL in general and perception of danger on personal safety show the highest mean with 2.6 ± 0.7. The lowest mean score is related to the perception of mental health deterioration (1.9 ± 0.8). Independent predictors of the total QoL scale are sex (regression coefficient (95% CI) = 0.1 (0.02 to 0.2), p value = 0.02), monthly income (regression coefficient (95% CI) = 0.1 (0.004 to 0.2), p value = 0.04), knowing someone infected with COVID-19 (regression coefficient (95% CI) = 0.15 (0.08 to 0.3), p value = 0.001), and data collection time (regression coefficient (95% CI) = 0.1 (0.006 to 0.2), p value = 0.04).

CONCLUSIONS

COVID-19 pandemic has impacted the public quality of life, particularly in terms of general quality of life and personal safety. People with substantial predictors of lower quality of life should be given more attention.

Cost-effectiveness of casirivimab/imdevimab in patients with COVID-19 in the ambulatory setting

BACKGROUND: Most patients infected with SARS-CoV-2, resulting in COVID-19, have only mild symptoms that can be managed in an ambulatory setting. However, a significant number of patients develop a more severe form of the disease and require hospital care, with the risk of long-term sequelae or death. Casirivimab/imdevimab is a combination of 2 recombinant human monoclonal antibodies that has been shown to significantly reduce the risk of hospitalization or death in patients with mild to moderate COVID-19 in the ambulatory setting. OBJECTIVE: To establish the cost-effectiveness of casirivimab/imdevimab in ambulatory individuals with COVID-19. METHODS: A cost-effectiveness model was constructed to simulate the natural history of COVID-19 in ambulatory patients and to identify those patients for whom casirivimab/imdevimab may be a cost-effective treatment from a US payer perspective. Patients enter the model in the ambulatory health state and can receive either active treatment with casirivimab/imdevimab or usual care. Patients can either recover from the infection or be hospitalized, from where they can recover from infection or die. Following this acute phase, patients enter a Markov model to estimate lifetime quality-adjusted life years. The model uses the risk of hospitalization in both the active treatment and usual care cohorts, and age- and sex-specific risk of mortality. Other model inputs include hospitalization costs and health-related utilities in the ambulatory acute treatment phase, the hospitalized setting, and the post-acute phase. Accounting for the heterogeneity of risk by age and comorbidities, results are presented separately for various combinations of baseline age and usual care risk in a 7 × 9 matrix. Outcomes related to "long COVID" are assessed in scenario analyses. RESULTS: In the base case, at a willingness-to-pay threshold of $100,000, treatment with casirivimab/imdevimab was found to be cost-effective in most patients, including those older than 40 years of age with a baseline hospitalization risk greater than or equal to 2% and patients aged 20 years with a baseline risk of hospitalization greater than or equal to 4%, whereas for hospitalization risk greater than or equal to 10%, casirivimab/imdevimab is dominant. Casirivimab/imdevimab was not cost-effective in patients aged 20 years with a 3% or lower risk of hospitalization or in patients aged 30 years with a 2% risk. CONCLUSIONS: This economic analysis found that casirivimab/imdevimab is a cost-effective treatment for most ambulatory patients with COVID-19. DISCLOSURES: N. Jovanoski and U. Becker are employees of F Hoffman-La Roche Ltd.; A. Kuznik and M. Hussein are employees of Regeneron Pharmaceuticals Inc. and hold stock and stock options; A. Briggs has provided consultancy to F Hoffman-La Roche Ltd. and has received consultancy fees from Merck and Co., Inc., GlaxoSmithKline plc., and Novartis. This study was funded by Regeneron Pharmaceuticals, Inc.

Haushaltsklima, Alleinleben und gesundheitsbezogene Lebensqualität während des COVID-19-Lockdowns in Deutschland

Hintergrund

Zur Eindämmung der COVID-19-Pandemie („coronavirus disease 2019“) wurden im Frühjahr 2020 Ausgang und Kontakte in Deutschland stark beschränkt. Studien weltweit lassen die Vermutung zu, dass die krisenbedingt angeordnete soziale Isolierung das Wohlbefinden der betroffenen Menschen signifikant beeinflusst. Um die gesundheitlichen Konsequenzen des Lockdowns verstehen und diesen präventiv begegnen zu können, wurde die gesundheitsbezogene Lebensqualität (gLQ) im Zusammenhang mit der Wohnsituation und dem subjektiv wahrgenommenen Haushaltsklima in diesem Zeitraum untersucht.

Methodik

Eine durch vier Strategien deutschlandweit rekrutierte Stichprobe von n = 541 Erwachsenen (MW = 34 Jahre; 67 % weiblich) wurde mit standardisierten Instrumenten zu der gLQ und dem Haushaltsklima während des Lockdowns mittels eines Online-Surveys befragt.

Ergebnisse

In der Stichprobe wurde im Mittel eine als mäßig einzustufende gLQ während des Lockdowns gefunden, die signifikant durch das subjektiv wahrgenommene Haushaltsklima vorhersagt wurde (p < 0,001). Alleinlebende Teilnehmende meldeten eine signifikant niedrigere gLQ zurück als Teilnehmende, die mit anderen Menschen zusammen in einem Haushalt lebten. Das Haushaltsklima sagte 26 % der Varianz der gLQ vorher; soziodemographische Merkmale klärten einen zusätzlichen Varianzanteil von 5 % auf.

