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Two years and counting: a prospective cohort study on the scope and severity of post-COVID symptoms across diverse patient groups in the Netherlands—insights from the CORFU study

  • Dorthe O. Klein*
  • , Sophie F. Waardenburg
  • , Emma B.N.J. Janssen
  • , CAPACITY-COVID Collaborative Consortium
  • , Marieke S.J.N. Wintjens
  • , Maike Imkamp
  • , Stella C.M. Heemskerk
  • , Erwin Birnie
  • , Gouke J. Bonsel
  • , Michiel C. Warlé
  • , Lotte M.C. Jacobs
  • , Bea Hemmen
  • , Jeanine Verbunt
  • , Bas C.T. van Bussel
  • , Susanne van Santen
  • , Bas L.J.H. Kietelaer
  • , Gwyneth Jansen
  • , Frederikus A. Klok
  • , Martijn D. de Kruif
  • , Kevin Vernooy
  • Juanita A. Haagsma, Folkert W. Asselbergs, Marijke Linschoten, Jochen W.L. Cals, Hugo Ten Cate, Iwan C.C. van der Horst, Nick Wilmes, Chahinda Ghossein-Doha, Sander M.J. van Kuijk
*Corresponding author for this work
  • Maastricht University Medical Centre
  • Maastricht University
  • Radboud University Medical Center
  • Adelante Center of Expertise in Rehabilitation and Audiology
  • Mayo Clinic Rochester, MN
  • Zuyderland Medical Center (Heerlen)
  • Leiden University
  • University of Amsterdam
  • National Institute for Health and Care Research
  • University College London
  • Interuniversity Cardiology Institute of the Netherlands

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
17 Downloads (Pure)

Abstract

Importance Little research has been done on post-COVID symptoms at 24 months postinfection and on the association these may have on health-related quality of life (HRQOL). Objective We assessed the prevalence and severity of post-COVID symptoms and quantified EuroQol 5 Dimension 5 Level (EQ-5D-5L), self-perceived health question (EuroQol Visual Analogue Scale (EQ-VAS)) and health utility scores (HUS) up to 24 months follow-up. Design The longitudinal multiple cohort CORona FollowUp (CORFU) study combines seven COVID-19 patient cohorts and a survey among the general public. The participants received questionnaires on several time points. Participants were stratified by: without a known SARS-CoV-2 infection (control group), proven SARSCoV-2 infection but non-hospitalised, proven SARS-CoV-2 infection hospitalised to the ward, and proven SARSCoV-2 infection hospitalised to the intensive care unit (ICU). Setting In this study, data of seven COVID-19 patient cohorts and a survey among the general public are included. Participants Former COVID-19 patients and controls participated in this cohort study. Main outcomes and measures Former COVID-19 patients and non-COVID-19 controls were sent questionnaires on symptoms associated with post-COVID condition. The CORFU questionnaire included 14 symptom questions on post-COVID condition using a five-level Likert-scale format. Furthermore, HRQOL was quantified using the EuroQol EQ-5D-5L questionnaire: EQ-VAS and the EQ-5D-5L utility score. The EQ-5D-5L questionnaire includes five domains that are scored on a five-point Likert scale: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Results A total of 901 participants (and 434 controls) responded at 24 months follow-up. In all former COVID-19 patients, the presence of post-COVID condition at 24 months was observed in 62 (42.5%, 95% CI 34.3% to 50.9%) of the non-hospitalised patients, 333 (65.0%, 95% CI 60.7% to 69.2%) of the hospitalised ward patients and 156 (63.2%, 95% CI 56.8% to 69.2%) of the ICU patients, respectively (p<0.001). The most common symptoms included fatigue, sleep problems, muscle weakness/pain and breathing issues, with hospitalised participants reporting most often having symptoms. Multiple post-COVID symptoms were significantly associated with EQ-5D-5L measures. The mean and SD of the EQ-VAS were 71.6 (17.9), 70.0 (17.3) and 71.4 (17.5) for non-hospitalised, ward and ICU participants, respectively, and 75.6 (17.7) for the controls (p<0.001). The HUS resulted in 0.81 (0.20), 0.77 (0.19) and 0.79 (0.22) for non-hospitalised, hospitalised ward and ICU participants, respectively, and 0.84 (0.19) for the control group (CG) (p<0.001). Conclusions Many former COVID-19 patients experience post-COVID symptoms at 24 months follow-up, with the highest prevalence in hospitalised participants. Also, former patients reported a lower HRQOL.

Original languageEnglish
Article numbere093639
JournalBMJ open
Volume15
Issue number9
DOIs
Publication statusPublished - 11 Sept 2025

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