The impact of testing positive versus negative for COVID-19 on health-related quality of life: cross-sectional evidence from the Alberta post-COVID-19 follow-up survey.

PURPOSE: The novel Coronavirus Disease 2019 (COVID-19) can have lasting physical and psychological outcomes, though little is known about the long-term impact of COVID-19 on the health-related quality of life (HRQoL) of Canadians. The aim of this study is to estimate the impacts of testing positive for COVID-19 using the EQ-5D-5 L instrument. METHODS: Our study is a secondary analysis of data collected in the Alberta POST-COVID-19 Follow-up Study, linking survey responses to administrative health data. The data included 11,705 individuals tested for COVID-19 in Alberta from October 2021 to September 2023. Survey data included test results, age, sex, and EQ-5D-5 L response. Linked administrative data included socioeconomic status, comorbidities, hospital, and intensive care unit admissions. We used linear regression to estimate differences in HRQoL pre- and post-COVID-19 testing and ordinal logistic regression to estimate the odds of worsening HRQoL in each of the EQ-5D domains. RESULTS: COVID-19-positive individuals were younger (mean 48.5 vs. 53.4 years), more often female (64.4% vs. 62.6%), and tested more recently (mean 274 vs. 519 days since test) compared to COVID-19-negative respondents. We estimated reductions in EQ-5D-5 L index score ranging from 0.0464 (CI 0.0393-0.0536) to 0.0702 (CI 0.0626-0.0777) points for respondents testing positive, and up to 0.0276 (CI 0.0190-0.0362) points for respondents testing negative. Positive respondents were also more likely to report problems within each of the EQ-5D-5 L domains. CONCLUSION: Previous COVID-19 infection has an important impact on HRQoL. These results can support health economic models and provide insight into optimal COVID-19 mitigation strategies.