Diskussion

Die Hinweise dafür, dass ein besser eingeschätztes Haushaltsklima mit einer höheren gLQ während des Lockdowns zusammenhing, betonen die Bedeutung des häuslichen Umfelds. Bei zukünftigen Maßnahmen zur Pandemieeindämmung, die soziale Kontakte einschränken, sollten in der Bevölkerung das Bewusstsein für den Zusammenhang zwischen Wohlbefinden und Haushaltsklima erhöht werden sowie Hilfen für Menschen mit einem konfliktbelasteten häuslichen Umfeld zugänglich bleiben.

Investigating Knowledge toward COVID-19 Vaccination: A Cross-sectional Survey in Yogyakarta, Indonesia

AIM: Since there were pros and cons, and insufficient knowledge among Indonesian regarding the vaccines, this research aims to investigate the knowledge regarding COVID-19 vaccination among employees who work in an Islamic University in Yogyakarta, Indonesia. METHODS: A descriptive cross-sectional design was used to investigate the people’s knowledge of COVID-19 vaccination. The survey was conducted before the first vaccination of COVID-19 in March 2021. A descriptive analysis method was performed. Seven hundred sixty-two respondents completed the questionnaire. RESULTS: Respondent’s average age was 34.61 years old (standard deviation = 11.821, range 20–64), 54.1% of female and 45.9% of male. 448 (58.8%) respondents did not have any comorbid history. Respondents mostly obtained vaccination information through social media (86.25%). Most respondents had sufficient knowledge about the COVID-19 vaccine (83.2%), particularly those aged 20–29. For side effects, 585 (76.8%) respondents answered that they experienced pain in the injection area after getting the COVID-19 vaccination. This study showed that the respondents aged 20–29 years old had sufficient knowledge regarding COVID-19 vaccination. CONCLUSION: As knowledge plays an essential role in accepting vaccinations, health-care workers’ efforts to promote COVID-19 vaccination should be directed toward the middle-aged and elderly population to support the government’s plan to increase the rate of COVID-19 vaccinations in Indonesia.

Clinical Applicability of Patient- and Clinician-Reported Outcome Tools in the Management of Patients with Acromegaly

OBJECTIVE

We aimed to assess treatment outcomes and disease control status in patients with acromegaly by patient- and clinician-reported outcome tools and to analyse correlations among different components of both tools.

METHODS

Cross-sectional study included 72 patients from the national referral centre with a median follow up of 8 (5-12) years. Baseline SAGIT at the diagnosis was determined retrospectively, while the follow up SAGIT and AcroQoL results were assessed at the most recent visit and by additional telephone interviews.

RESULTS

All SAGIT subscores significantly lowered from baseline to follow up (global score from 14 to 4 (P<0.001)). SAGIT at baseline did not discriminate the current disease control status. However, higher baseline SAGIT score and subscore T were associated with uncontrolled disease after the first-line treatment. Diagnostic delay correlated with baseline S, A, G, and global SAGIT scores. At follow up, global SAGIT score discriminated between cured/controlled and uncontrolled groups (4 vs. 6 (P=0.007)). AcroQoL score was 69.3, with »Personal relations subscale« being the least and »Physical scale« the most affected. There was no difference in AcroQoL between patients classified as uncontrolled or cured/controlled. At baseline and follow up, there were significant negative correlations between S and A subscores and AcroQoL. Higher BMI, presence of swelling, joint symptoms, headaches, sleep apnea, and hypertension significantly impaired QoL.

CONCLUSION

Our results emphasised the complementary nature of patient- and clinician-reported outcome tools in acromegaly management. We identified modifiable signs, symptoms, and comorbidities as treatment targets that might help clinicians improve QoL in this population.

First population norms for the EQ-5D-3L in the Russian Federation

Purpose

The EQ–5D survey instrument is routinely applied to general and patient specific populations in many countries, as a means of measuring Health Related Quality of Life (HRQOL) and/or informing Health Technology Assessment. The instrument is the subject of growing interest in the Russian Federation, as too is Health Technology Assessment. This research is the first to systematically present the EQ–5D–3L nationally representative population norms and to examine the socioeconomic and socio-demographic characteristics of the instrument among a representative sample of the Russian population.

Methods

Based on a nationally representative health and well-being survey of the Russian population, conducted in November 2017, we establish the descriptive results, including the EQ-VAS and the EQ-5D Index, by age and gender, examine the correspondence between the EQ–5D health classifications and the separate EQ-VAS scores, and draw on a set of augmented logistic regressions to evaluate the association between the presence of problems in each dimension and various socio-economic and health-related characteristics.

Results

We find strong evidence that the EQ-5D instrument is sensitive to underlying observed and latent health experiences, that it mirrors many of the characteristics familiar from other settings but that there are Russian specificities which merit further research, particularly with respect to the anxiety/depression dimension of the instrument.

Conclusion

This research represents an important landmark for HRQOL studies in Russia as well as for the prospects of continuing to develop the scholarly and practical infrastructure necessary for Russian Health Technology Assessment to advance.

“This path I must walk alone”. Challenges experienced by older patients while recovering from severe COVID-19 – a qualitative study

Background

In March 2020, the COVID-19 pandemic challenged both the Norwegian population and healthcare system. In this study we explored how older men and women experienced rehabilitation and recovery after hospitalisation due to severe COVID-19.

Methods

Semi-structured interviews with 17 participants aged 60–96 years were performed 6 months after discharge from hospital. A thematic descriptive analysis was conducted.

