Determinants of Health-related Quality of Life in Iranian Patients after Recovery from COVID-19: Demographic Influences and Insomnia

Mohsen Saffari, Amir H. Pakpour, Hormoz Sanaeinasab, Hojat Rashidi-Jahan, Hosein Mahmoudi, Faten Al-Zaben, Harold G. Koenig


Background: Health-related quality of life (HRQoL) may be affected by COVID-19. The current study sought to identify factors that may affect HRQoL in patients recovering from this infection in Iran.

Methods: In a cross-sectional study 258 patients diagnosed with COVID-19, participants completed a questionnaire approximately one month after hospital discharge when demographic and clinical factors (including insomnia) and HRQoL were assessed. The Insomnia Severity Index and Short Form Health Survey (SF-8) were administered at that time.  Logistic regression was used to examine independent correlates of the physical and mental health components of HRQoL.

Results: In bivariate analyses, age, gender, marital status, education, having child, early physician visit, early diagnosis, early hospitalization, symptom type, Rhesus factor, and level of insomnia were associated with various components of HRQoL (p<0.05). In multivariate analyses, poorer physical HRQoL was independently associated with female gender (OR= 4.53, 95% CI=2.22-2.29), initial symptom of cough (OR=2.73, 95% CI=1.26-5.94), and insomnia (OR=2.74, 95% CI=1.22-6.14).  Poorer mental HRQoL was associated with being age 40 years or older (OR=1.90, 95% CI=1.02-3.54), female gender (OR=2.48, 95% CI=1.26-4.88), initial symptom being cough (OR=3.12, 95% CI=1.46-6.68), and insomnia (sub-threshold insomnia, OR=3.19, 95% CI, 1.51-6.74, to severe insomnia, OR=3.86; 95% CI=1.35-11.07). 

Conclusion: Older age, female gender, initial symptom of cough, and insomnia are associated with worse HRQoL in Iranian patients recovered from COVID-19.  Healthcare professionals should be aware that these individuals may be it greater risk for poor quality of life following hospital discharge.


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