The Lancet Regional Health. Europe (May 2024)
Impact of long COVID on health-related quality-of-life: an OpenSAFELY population cohort study using patient-reported outcome measures (OpenPROMPT)Research in context
- Oliver Carlile,
- Andrew Briggs,
- Alasdair D. Henderson,
- Ben F.C. Butler-Cole,
- John Tazare,
- Laurie A. Tomlinson,
- Michael Marks,
- Mark Jit,
- Liang-Yu Lin,
- Chris Bates,
- John Parry,
- Sebastian C.J. Bacon,
- Iain Dillingham,
- William A. Dennison,
- Ruth E. Costello,
- Alex J. Walker,
- William Hulme,
- Ben Goldacre,
- Amir Mehrkar,
- Brian MacKenna,
- Emily Herrett,
- Rosalind M. Eggo,
- Alex Walker,
- Amelia Green,
- Amir Mehrkar,
- Andrea Schaffer,
- Andrew Brown,
- Ben Goldacre,
- Ben Butler-Cole,
- Brian MacKenna,
- Caroline Morton,
- Caroline Walters,
- Catherine Stables,
- Christine Cunningham,
- Christopher Wood,
- Colm Andrews,
- David Evans,
- George Hickman,
- Helen Curtis,
- Henry Drysdale,
- Iain Dillingham,
- Jessica Morley,
- Jon Massey,
- Linda Nab,
- Lisa Hopcroft,
- Louis Fisher,
- Lucy Bridges,
- Milan Wiedemann,
- Nicholas DeVito,
- Orla Macdonald,
- Peter Inglesby,
- Rebecca Smith,
- Richard Croker,
- Robin Park,
- Rose Higgins,
- Sebastian Bacon,
- Simon Davy,
- Steven Maude,
- Thomas O'Dwyer,
- Tom Ward,
- Victoria Speed,
- William Hulme,
- Liam Hart,
- Pete Stokes,
- Krishnan Bhaskaran,
- Ruth Costello,
- Thomas Cowling,
- Ian Douglas,
- Rosalind Eggo,
- Stephen Evans,
- Harriet Forbes,
- Richard Grieve,
- Daniel Grint,
- Emily Herrett,
- Sinead Langan,
- Viyaasan Mahalingasivam,
- Kathryn Mansfield,
- Rohini Mathur,
- Helen McDonald,
- Edward Parker,
- Christopher Rentsch,
- Anna Schultze,
- Liam Smeeth,
- John Tazare,
- Laurie Tomlinson,
- Jemma Walker,
- Elizabeth Williamson,
- Kevin Wing,
- Angel Wong,
- Bang Zheng,
- Christopher Bates,
- Jonathan Cockburn,
- John Parry,
- Frank Hester,
- Sam Harper,
- Shaun O'Hanlon,
- Alex Eavis,
- Richard Jarvis,
- Dima Avramov,
- Paul Griffiths,
- Aaron Fowles,
- Nasreen Parkes,
- Rafael Perera,
- David Harrison,
- Kamlesh Khunti,
- Jonathan Sterne,
- Jennifer Quint
Affiliations
- Oliver Carlile
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK; Corresponding author.