Results

The results revealed that the participants experienced a challenging span between loneliness and companionship in recovering from severe COVID-19. The four subthemes highlighted experiences of being discharged to home and left to themselves, the importance of exercise and companionship at rehabilitation stay, requirement of self-effort and time to recover, and the challenging span between loneliness and companionship when being with family.

Conclusion

Among participants, the experiences of loneliness throughout the recovery period were striking. An individualised approach including psychological support should be emphasized in primary healthcare to promote recovery in older survivors after severe COVID-19 and their next-of-kin.

Quality of Life and Depressive Symptoms Among Peruvian University Students During the COVID-19 Pandemic

Objective

To determine the factors associated with quality of life and depressive symptoms in Peruvian university students during the COVID-19 pandemic.

Methods

Multicentre study in 1,634 students recruited by convenience sampling. The quality of life (QoL) was assessed with the European Quality of Life-5 Dimensions at three levels (EQ-5D-3L) and depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9). To assess factors associated with QoL and depressive symptoms, linear regressions and fitted regressions were used, with robust coefficients of variance information (β).

Results

A 345 (21.1%) reported problems in performing daily activities, 544 (33.3%) reported pain and discomfort, 772 (47.2%) were moderately/very anxious or depressed. Furthermore, 207 (12.7%) had moderate-severe and severe depressive symptoms. Men reported better QoL than women (β: 3.2; 95% CI: 1.1, 5.4; p = 0.004) and fewer depressive symptoms (β: −0.7; 95% CI: −1.3, −0.2; p = 0.011). Ayacucho’s residents had more depressive symptoms than Ancash’s residents (β: 0.8; 95% CI: 0.1, 1.5; p = 0.022) and Piura’s residents had fewer depressive symptoms than Ancash’s residents (β: −1.195% CI: −1.8, −0.3, p = 0.005). Students who left home during quarantine reported more depressive symptoms (β: 0.7, 95% CI: 0.2, 1.2, p = 0.006).

Conclusion

Problems performing daily activities, pain and discomfort, as well as mild to severe depressive symptoms were found in more than three-quarters of the sample. Authorities could consider depression care to improve quality of life in regions where high rates of infection occurred during the pandemic.

Long-Term Health-Related Quality of Life in Non-Hospitalized Coronavirus Disease 2019 (COVID-19) Cases With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in England: Longitudinal Analysis and Cross-Sectional Comparison With Controls

BACKGROUND

We aimed to quantify the unknown losses in health-related quality of life of coronavirus disease 2019 (COVID-19) cases using quality-adjusted lifedays (QALDs) and the recommended EQ-5D instrument in England.

METHODS

Prospective cohort study of nonhospitalized, polymerase chain reaction (PCR)-confirmed severe acute respiratory syndrome coronavirus 2-positive (SARS-CoV-2-positive) cases aged 12-85 years and followed up for 6 months from 1 December 2020, with cross-sectional comparison to SARS-CoV-2-negative controls. Main outcomes were QALD losses; physical symptoms; and COVID-19-related private expenditures. We analyzed results using multivariable regressions with post hoc weighting by age and sex, and conditional logistic regressions for the association of each symptom and EQ-5D limitation on cases and controls.

RESULTS

Of 548 cases (mean age 41.1 years; 61.5% female), 16.8% reported physical symptoms at month 6 (most frequently extreme tiredness, headache, loss of taste and/or smell, and shortness of breath). Cases reported more limitations with doing usual activities than controls. Almost half of cases spent a mean of £18.1 on nonprescription drugs (median: £10.0), and 52.7% missed work or school for a mean of 12 days (median: 10). On average, all cases lost 13.7 (95% confidence interval [CI]: 9.7, 17.7) QALDs, whereas those reporting symptoms at month 6 lost 32.9 (95% CI: 24.5, 37.6) QALDs. Losses also increased with older age. Cumulatively, the health loss from morbidity contributes at least 18% of the total COVID-19-related disease burden in the England.

CONCLUSIONS

One in 6 cases report ongoing symptoms at 6 months, and 10% report prolonged loss of function compared to pre-COVID-19 baselines. A marked health burden was observed among older COVID-19 cases and those with persistent physical symptoms.

Sleep Quality and Its Associations with Physical and Mental Health-Related Quality of Life among University Students: A Cross-Sectional Study

The association between sleep problems and quality of life has been well documented and the COVID-19 pandemic seemingly had an impact on both sleep quality and health-related quality of life (HRQoL). However, recent evidence about this relationship among university students is limited. The aims of this study are to investigate the prevalence of poor sleep quality and insomnia and to explore the associations between these outcomes, perceived stress, and HRQoL among Italian university students. An anonymous questionnaire comprising the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Short Form-12 health survey, and the Perceived Stress Scale was administered to a convenience sample of 1279 students (1119 females and 160 males, mean age: 23.4 ± 2.5 years) attending one of the largest Italian universities. A total of 65% of the participants showed poor sleep quality, whereas 55% reported insomnia symptoms. Students reporting poor sleep quality and insomnia obtained higher perceived stress scores and lower physical and mental HRQoL scores. Controlling for health-related variables and perceived stress, hierarchical regression analyses showed that sleep quality components added a significant contribution to the prediction of both physical (ΔR² = 0.1) and mental (ΔR² = 0.02) HRQoL. As a whole, these findings confirm the relevance of sleep for university students’ well-being and might inform the development of health promotion interventions for this population.

