A comparison of allied healthcare versus no allied healthcare on participation, fatigue, physical functioning and health-related quality of life for patients with persistent complaints after a COVID-19 infection.

OBJECTIVE

To assess the effectiveness of allied healthcare versus no allied healthcare.

MATERIALS AND

METHODS

Data from the ParaCOV cohort (allied healthcare, n = 1,451) and the LongCOVID cohort (no allied healthcare/control, n = 1427) were analyzed. Average treatment effects (ATEs) between groups were estimated using Targeted Maximum Likelihood Estimation adjusted for age, sex, body mass index, smoking status, comorbidities, and effect outcomes' baseline values. A ≥ 10% between-group difference in improvement from baseline (BTGD) was considered clinically relevant for participation, fatigue, and physical functioning, and ≥0.062 for health-related quality of life.

RESULTS

Patients receiving allied healthcare were older (49.2 vs. 41.2 years), less often female (63.3% vs. 70.1%), had higher BMI (28.2 vs. 26.1), smoked less frequently (5.0% vs. 9.0%), had more comorbidities (49.2% vs. 41.9%), and lower baseline anxiety and depression scores compared to those not receiving allied healthcare. For participation, ATEs after 6 and 12 months were respectively -2.62 (95%CI: -4.39; -0.86) and -1.68 (95%CI: -4.81;1.45), with BTGDs of 4.7% and 1.8% favoring the control. For fatigue, ATEs were 1.72 (95%CI: -0.14; 3.58) and 0.97 (95%CI: -1.48; 3.41), with BTGDs of 6.5% and 3.7% favoring the control. For physical functioning, ATEs were 5.75 (95% CI: 4.42; 7.09) and 6.36 (95%CI: 4.84; 7.88), with BTGDs of 1.4% and 2.2% favoring allied healthcare. For health-related quality of life, ATEs were 0.017 (95%CI: -0.008; 0.0044) and 0.033 (95%CI: 0.011; 0.054).

CONCLUSIONS

Patients with persistent complaints after a COVID-19 infection showed significantly lower participation after 6 months, higher health-related quality of life after 12 months, and better physical functioning after 6 and 12 months of allied healthcare, however, BTGDs were not clinically relevant. Study limitations warrant cautious results interpretation.