- Andrew Briggs
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Alasdair D. Henderson
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Ben F.C. Butler-Cole
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- John Tazare
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Laurie A. Tomlinson
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Michael Marks
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK; Hospital for Tropical Diseases, University College London Hospital, London, WC1E 6JD, UK; Division of Infection and Immunity, University College London, London, WC1E 6BT, UK
- Mark Jit
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Liang-Yu Lin
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Chris Bates
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
- John Parry
- TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX, UK
- Sebastian C.J. Bacon
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- Iain Dillingham
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- William A. Dennison
- Patient and Public Involvement Steering Committee, London, UK
- Ruth E. Costello
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Alex J. Walker
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- William Hulme
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- Ben Goldacre
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK
- Emily Herrett
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Rosalind M. Eggo
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Alex Walker
- Amelia Green
- Amir Mehrkar
- Andrea Schaffer
- Andrew Brown
- Ben Goldacre
- Ben Butler-Cole
- Brian MacKenna
- Caroline Morton
- Caroline Walters
- Catherine Stables
- Christine Cunningham
- Christopher Wood
- Colm Andrews
- David Evans
- George Hickman
- Helen Curtis
- Henry Drysdale
- Iain Dillingham
- Jessica Morley
- Jon Massey
- Linda Nab
- Lisa Hopcroft
- Louis Fisher
- Lucy Bridges
- Milan Wiedemann
- Nicholas DeVito
- Orla Macdonald
- Peter Inglesby
- Rebecca Smith
- Richard Croker
- Robin Park
- Rose Higgins
- Sebastian Bacon
- Simon Davy
- Steven Maude
- Thomas O'Dwyer
- Tom Ward
- Victoria Speed
- William Hulme
- Liam Hart
- Pete Stokes
- Krishnan Bhaskaran
- Ruth Costello
- Thomas Cowling
- Ian Douglas
- Rosalind Eggo
- Stephen Evans
- Harriet Forbes
- Richard Grieve
- Daniel Grint
- Emily Herrett
- Sinead Langan
- Viyaasan Mahalingasivam
- Kathryn Mansfield
- Rohini Mathur
- Helen McDonald
- Edward Parker
- Christopher Rentsch
- Anna Schultze
- Liam Smeeth
- John Tazare
- Laurie Tomlinson
- Jemma Walker
- Elizabeth Williamson
- Kevin Wing
- Angel Wong
- Bang Zheng
- Christopher Bates
- Jonathan Cockburn
- John Parry
- Frank Hester
- Sam Harper
- Shaun O'Hanlon
- Alex Eavis
- Richard Jarvis
- Dima Avramov
- Paul Griffiths
- Aaron Fowles
- Nasreen Parkes
- Rafael Perera
- David Harrison
- Kamlesh Khunti
- Jonathan Sterne
- Jennifer Quint
- Journal volume & issue
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Vol. 40
p. 100908
Abstract
Summary: Background: Long COVID is a major problem affecting patient health, the health service, and the workforce. To optimise the design of future interventions against COVID-19, and to better plan and allocate health resources, it is critical to quantify the health and economic burden of this novel condition. We aimed to evaluate and estimate the differences in health impacts of long COVID across sociodemographic categories and quantify this in Quality-Adjusted Life-Years (QALYs), widely used measures across health systems. Methods: With the approval of NHS England, we utilised OpenPROMPT, a UK cohort study measuring the impact of long COVID on health-related quality-of-life (HRQoL). OpenPROMPT invited responses to Patient Reported Outcome Measures (PROMs) using a smartphone application and recruited between November 2022 and October 2023. We used the validated EuroQol EQ-5D questionnaire with the UK Value Set to develop disutility scores (1-utility) for respondents with and without Long COVID using linear mixed models, and we calculated subsequent Quality-Adjusted Life-Months (QALMs) for long COVID. Findings: The total OpenPROMPT cohort consisted of 7575 individuals who consented to data collection, with which we used data from 6070 participants who completed a baseline research questionnaire where 24.6% self-reported long COVID. In multivariable regressions, long COVID had a consistent impact on HRQoL, showing a higher likelihood or odds of reporting loss in quality-of-life (Odds Ratio (OR): 4.7, 95% CI: 3.72–5.93) compared with people who did not report long COVID. Reporting a disability was the largest predictor of losses of HRQoL (OR: 17.7, 95% CI: 10.37–30.33) across survey responses. Self-reported long COVID was associated with an 0.37 QALM loss. Interpretation: We found substantial impacts on quality-of-life due to long COVID, representing a major burden on patients and the health service. We highlight the need for continued support and research for long COVID, as HRQoL scores compared unfavourably to patients with conditions such as multiple sclerosis, heart failure, and renal disease. Funding: This research was supported by the National Institute for Health and Care Research (NIHR) (OpenPROMPT: COV-LT2-0073).