Mental health of Brazilian adolescents during the COVID-19 pandemic

We aimed to assess the factors associated with frequent sadness and nervousness in Brazilian adolescents, during the Covid-19 pandemic, in 9470 adolescents (aged 12-17 years), interviewed from June 27 to September 17, 2020. Prevalences and prevalence ratios were estimated according to socio-demographic variables and factors related to family, school, friends, and health. Brazilian adolescents often felt sad (32.4%) and nervous (48.7%). Higher prevalences of these feelings were related to: being female; aged 15-17 year; from families with financial difficulties; having learned little or nothing with remote education; missing friends; having few friends; family disagreements; having regular/bad health before the pandemic; and worsened health and sleep during the pandemic. Higher prevalence of nervousness was also found in adolescents who worked before the pandemic and those who reported lack of concentration and not knowing if they had COVID-19. Sadness and nervousness in Brazilian adolescents is high and the need for action by the government, schools, health services, and parents to mitigate the impact of the pandemic on the physical and mental health of adolescents. Special attention must be paid to adolescents with previous health problems and those belonging to the most socially vulnerable population.

The COVID-19 pandemic impacts all domains of quality of life in Egyptians with spinal cord injury: a retrospective longitudinal study

Background and objective

During the COVID-19 pandemic, several aspects of life have been affected. These aspects have been impacted especially in persons with spinal cord injury (SCI). The current study explored the overall effect of the COVID-19 pandemic on quality of life (QOL) domains in persons with SCI as well as evaluated their adherence to WHO-COVID 19-preventive measures.

Design

A retrospective longitudinal study was conducted after asking participants to complete an online validated Arabic version of the WHOQOL-BREF questionnaires including their demographics. The WHOQOL-BREF questionnaires were completed targeting two separate occasions to represent their scores prior to and during the pandemic. Participants were asked to rate their adherence to WHO-COVID-19 preventive measures on a 10-point scale.

Setting and participants

115 participants with complete/ incomplete SCI were recruited via social media and contacted by phone to complete the questionnaires.

Results

Persons with SCI had lower QOL scores during the COVID-19 period compared to their QOL during the pre-COVID-19 period; all QOL domains (Physical Health, Psychological, Social Relationships, and Environment) showed a significant decrease (P < 0.001). Regarding COVID-19 preventative measures, participants were most likely to endorse self-isolation as well as staying home measures and least likely to adhere to hand washing and social distancing measures.

Conclusion

The robustly reduced QOL reported by individuals with SCI during the COVID-19 pandemic highlights the need for rehabilitation and mental health services, particularly administered via telehealth, to buffer the effects of the pandemic. Additionally, psychoeducation and support regarding COVID-19 preventative behaviors in this region would be critical.

Health-related quality of life of younger and older lower-income households in Malaysia

Background

Globally, a lower income is associated with poorer health status and reduced quality of life (QOL). However, more research is needed on how being older may influence QOL in lower-income households, particularly as older age is associated with an increased risk of chronic diseases and care needs. To this end, the current study attempts to determine the health-related QOL (HRQOL) among individuals from lower-income households aged 60 years and over compared to lower-income adults aged less than 60 years.

Methods

Participants were identified from the Department of Statistics Malaysia sampling frame. Surveys were carried out with individual households aged 18 years and older through self-administered questionnaires. Information was collected on demographics, household income, employment status, number of diseases, and HRQOL assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) tool.

Results

Out of a total of 1899 participants, 620 (32.6%) were female and 328 (17.3%) were aged 60 years and above. The mean (SD) age was 45.2 (14.1) and mean (SD) household income was RM2124 (1356). Compared with younger individuals, older respondents were more likely to experience difficulties in mobility (32.1% vs 9.7%, p<0.001), self-care (11.6% vs 3.8%, p<0.001), usual activities (24.5% vs 9.1%, p<0.001), pain/discomfort (38.8% vs 16.5%, p<0.001) and anxiety/depression (21.4% vs 13.5%, p<0.001). The mean (SD) EQ-5D index scores were lower among older respondents, 0.89 (0.16) vs 0.95 (0.13), p = 0.001. After adjusting for covariates, age was a significant influencing factor (p = 0.001) for mobility (OR = 2.038, 95% CI:1.439–2.885), usual activities (OR = 1.957, 95% CI:1.353–2.832) and pain or discomfort (OR = 2.241, 95% CI:1.690–2.972).

Conclusion

Lower-income older adults had poorer HRQOL compared to their younger counterparts. This has important implications concerning intervention strategies that incorporate active ageing concepts on an individual and policy-making level to enhance the QOL and wellbeing, particularly among the older lower-income population.

Biomarkers of non-communicable chronic disease: an update on contemporary methods

