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LOS ANGELES – A new study indicates that individuals recovering from COVID-19-like illnesses may experience a slower return to mental well-being compared to physical health. The research, which followed participants for up to a year, found that while physical health typically rebounded within three months, mental well-being could take up to nine months to recover fully. Even after a year, approximately 20% of those studied reported continued suboptimal health-related quality of life (HRQoL).
The study, published in Open Forum Infectious Diseases, compared individuals who sought treatment for COVID-like symptoms. Of these, 75% tested positive for COVID-19, while the remainder tested negative.
Credit: VLADA KARPOVICH from Pexels
According to Lauren Wisk, an assistant professor of medicine at the David Geffen School of Medicine at UCLA and the study’s co-lead author, those who tested positive for COVID-19 were statistically more likely to return to optimal health-related quality-of-life than their COVID-negative counterparts over the year following infection.
This finding suggests that health authorities may have underestimated the long-term impact of other, non-COVID infections on overall well-being.
“We have newly recognized the difference in recovery with respect to mental vs. physical well-being after a COVID infection,” Wisk said.
“The findings showed that health care professionals need to pay more attention to their patients’ mental well-being after a COVID-19 infection and provide more resources that will help improve their mental health, along with their physical health.”
Understanding Health-Related Quality of Life (HRQoL)
Health-related quality of life (HRQoL) is a multi-dimensional concept that includes aspects of physical, mental, emotional, and social functioning. It goes beyond simply the absence of disease and focuses on the impact of health conditions on an individual’s overall well-being and ability to function in daily life.
HRQoL is often measured using questionnaires that assess various domains,such as physical function (e.g., mobility, energy levels), emotional well-being (e.g., anxiety, depression), social function (e.g., ability to participate in social activities), and cognitive function (e.g., memory, concentration). These measures can provide valuable insights into the subjective experience of health and illness, helping healthcare professionals tailor interventions to improve patients’ overall quality of life.Factors that can influence HRQoL include chronic diseases, acute illnesses, injuries, disabilities, and mental health conditions. Socioeconomic factors, such as income, education, and access to healthcare, can also play a significant role.
Study details and Findings
The study was conducted as part of the INSPIRE (Innovative Support for Patients with SARS-CoV-2 Infections Registry) project. It involved 4,700 participants who experienced COVID-like symptoms between December 11, 2020, and August 29, 2022, with approximately 68% being women.Researchers analyzed responses from 1,096 COVID-positive and 317 COVID-negative participants, focusing on questions related to physical function, anxiety, depression, fatigue, social participation, sleep disturbance, pain interference, and cognitive function.The responses revealed four distinct well-being categories: optimal poor mental, poor physical, and poor overall health-related quality-of-life.
“In this large, geographically diverse study of individuals with 12 months of follow-up after COVID-19-like illness, a substantial proportion of participants continued to report poor HRQoL, whether or not the inciting acute symptoms were due to SARS-CoV-2 or another illness,” the researchers wrote.
They also noted, “The majority of the recovery in physical HRQoL was observed within three months after acute illness, whereas recovery in mental well-being appeared to be more gradual, with significant improvements manifesting more profoundly between six and nine months after infection.”
“Importantly for patient prognostics, we found somewhat more pronounced recovery (ie, return to the optimal HRQoL) for those in the COVID+ group compared to the COVID- groups, after adjustment.”
However, the researchers cautioned that “approximately one in five respondents remained in the poor overall HRQoL group with a high likelihood of self-reporting long COVID up to 12 months after initial infection.”
Limitations and Future Research
The study’s authors acknowledge certain limitations that warrant further inquiry.These include the potential inability to capture all differences among participants, uncertainty regarding the specific conditions affecting symptomatic COVID-negative patients, and the possibility of false-positive or false-negative COVID test results.
“Future research should focus on how to improve the treatment models of care for patients who continue to experience COVID-19 symptoms and their impact on patients’ quality of life, especially as one in five patients may continue to suffer over a year after their initial infection which likely reflects long COVID,” Wisk said.
The study co-authors are Dr. Joann Elmore of UCLA, Dr. Michael Gottlieb and dr. Robert Weinstein of Rush University, and others with the INSPIRE Group.
More details:
Association ofSARS-cov-2 With health-related Quality of Life 1 Year After Illness Using Latent Transition Analysis, Open forum Infectious Diseases (2025).
