Functioning of post-COVID-19 patients: a cross-sectional study at the outpatient clinic for long-term effects

Sanna Stålnacke; Helena Liira; Velina Vangelova-Korpinen; Hélène Virrantaus; Mari Kanerva; Kirsi Kvarnström; Markku Sainio; Antti Malmivaara; Aki Vuokko; Mikko Varonen; Mikko Venäläinen; Jari Arokoski

doi:10.1080/02813432.2024.2410986

Functioning of post-COVID-19 patients: a cross-sectional study at the outpatient clinic for long-term effects

Scand J Prim Health Care. 2024 Oct 3:1-9. doi: 10.1080/02813432.2024.2410986. Online ahead of print.

Authors

Affiliations

¹ Outpatient Clinic for Persistent Symptom Rehabilitation, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
² Turku University Hospital and University, Turku, Finland.
³ Finnish Institute for Health and Welfare, Orton Orthopaedic Hospital, University of Helsinki, Helsinki, Finland.
⁴ Finnish Institute of Occupational Health, Helsinki, Finland.
⁵ Department of Medical Physics, University of Turku, Turku, Finland.
⁶ Department of Internal Medicine and Rehabilitation, Division of Rehabilitation, Helsinki University Hospital and Helsinki University, Helsinki, Finland.

PMID: 39360345
DOI: 10.1080/02813432.2024.2410986

Abstract

Background: After COVID-19 infection, long-term impacts on functioning may occur. We studied the functioning of patients with post-COVID-19 condition (PCC) and compared them to controls without PCC.

Methods: This cross-sectional study consisted of 442 patients with PCC referred to rehabilitation at the Helsinki University Hospital (HUS) Outpatient Clinic for the Long-Term Effects of COVID-19, and 198 controls without PCC. Functioning was assessed with a questionnaire including WHODAS 2.0. Patients underwent physical testing including a hand grip strength test (HGST) and a 6-minute walking test (6MWT). Lifestyle was assessed by questionnaire and comorbidities were collected as ICD-10 codes from the HUS Data Lake on the HUS Acamedic platform.

Results: The WHODAS 2.0 average total score was 34 (SD 18) (moderate functional limitation) for patients with PCC and 6 (SD 8) (normal or mild limitation) for the controls. The disability was higher in all aspects of WHODAS 2.0 in patients with PCC. Bivariate binomial and multivariable regression analyses showed that the presence of comorbidities, anxiety, depression, and smoking predicted a WHODAS 2.0 score of 24 (moderate functional limitation) or above in the PCC group. The average 6MWT distance was 435 m (SD 98 m) in patients with PCC and 627 m (SD 70 m) in controls. HGST measurements showed no significant differences from controls.

Conclusions: In conclusion, patients with PCC had significantly reduced functioning based on WHODAS 2.0 scores and the 6MWT results. Comorbidities, anxiety, depression, and smoking were associated with moderate or severe limitations in functioning. Findings support that PCC is multifactorial and requires a holistic approach to rehabilitation.

Keywords: 6-minute walk test; Post-COVID-19 condition; WHODAS 2.0; cross-sectional study; functioning; hand grip strength.

Plain language summary

The post-COVID-19 condition (PCC) has been shown to negatively impact functioning, quality of life, and mental health, with cognitive and physical impairments being prevalent.This study found that patients with PCC had significantly reduced functioning compared to controls.Key factors predicting severe disability included comorbidities, smoking, and mental health issues like anxiety and depression.The reduced functioning in patients with PCC appears to be multifactorial and not only related to COVID-19 infection.