Chronic diseases constitute a major global burden with significant impact on health systems, economies, and quality of life. Chronic diseases include a broad range of diseases that can be communicable or non-communicable. Chronic diseases are often associated with modifications of normal physiological levels of various analytes that are routinely measured in serum and other body fluids, as well as pathological findings, such as chronic inflammation, oxidative stress, and mitochondrial dysfunction. Identification of at-risk populations, early diagnosis, and prediction of prognosis play a major role in preventing or reducing the burden of chronic diseases. Biomarkers are tools that are used by health professionals to aid in the identification and management of chronic diseases. Biomarkers can be diagnostic, predictive, or prognostic. Several individual or grouped biomarkers have been used successfully in the diagnosis and prediction of certain chronic diseases, however, it is generally accepted that a more sophisticated approach to link and interpret various biomarkers involved in chronic disease is necessary to improve our current procedures. In order to ensure a comprehensive and unbiased coverage of the literature, first a primary frame of the manuscript (title, headings and subheadings) was drafted by the authors working on this paper. Second, based on the components drafted in the preliminary skeleton a comprehensive search of the literature was performed using the PubMed and Google Scholar search engines. Multiple keywords related to the topic were used. Out of screened papers, only 190 papers, which are the most relevant, and recent articles were selected to cover the topic in relation to etiological mechanisms of different chronic diseases, the most recently used biomarkers of chronic diseases and finally the advances in the applications of multivariate biomarkers of chronic diseases as statistical and clinically applied tool for the early diagnosis of chronic diseases was discussed. Recently, multivariate biomarkers analysis approach has been employed with promising prospect. A brief discussion of the multivariate approach for the early diagnosis of the most common chronic diseases was highlighted in this review. The use of diagnostic algorithms might show the way for novel criteria and enhanced diagnostic effectiveness inpatients with one or numerous non-communicable chronic diseases. The search for new relevant biomarkers for the better diagnosis of patients with non-communicable chronic diseases according to the risk of progression, sickness, and fatality is ongoing. It is important to determine whether the newly identified biomarkers are purely associations or real biomarkers of underlying pathophysiological processes. Use of multivariate analysis could be of great importance in this regard.

Impact of lack of face-to-face schooling during COVID-19 confinement on family quality of life of children with disabilities and typical development

Objective:

The aim of this study was to analyze the impact of the lack of face-to-face schooling during the COVID-19 confinement on the family quality of life of children aged 3–6 years with hemiplegia, obstetrical brachial palsy, and typical development.

Materials and Methods:

An observational and cross-sectional study, using an online survey hosted in Google Forms from October to December 2020, was performed in families with children with infantile hemiplegia, obstetrical brachial palsy, and typical development aged 3–6 years living in Spain. The quality of life and family impact (measured through Pediatric Quality of Life Questionnaires, PedsQL™) were evaluated, as well as the affected upper limb side, the presence of other associated problems, the parents’ job, lack of use of the affected upper limb, and the type of online intervention using different channels: phone calls, emails, and video calls. Family expectations on the treatment and on their acquired capacity to solve problems related to their children were also measured.

Results:

A total of 93 families participated in the study and the children’s quality of life and family impact obtained a strong correlation in three populations: infantile hemiplegia (r = 0.844), obstetrical brachial palsy (r = 0.513), and typical development (r = 0.904). There was no association between quality of life and online intervention (phone calls and emails were selected), p > 0.05.

Conclusion:

The deprivation of schooling coupled with home confinement due to the COVID-19 pandemic had a greater impact on the quality of life of children with disabilities: infantile hemiplegia and obstetrical brachial palsy than on typically developing children and on their families. However, the online intervention did not produce improvements in quality of life, which could be a consequence of using emails or phone calls instead of video calls to interact with the families.

Association between Pet Ownership and Mental Health and Well-Being of Canadians Assessed in a Cross-Sectional Study during the COVID-19 Pandemic

The objective of this cross-sectional study was to assess the association between pet ownership and quality of life (QoL), loneliness, anxiety, stress, overall health, and mental health of Canadians during the COVID-19 pandemic using a One Health perspective. An online bilingual survey was completed by 1500 Canadians in April-May 2021. Socio-demographics, health, QoL, stress and anxiety, loneliness, social support, pet ownership, and attitude towards pets data were collected. Crude and adjusted associations between pet ownership and mental health and well-being indicators were estimated. The 1500 participants were from all provinces and territories, half were women; half of the participants were pet owners by design. The crude association estimates showed that pet owners had poorer QoL, overall health, and mental health than non-pet owners, and were lonelier, more stressed, and more anxious than non-pet owners. Adjusted estimates showed that these associations disappeared with the inclusion of the confounders (socio-economic, demographic, health, and pet-related variables). Our results suggest that there was no association between pet ownership and the mental health and well-being indicators measured in the present study.

Impact of COVID-19 on the Quality of Life of Households in Saudi Arabia

The COVID-19 pandemic has affected every stratum of the population and all categories of households to varying degrees. The impact of the pandemic on the quality of life (QoL) of populations is complex and can vary by region, socio-economic status, and other demographic factors. The main purpose of this study was to empirically examine the effects of pandemic trauma on the QoL of households in Saudi Arabia. Primary data from 506 households in different regions were collected through online surveys and estimated using descriptive statistics, analysis of variance (ANOVA), statistical regression techniques, and ordered Probit analysis. It was found that the QoL of Saudi households dropped significantly due to the COVID-19 crisis. Demographically, there were significant differences in the impact of COVID-19 on QoL. Low-income households, large households, male-led households, urban households, households living in the central and western regions, households with head unemployment or low educational attainment, and households with elderly head reported greater QoL declines. The findings emphasize the significance of generating on-the-ground survey data to track the well-being of households during the crisis to accumulate the information required to construct evidence-based policy responses. This study makes a significant contribution to the literature on the impact of COVID-19 by providing additional evidence of the pandemic's impact at the household level. The study paints a grim picture of the effects of COVID-19, as it was carried out at a time when the coronavirus was spreading, millions were dying or fighting it in healthcare centers, and lockdowns were imposed throughout the world.

