Quality of life and persistent symptoms in patients with post-covid syndrome

Authors

  • Renata Escorcio Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Humanas e da Saúde. Departamento de Teorias e Métodos em Fonoaudiologia e Fisioterapia https://orcid.org/0000-0002-8781-1679
  • Emília Brollo Guedes Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Humanas e da Saúde. Departamento de Teorias e Métodos em Fonoaudiologia e Fisioterapia https://orcid.org/0000-0001-8795-9940
  • Patrícia Jundi Penha Pontifícia Universidade Católica de São Paulo. Faculdade de Ciências Humanas e da Saúde. Departamento de Teorias e Métodos em Fonoaudiologia e Fisioterapia https://orcid.org/0000-0003-0491-0418

DOI:

https://doi.org/10.21527/2176-7114.2025.50.14615

Keywords:

COVID-19, Symptom Assessment, Behavioral Symptoms, Quality of Life

Abstract

Introduction: "Post-COVID-19 syndrome" refers to the persistence of physical and mental symptoms after the acute phase of the disease. These symptoms affect the individual's well-being, modifying his relationship with and perception of social and cultural contexts. Objective: To investigate how COVID-19 and its sequelae affected the individual's quality of life. Method: The research was divided into two phases: retrospective and observational cross-sectional analysis. The retrospective cross-sectional analysis consisted of analyzing the medical records of patients admitted to a hospital in the city of São Paulo, while the observational phase consisted of conducting structured interviews via telephone within one year after hospital discharge. Results: Data from 103 respondents were analyzed, of which 65% had pulmonary involvement, 52% were admitted to the ward, 39% to the ICU, and 53% were intubated. The most common persistent symptoms were muscle weakness (74.8%), dyspnea (61.2%), and loss of taste (48.5%), loss of smell (45.6%), desaturation (35.9%), and oxygen dependence (11.7%). Regarding quality of life, the environmental domain had the lowest score (~15%). Conclusion: More than half of the individuals developed persistent symptoms, a condition that affected quality of life, especially in the environmental domain, making it difficult to return to work and leisure activities.

References

1. Tomasoni D, Bai F, Castoldi R, Barbanotti D, Falcinella C, Mulè G, et al. Anxiety and depression symptoms after virological clearance of COVID‐19: A cross‐sectional study in Milan, Italy. Journal of Medical Virology. 2020 Sep 30;93(2):1175–9.

2. Amdal CD, Pe M, Falk RS, Piccinin C, Bottomley A, Arraras JI, et al. Health-related quality of life issues, including symptoms, in patients with active COVID-19 or post COVID-19; a systematic literature review. Quality of Life Research. 2021 Jun 19; 30(12):3367-3381

3. Yomogida K. Post-Acute Sequelae of SARS-CoV-2 Infection Among Adults Aged ≥18 Years — Long Beach, California, April 1–December 10, 2020. MMWR Morbidity and Mortality Weekly Report [Internet]. 2021;70. Available from: https://www.cdc.gov/mmwr/volumes/70/wr/mm7037a2.htm

4. Ramakrishnan RK, Kashour T, Hamid Q, Halwani R, Tleyjeh IM. Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19. Frontiers in Immunology [Internet]. 2021 Jun 30;12. Available from: https://pubmed.ncbi.nlm.nih.gov/34276671/

5. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nature Medicine [Internet]. 2021 Apr 1;27(4):626–31. Available from: https://www.nature.com/articles/s41591-021-01292-y

6. Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA. 2020 Jul 9;324(6):603–5.

7. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet [Internet]. 2021 Jan 8;397(10270):220–32. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext

8. Bell ML, Catalfamo CJ, Farland LV, Ernst KC, Jacobs ET, Klimentidis YC, et al. Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT. Ghozy S, editor. PLOS ONE. 2021 Aug 4;16(8):e0254347.

9. Wang F, Kream RM, Stefano GB. Long-Term Respiratory and Neurological Sequelae of COVID-19. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research [Internet]. 2020 Nov 1;26:e928996-1e928996-10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643287/

10. Whitaker M, Elliott J, Chadeau-Hyam M, Riley S, Darzi A, Cooke G, et al. Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nature Communications [Internet]. 2022 Apr 12 [cited 2022 May 28];13(1):1957. Available from: https://www.nature.com/articles/s41467-022-29521-z#ref-CR2%202.

11. Asly M, Hazim A. Rehabilitation of post-COVID-19 patients. Pan African Medical Journal. 2020 Jul 9;36(168).

12. Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, et al. COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Medicine and Infectious Disease [Internet]. 2021 Feb 22;40:101995. Available from: https://pubmed.ncbi.nlm.nih.gov/33631340/

13. Pereira ÉF, Teixeira CS, Santos A dos. Qualidade de vida: abordagens, conceitos e avaliação. Revista Brasileira de Educação Física e Esporte [Internet]. 2012 Jun 1;26(2):241–50. Available from: http://www.periodicos.usp.br/rbefe/article/view/45895

14. Kluthcovsky ACGC, Kluthcovsky FA. O WHOQOL-bref, um instrumento para avaliar qualidade de vida: uma revisão sistemática. Revista de Psiquiatria do Rio Grande do Sul. 2009;31(3 suppl).

15. Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al. A systematic review of quality of life research in medicine and health sciences. Quality of Life Research. 2019 Jun 11;28(10):2641–50.

16. Word Health Organization. (1998). Programme on mental health: WHOQOL user manual, 2012 revision. World Health Organization.

17. World Health Organization. (1996). WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996 (No. WHOQOL-BREF). World Health Organization

18. Fleck MP, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref.” Revista de Saúde Pública. 2000 Apr;34(2):178–83.

19. Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. Journal of Infection. 2020 Dec; 81(6): e4–e6

20. Han JH, Womack KN, Tenforde MW, Files DC, Gibbs KW, Shapiro NI, et al. Associations between persistent symptoms after mild COVID‐19 and long‐term health status, quality of life, and psychological distress. Influenza and Other Respiratory Viruses. 2022 Jul;16(4):680-689

21. Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post‐COVID‐19 manifestations. International Journal of Clinical Practice. 2021 Mar;75(3):e13746

22. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv: The Preprint Server for Health Sciences [Internet]. 2021 Jan 30; Available from: https://pubmed.ncbi.nlm.nih.gov/33532785/

23. Tabacof L, Tosto-Mancuso J, Wood J, Cortes M, Kontorovich A, McCarthy D, et al. Post-acute COVID-19 Syndrome Negatively Impacts Physical Function, Cognitive Function, Health-Related Quality of Life, and Participation. American Journal of Physical Medicine & Rehabilitation [Internet]. 2022 Jan;101(1):48–52. Available from: https://dx.doi.org/10.1097%2FPHM.0000000000001910

24. John AE, Joseph C, Jenkins G, Tatler AL. COVID‐19 and pulmonary fibrosis: A potential role for lung epithelial cells and fibroblasts. Immunological Reviews. 2021 May 24;302(1):228–40

25. Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulmonary Medicine. 2020 Aug 11;2020:1–10.

26. Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis- Is it reversible? The Indian Journal of Tuberculosis [Internet]. 2020 Nov 10 [cited 2021 Jan 27]; Available from: https://pubmed.ncbi.nlm.nih.gov/34099197/

27. Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. The Lancet Respiratory Medicine. 2022 Sep;10(9):863-876

28. de Andrade CLT, Pereira CC de A, Martins M, Lima SML, Portela MC. COVID-19 hospitalizations in Brazil’s Unified Health System (SUS). Nunes BP, editor. PLOS ONE. 2020 Dec 10;15(12):e0243126.

29. Oxygen sources and distribution for COVID-19 treatment centres [Internet]. www.who.int. Available from: https://www.who.int/publications/i/item/oxygen-sources-and-distribution-for-covid-19-treatment-centres

30. Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Medicine. 2020 Feb 19;46(4):637–53.

31. Stevens RD, Marshall SA, Cornblath DR, Hoke A, Needham DM, de Jonghe B, et al. A framework for diagnosing and classifying intensive care unit-acquired weakness. Critical Care Medicine. 2009 Oct;37:S299–308.

32. Lechowicz K, Drożdżal S, Machaj F, Rosik J, Szostak B, Zegan-Barańska M, et al. COVID-19: The Potential Treatment of Pulmonary Fibrosis Associated with SARS-CoV-2 Infection. Journal of Clinical Medicine [Internet]. 2020 Jun 19;9(6). Available from: https://pubmed.ncbi.nlm.nih.gov/32575380/

33. Fleck MP de A, Leal OF, Louzada S, Xavier M, Chachamovich E, Vieira G, et al. Desenvolvimento da versão em português do instrumento de avaliação de qualidade de vida da OMS (WHOQOL-100). Revista Brasileira de Psiquiatria. 1999 Mar;21(1):19–28

34. Carneiro L. taxa de informalidade cai para 40% no Brasil em 2022, diz IBGE. Globo. 2023.

35. Iob E, Steptoe A, Zaninotto P. Mental health, financial, and social outcomes among older adults with probable COVID-19 infection: A longitudinal cohort study. Proceedings of the National Academy of Sciences. 2022 Jun 28;119(27).

36. Iob E, Steptoe A, Zaninotto P. Mental health, financial, and social outcomes among older adults with probable COVID-19 infection: A longitudinal cohort study. Proceedings of the National Academy of Sciences. 2022 Jun 28;119(27).

37. Halpin, S. J. et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol., v. 93, n. 2, p. 1013-22

Published

2025-08-22

How to Cite

Escorcio, R., Guedes, E. B., & Penha, P. J. (2025). Quality of life and persistent symptoms in patients with post-covid syndrome. Revista Contexto & Saúde, 25(50), e14615. https://doi.org/10.21527/2176-7114.2025.50.14615

Issue

Section

ORIGINAL ARTICLE