Long-Term Changes in Health-Related Quality of Life and Economic Burden After a SARS-CoV-2 Infection: Analysis of the Long COVID Prospective Cohort Study in Nairobi
Issued Date
2026-05-01
Resource Type
ISSN
22121099
eISSN
22121102
Scopus ID
2-s2.0-105022254498
Pubmed ID
41259895
Journal Title
Value in Health Regional Issues
Volume
53
Rights Holder(s)
SCOPUS
Bibliographic Citation
Value in Health Regional Issues Vol.53 (2026)
Suggested Citation
Ben Â.J., Kisiangani I., Kinya I., Wynberg E., de Jong M.D., Schultsz C., Asiki G., Vassall A. Long-Term Changes in Health-Related Quality of Life and Economic Burden After a SARS-CoV-2 Infection: Analysis of the Long COVID Prospective Cohort Study in Nairobi. Value in Health Regional Issues Vol.53 (2026). doi:10.1016/j.vhri.2025.101545 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114437
Title
Long-Term Changes in Health-Related Quality of Life and Economic Burden After a SARS-CoV-2 Infection: Analysis of the Long COVID Prospective Cohort Study in Nairobi
Corresponding Author(s)
Other Contributor(s)
Abstract
Objectives To characterize long-term changes in health-related quality of life (HRQoL) and factors associated with catastrophic expenditures and catastrophic costs after a SARS-CoV-2 infection. Methods Data from 291 participants of the Long COVID Prospective Cohort Study in Nairobi were analyzed. Participants were enrolled between 2022 and 2023 and followed up for 12 months. Possible factors and outcomes (HRQoL, catastrophic expenditures, and catastrophic costs) were measured every 3 months. Changes in outcomes over time were assessed using generalized estimating equations. Results HRQoL was significantly reduced by 11.4% (95% CI −16.3% to −6.5%), 8.6% (95% CI −12.5% to −4.6%), 6.1% (95% CI −10.5% to −1.8%), and 4.1% (95% CI −7.9% to −0.3%) at 6, 9, 12, and 15 months after a positive polymerase chain reaction test, respectively, compared with the period before COVID-19. HRQoL was significantly reduced by 3.3% (95% CI −6.2% to −0.5%), and 10.9% (95% CI −16.5% to −5.3%), respectively, in participants with any COVID-19-related symptoms or fatigue. Older age (odds ratio [OR] 5.83, 95% CI 2.11 to 16.15), no COVID-19 vaccination (OR 5.83, 95% CI 2.11 to 16.15), any COVID-19-related symptoms (OR 2.22, 95% CI 1.15 to 4.28), and pay cut or reduced income due to COVID-19-related symptoms (OR 17.36, 95% CI 2.28 to 132.07) were associated with high odds of experiencing catastrophic expenditures. Severe/critical SARS-CoV-2 infection (OR 4.77, 95% CI 1.72 to 13.25) and fatigue (OR 2.27, 95% CI 1.03 to 4.96) significantly increased the odds of experiencing catastrophic costs, whereas better HRQoL (OR 0.12, 95% CI 0.02 to 0.57) and social support (OR 0.30, 95% CI 0.09 to 0.93) decreased the odds. Conclusions HRQoL remains reduced up to 15 months after a SARS-CoV-2 infection compared with pre-COVID-19 levels, with participants in better health and socioeconomic status less likely to experience catastrophic expenditures and catastrophic costs.