COVID-19 behavioral health and quality of life

In addition to concern about physical health consequences of COVID-19, many researchers also note the concerning impact on behavioral health and quality of life due to disruption. The purpose of this paper is to explore pathways of COVID-19 behavioral health and quality of life. We found increased anxiety, depression, and alcohol misuse and that the pandemic exacerbated prior problems. Further community indicators also lead to poorer behavioral health and overall decreased quality of life. The nature of COVID-19 and vast reach of the virus suggests that behavioral health concerns should take a primary role in pandemic recovery.

Health-related quality of life among COVID-19 individuals: A cross-sectional study in Tamil Nadu, India

Introduction

The EQ-5D-5L questionnaire is a tool that is a very generic and preference-based instrument to describe the health-related quality of life. We have generated the stratified index utility value for the Tamil Nadu population and compared the utility values based on socio-demographic and clinical characteristics.

Methods

We conducted a community-based analytical cross-sectional study using telephonic interviews from November 2020 till December 2020 among individuals aged 18 years and above who were infected by the coronavirus confirmed with an RT-PCR within 30 days in Tamil Nadu State. EQ-5D-5L profile, socio-demographic and clinical characteristics of the study participants were collected and analysed.

Results

We interviewed 372 participants, with 57.5% were males, and their mean age was 44.5 ± 15.3 years. About 40% of participants reported as having comorbidities, such as diabetes (19.4%), hypertension (12.4%), heart disease (2.4%), kidney disease (0.8%) and others. The mean EQ-5D utility score was 0.925 ± 0.150, and the mean EQ-VAS was 90.68 ± 11.81. Overall, men had a higher utility value (0.938 ± 0.130) than women, (0.907 ± 0.170). Individuals with comorbidities, requiring longer hospitalisation were having lower utility scores than their counterparts.

Conclusion

We report the EQ-5D-5L utility values for the COVID-19 illness. These values would help to estimate quality-adjusted life years in health economic evaluation studies.

Health-related quality of life in survivors of severe COVID-19 infection

BACKGROUND

Long-term effects of Coronavirus Disease 2019 (COVID-19) are increasingly recognized as having a significant impact on Health-Related Quality of Life (HRQoL). Understanding HRQoL status for each patient affected by long COVID-19 and its determinants may have a key role to prevent and treat this condition.

METHODS

In this prospective observational study conducted in a large academic COVID-19 hospital in Rome, participants were contacted 2 years after hospital admission for severe COVID-19. To assess HRQoL, EQ-5D-5L and Visual analog scale (EQ VAS) standard questionnaires were administered by interview. Logistic regression model was used to the five health dimensions as dependent variables (0 = no problem, 1 = some/extreme problem).

KEY RESULTS

In 137 enrolled patients, the mean pre-COVID and post-COVID EQ-5D-5L index and EQ-VAS score were 0.97 (SD 0.06), 0.79 (SD 0.26) and 72.38 (SD 15.18), respectively. After subdivision of the participants for clinical and social variables, the EQ-5D-5L index resulted significantly lower than in the pre-COVID-19 period. Female gender, unemployed status, and chronic comorbidities were the most common predictors for having any problems in each EQ-5D-5L domain, while also older age and higher Body Mass Index (BMI) showed to be related to a lower EQ-VAS score.

CONCLUSION

HRQoL showed to be still low in patients 2 years after acute severe COVID-19. Given the significant impact of SARS-CoV-2 on long-term chronic symptoms, predictors of poor outcomes must be considered during the acute phase of illness to plan a tailored follow-up path for each patient.

Evaluation of health-related quality of life of Covid-19 patients: a hospital-based study in South Central Ethiopia

BACKGROUND

Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia.

METHODS

We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU-visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann-Whitney U test or Kruskal-Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15.

RESULTS

The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001).

CONCLUSION

Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.

A pilot study on the validity and psychometric properties of the electronic EQ-5D-5L in routine clinical practice

Background

Electronic measurement of health-related quality of life (HRQOL) may facilitate timely and regular assessments in routine clinical practice. This study evaluated the validity and psychometric properties of an electronic version of the EQ-5D-5L (e-EQ-5D-5L) in Chinese patients with chronic knee and/or back problems.

Methods

151 Chinese subjects completed an electronic version of the Chinese (Hong Kong) EQ-5D-5L when they attended a primary care or orthopedics specialist out-patient clinic in Hong Kong. They also completed the Chinese Western Ontario and McMaster University Osteoarthritis Index (WOMAC), a Pain Rating Scale, and a structured questionnaire on socio-demographics, co-morbidities and health service utilization. 32 subjects repeated the e-EQ-5D-5L two weeks after the baseline. 102 subjects completed e-EQ-5D-5L and 99 completed the Global Rating on Change Scale at three-month clinic follow up. Construct validity was assessed by the association of EQ-5D-5L scores with external criterion of WOMAC scores. We tested mean differences of WOMAC scores between adjacent response levels of the EQ-5D-5L dimensions by one-way ANOVA, test–retest reliability by intra-class correlation, sensitivity by known group comparisons and responsiveness by changes in EQ-5D-5L scores over 3 months.

