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- Title
Self-Reported Everyday Functioning After COVID-19 Infection.
- Authors
Iwashyna, Theodore J.; Smith, Valerie A.; Seelye, Sarah; Bohnert, Amy S. B.; Boyko, Edward J.; Hynes, Denise M.; Ioannou, George N.; Maciejewski, Matthew L.; O'Hare, Ann M.; Viglianti, Elizabeth M.; Berkowitz, Theodore S.; Pura, John; Womer, James; Kamphuis, Lee A.; Monahan, Max L.; Bowling, C. Barrett
- Abstract
Key Points: Question: Do veterans who had a history of COVID-19 report worse everyday function 18 months after their infection than veterans with a similar risk with no history of COVID-19? Findings: In this cohort study of 372 veterans, many veterans reported worse everyday function compared with how they recalled feeling before the COVID-19 pandemic. However, there was no consistent pattern of worse functioning among those who had a confirmed infection of COVID-19 compared with those without confirmed infection. Meaning: These findings suggest that the negative impacts of the COVID-19 pandemic on everyday function may occur via multiple pathways regardless of whether or not they had a documented infection with COVID-19. This cohort study examines the association of COVID-19 infection with everyday functioning 18 months after infection among US veterans. Importance: Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection. Objective: To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histories of COVID-19 infection. Design, Setting, and Participants: This cohort study used data from the US Veterans Affairs (VA) and included 186 veterans who had COVID-19 between October 2020 and April 2021 (ie, COVID-19 cohort) and 186 matched comparators who did not have documented COVID-19 infections (ie, control cohort). This match balanced the risk of COVID-19 based on 39 variables measured in the 24 months before infection or match, using principles of target trial emulation. Data were analyzed from December 2022 to December 2023. Exposure: First documented COVID-19. Main Outcome and Measures: The differences in self-reported everyday functioning 18 months after COVID-19 infection were estimated and compared with their matched comparators. Within–matched pair logistic and linear regressions assessed differences in outcomes and were weighted to account for sampling and nonresponse. Results: Among the 186 matched pairs of participants, their weighted mean age was 60.4 (95% CI, 57.5 to 63.2) years among veterans in the COVID-19 cohort (weighted sample, 91 459 of 101 133 [90.4%] male; 30 611 [30.3%] Black or African American veterans; 65 196 [64.4%] White veterans) and 61.1 (95% CI, 57.8 to 64.4) years among their comparators in the control cohort (91 459 [90.4%] male; 24 576 [24.3%] Black or African American veterans; 70 157 [69.4%] White veterans). A high proportion of veterans in the COVID-19 cohort (weighted percentage, 44.9% [95% CI, 34.2% to 56.2%]) reported that they could do less than what they felt they could do at the beginning of 2020 compared with the control cohort (weighted percentage, 35.3%; [95% CI, 25.6% to 46.4%]; within–matched pair adjusted odds ratio [OR], 1.52 [95% CI, 0.79 to 2.91]). There was no association of documented COVID-19 infection with fatigue, substantial pain, limitations in either activities of daily living and instrumental activities of daily living, severely curtailed life-space mobility, employment, or mean health-related quality of life on a utility scale. Conclusions and Relevance: In this cohort study of veterans with and without documented COVID-19, many reported a substantial loss of everyday functioning during the pandemic regardless of whether or not they had a documented infection with COVID-19. Future work with larger samples is needed to validate the estimated associations.
- Subjects
COVID-19; CONFIDENCE intervals; SELF-evaluation; ACTIVITIES of daily living; REGRESSION analysis; QUALITY of life; DESCRIPTIVE statistics; RESEARCH funding; LOGISTIC regression analysis; ODDS ratio; LONGITUDINAL method
- Publication
JAMA Network Open, 2024, Vol 7, Issue 3, pe240869
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.0869