Association of SARS-CoV-2 With Health-related Quality of Life 1 Year After Illness Using Latent Transition Analysis
By
Lauren E Wisk
Michael Gottlieb
Peizheng Chen
Huihui Yu
Kelli N O’Laughlin
Kari A Stephens
Graham Nichol
Juan Carlos C Montoy
Robert M Rodriguez
Michelle Santangelo
Kristyn Gatling
Erica S Spatz
Arjun K Venkatesh
Kristin L Rising
Mandy J Hill
Ryan Huebinger
Ahamed H Idris
Michael Willis
Efrat Kean
Samuel A McDonald
Joann G Elmore
Robert A Weinstein
for the INSPIRE Group
June 10, 2025
Clinical Scorecard: Impact of SARS-CoV-2 on Health-Related Quality of Life One Year Post-Infection: A Latent Transition Analysis
At a Glance
Category Detail
Condition Post-acute sequelae of SARS-CoV-2 infection affecting health-related quality of life (HRQoL) Key Mechanisms Persistent physical and mental health impairments including fatigue, cognitive deficits, and emotional distress impacting HRQoL domains Target Population Adults (≥18 years) with acute COVID-19–like illness tested for SARS-CoV-2 Care Setting Multicenter outpatient and community settings across the United States
Key Highlights
Four distinct HRQoL classes identified: optimal overall, poor mental, poor physical, and poor overall HRQoL. COVID-19 positive participants showed significant physical HRQoL recovery by 3 months and mental HRQoL improvement by 9 months post-infection. Approximately 20% of adults experienced suboptimal HRQoL persisting from 3 to 12 months after infection. Guideline-Based Recommendations
Diagnosis
Use FDA-approved molecular or antigen-based SARS-CoV-2 testing in symptomatic adults to confirm infection status. Assess HRQoL using validated patient-reported outcome measures such as PROMIS-29 and PROMIS SF-8a. Management
Monitor physical and mental health domains longitudinally to identify patients with persistent impairments. Provide supportive care targeting fatigue, cognitive dysfunction, and emotional distress to improve HRQoL. Recognize that mental health recovery may lag behind physical recovery, requiring extended follow-up. Monitoring & Follow-up
Conduct follow-up assessments every 3 months up to 12 months post-infection to track HRQoL trajectories. Utilize latent transition analysis or similar methods to identify changes in HRQoL status over time. Risks
Persistent poor HRQoL can impact return to work and social participation. Approximately one-fifth of patients may experience long-term suboptimal HRQoL despite recovery efforts. Patient & Prescribing Data
Adults with symptomatic COVID-19–like illness tested for SARS-CoV-2
Recovery trajectories differ between physical and mental health domains; interventions may need to be tailored accordingly.
Clinical Best Practices
Incorporate standardized patient-reported outcome measures (PROMIS instruments) in routine follow-up of COVID-19 patients. Recognize and address both physical and mental health components of post-COVID conditions. Use longitudinal data to guide individualized patient care and resource allocation. Educate patients about the expected timeline of recovery, emphasizing that mental health improvements may take longer. References