Results

There was an association between EQ-5D-5L and WOMAC scores. Mean WOMAC scores increased with the increase in adjacent response levels of EQ-5D-5L dimensions. Test–retest intraclass correlation coefficient (ICC) of EQ-5D-5L utility and EQ-VAS scores were 0.76 and 0.83, respectively, indicating good reliability. There were significant differences in the proportions reporting limitations in the EQ-5D-5L dimensions, the utility and VAS scores between the mild and severe pain groups (utility = 0.28, p = 0.001; VAS = 11.46, p < 0.001), and between primary care and specialist out-patient clinic patients (utility = 0.15, p = 0.001; VAS = 10.21, p < 0.001), supporting sensitivity. Among those reporting ‘better’ global health at three-months, their EQ-5D-5L utility and EQ-VAS scores were significantly increased from baseline (utility = 0.18, p < 0.001; VAS = 10.75, p = 0.005).

Conclusions

The electronic version of the EQ-5D-5L is valid, reliable, sensitive and responsive in the measurement of HRQOL in Chinese patients with chronic knee or back pain in routine clinical practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01898-3.

Quality of Life, Insomnia and Coping Strategies during COVID-19 Pandemic in Hospital Workers. A Cross-Sectional Study

COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during the first wave of the COVID-19 pandemic in Italy. This cross-sectional study was conducted from May to November 2020 through an online survey. There were 558 participants (28.5% males and 71.5% females) enrolled in two different metropolitan areas (in North and South of Italy, respectively). Three standardized questionnaires were administered: European Quality of life-5 Dimensions (EQ-5D), Athens Insomnia Scale (AIS), and Brief COPE. Differences in sociodemographic characteristics and work-related factors were also investigated in order to identify possible predictors through a generalized linear model and logistic regression analysis. Results showed good perceived life quality and high insomnia prevalence. After sample stratification, the statistical analysis highlighted that personal (gender, age, educational level) and work-related factors (employment in COVID wards, remote working) played different roles in predicting quality of life, insomnia, and coping attitude. Active, Planning, and Acceptance were the most frequently adopted coping strategies. Despite women confirming their attitude in reacting to the difficulties, adopting emotion-focused coping strategies, they showed a higher probability to develop insomnia, so a gender perspective should be considered in the health protection of this working category. An integrated approach should be implemented at individual, interpersonal and organizational levels aiming to monitor psychological distress, favor regular sharing and communication between peers, and also allow conciliation of work with family life. At the organizational level, preventive and protective measures adequate to work-related risk to COVID-19 should be adopted.

Effect of Resilience on Health-Related Quality of Life during the COVID-19 Pandemic: A Cross-Sectional Study

The unprecedented outbreak of coronavirus disease 2019 (COVID-19) has caused a huge global health and economic crisis. The aim of the study was to examine the extent to which the resilience of a person is associated with the quality of life (QoL) of adults amongst Saudi Arabia. A cross-sectional study was conducted among a sample of adults in Saudi Arabia. A total of 385 adults voluntarily participated in and completed the survey. The quality of life was measured using the “World Health Organization QoL”. The “Connor-Davidson Resilience Scale” instrument was also used to assess resilience during the COVID-19 pandemic. Amongst the 385 participants, 179 (46%) showed a good QoL, and 205 (54%) reported a relatively poor QoL. The resilience was found to be significantly associated with QoL. The study further revealed that gender-based differences were dominant in the QoL; the men respondents reported a significantly higher QoL in all the domains in comparison to the women respondents. The gender, income, and psychological health and interaction effect of resilience and age explained 40% of the variance in the total score of QoL. In reference to the predictors of the physical health domain of QoL, resilience, gender, and psychological health were significantly associated with the physical health domain of the QoL (R² = 0.26, p = 0.001). It was also noted that gender was not associated with the social relationships and environmental domains of QoL (p > 0.05). Findings showed a statistically significant association between the score of QoL and resilience, age, gender, income, and psychological health. These findings highlight the significant contribution of gender-based differences, psychological health, and resilience on the domains of QoL.

Impact of Covid-19 on health-related quality of life of patients: A structured review

Introduction

Coronavirus disease (Covid-19) has led to a global pandemic since its emergence in December 2019. The majority of research into Covid-19 has focused on transmission, and mortality and morbidity associated with the virus. However, less attention has been given to its impact on health-related quality of life (HRQoL) of patients with Covid-19.

Methods

We searched for original studies published between December 2019 and Jan 2021 in PubMed, Scopus and Medline databases using a specific search strategy. We also explored literature on websites of distinguished public health organisations and hand-searched reference lists of eligible studies. The studies were screened by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart using pre-determined eligibility criteria. Data were synthesised, analysed descriptively and reported in line with PRISMA guidelines.

Results

In total, 1276 studies were identified through the search strategy. Of these, 77 studies were selected for full-text reading after screening the studies. After reading full-text, 12 eligible studies were included in this review. The majority of the studies used a generic HRQoL assessment tool; five studies used SF-36, five studies used EQ-5D-5L, and three used pulmonary disease-specific HRQoL tools (two studies used two tools each). The impact of Covid-19 on HRQoL was found to be considerable in both Acute Covid and Long Covid patients. Higher impact on HRQoL was reported in Acute Covid, females, older ages, patients with more severe disease and patients from low-income countries.

Conclusion

The impact of Covid-19 on HRQoL of Acute and Long Covid patients is substantial. There was disproportional impact on patients by gender, age, severity of illness and study country. The long-term impact of Covid-19 is still in its initial stage. The findings of the review may be useful to researchers, policymakers, and clinicians caring for people following Covid-19 infection.

Cultural adaptation and validation of the Sidamic version of the World Health Organization Quality-of-Life-Bref Scale measuring the quality of life of women with severe preeclampsia in southern Ethiopia, 2020

Background

Women with severe preeclampsia often present with more health complaints compared to those with uncomplicated pregnancies. Estimating the quality of life of women affected with severe preeclampsia could provide direction for further interventions. However, the current measurement of the quality of life has not been culturally adapted and validated for this population. This study aimed to translate, culturally adapt, and test the reliability and validity of the World Health Organization Quality-of-Life-Bref Scale (WHOQOL-BREF) in southern Ethiopia among women with severe preeclampsia.

Methods

An institutional-based cross-sectional study was conducted in southern Ethiopia in selected hospitals with randomly recruited women with severe preeclampsia. Cultural adaptation and validation techniques were used to translate and adapt the WHOQOL-BREF scale. Face, content validity, forward and backward translations, and synthesis were computed using an expert panel. The scale was pretested and adjusted accordingly. Internal consistency (Cronbach’s alpha) and test–retest reliability (Intraclass Correlation Coefficient = ICC) were examined. Confirmatory factor analysis (CFA) was computed to test the fit of the structure to the local setting before conducting exploratory factor analysis (EFA). Multiple methods for determining the number of factors extracted (scree test, eigenvalues) were used. We compared the original English structure with the new structure in the study setting and extracted a new structure using EFA.

Results

The internal consistency reliabilities ranged from 0.8045 to 0.9123 indicating good-to-excellent reliability. The item‑level content validity ranged from 0.86 to 1.00; the scale‑level content validity index was 0.97. In CFA, the model fit indices were unacceptable (Comparative Fit Index (CFI = 0.87), Root Mean Square Error of Approximation (RMSEA = 0.23), Standardized Root Mean Square Residual (SRMR = 0.38), Tucker Lewis Index (TLI = 0.85) and (PCLOSE = 0.00). Three new factor structures were extracted using EFA for current research with a total variance was 91%.

Conclusions

The failure of the original scale in this study population highlights the importance of culturally adapting tool to local settings. EFA confirmed a three-factor structure, inconsistent with the original English structure.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01872-z.

COVID-19 confinement and related well being measurement using the EQ-5D questionnaire: A survey among the Palestinian population

PURPOSE

This study aims to assess the effect of the COVID-19 confinement on the population wellbeing using the EQ-5D questionnaire.

METHODS

After receiving the written permission from the EuroQol Research Foundation, an online-based survey was prepared and a total of 1380 participants were recruited via social media. The relationships of all the factors were studied as well as the scores of the EQ-5D including EQ-5D Index, Visual Analogue Scale (VAS), and each of the EQ-5D dimension. Linear regression for the Index and VAS and Logistic regression model was used to examine each dimension.

RESULTS

The median EQ-5D Index and VAS scores were 0.65 (0.5-0.75) and 80 (60-90), respectively. The most frequently reported problem was anxiety/depression (67.3%), followed by usual activities (48.6%). The statistical analysis showed that factors significantly associated with more reported problems in at least one EQ-5D dimension (P < .05) were: females, ageing, being unmarried, low income, school studies, living in refugee camps, and villages, unemployment, having chronic diseases or pain, and obesity. It is important to note that participants who responded in November showed more problems compared with December 2020. On the other hand, more problems were reported by participants who were infected, had known affected persons, had no enough information, perceived negative effect of confinement, and indicated having a high infection chance (P < .05).

CONCLUSIONS

This work provides important evidence on the health status and wellbeing during the COVID-19 confinement in a sample of the Palestinian population, affecting almost all the aspects of the health state and wellbeing. This effect could be minimised by improving the COVID-19 preventive education and monitoring that can play an important role in all health and life aspects among the Palestinian population in facing this pandemic.

Quality of Life of Urolithiasis Patients During the COVID-19 Pandemic: A Multi-Institutional Cross-Sectional Study

Purpose The COVID-19 pandemic is an unprecedented global event that has caused significant fear and anxiety across all populations. To date, there have been no studies on how major health crises have affected the stone-related quality-of-life (QOL) of urolithiasis patients. In this multi-institutional study, we investigated whether the fear of COVID-19 affects the QOL of urolithiasis patients during the COVID-19 pandemic using the Fear of COVID-19 Scale (FCV-19S) and the Wisconsin Stone Quality of Life (WISQOL) questionnaires. Materials and Methods Patient-reported data collection occurred between April-October 2020 during the COVID-19 pandemic where many procedures (radiological or surgical) and visits were either delayed or cancelled. The scores generated from patient-reported responses to questionnaires were correlated and then further sub-analyzed dependent on categorical responses related to procedural delays or care and were analyzed via the Student's T-test. A single factor analysis of variance (ANOVA) was performed to analyze varying QOL scores across the FCV-19S quartiles. Results 400 respondents participated in this study. Overall mean total standardized FCV-19S and WISQOL scores (both transformed to min-max 0-100) were 34.3 and 70.3 respectively. A significant inverse correlation (r=-0.265, p<0.0001) was demonstrated suggesting greater COVID-19 fear may result in lower stone-related quality-of-life. A significant difference in fear and QOL scores was observed between the sexes, with women having more COVID-19 fear (35.8 vs. 28.6, p<0.01) and lower stone-related QOL (64.2 vs. 75.2, p<0.01). Quartile ANOVA analysis revealed significant mean difference in WISQOL scores across all FCV-19S score quartiles (p<0.05). Conclusions Using two validated questionnaires (FCV-19S and WISQOL) and correlating patient-reported responses, we found that greater fear for COVID-19 was associated lower stone-related QOL in urolithiasis patients.