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Fear of COVID-19 Among Post-Infected Adults Can Impact Quality of Life
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Key Takeaways
- COVID-19 survivors experience varying levels of fear and psychological impact, affecting their HRQoL significantly.
- The study identified distinct survivor groups based on fear and impact, with "fearful and highly impacted" individuals facing severe life challenges.
COVID-19 survivors deemed the most highly impacted and fearful also reported the lowest health-related quality of life scores, indicating an association.
Among thousands of adult survivors of COVID-19, many indicated they feel at least mildly impacted by fear and adverse psychological health effects related to their infection, and almost half of respondents noted that they were moderately or highly impacted by the effects of their disease course, according to the results of a cross-sectional study published in the Journal of Epidemiology and Global Health.1
The fear and impact of COVID-19 can cause reductions in quality of life for those affected. | Image Credit: © pressmaster | stock.adobe.com
Imperatively, these psychological effects related to their infection led to impacts to health-related (HR) quality of life (QOL) (HRQOL), with patients who were deemed “less impacted and less fearful” following their infection demonstrating significantly higher HRQOL scores, both regarding mental and physical health, compared with patients who were “highly impacted and fearful.”1
Research has previously linked COVID-19-associated fear or symptoms of post-traumatic stress disorder (PTSD) to worsened HRQoL in the general population. While investigators have also found that the fear of COVID-19 may serve a protective function by elevating disease prevention behaviors, the likelihood of accompanying psychological distress is strong, leading to poor health behaviors and complications such as fatigue or cognitive function decline.1,2,3
Long COVID, the condition in which survivors of COVID-19 experience prolonged symptoms for weeks or months following their infection, can further lower QoL scores as the impacts and fear of infection or continued symptoms can translate into long-term emotional burdens. One systemic review found that 37% of included patients indicated reduced QoL at a mean follow-up point of 221 days following infection, demonstrating the potential for long-term QoL impacts in COVID-19 survivors.4
The current trial sought to determine distinct types of fear and impact of the COVID-19 pandemic experienced by survivors of COVID-19 and examine the association between types of COVID-19 fear with post-traumatic stress symptoms and HRQoL. To assess COVID-19 impact and fear, the investigators used the COVID-19 Impact Battery – Disability Scale (CIB-D) and the Fear of COVID-19 Scale (FCoV-19 S). Post-traumatic stress symptoms were analyzed using the Impact of Event Scale-Revised (IES-R) questionnaire, while HRQoL was measured using the 36-item Short Form Survey.1
A total of 5890 COVID-19 survivors were examined. Individuals with the highest COVID-19 impact and fear scores, labeled “fearful and highly impacted,” comprised 27% of patients. Another group, consisting of patients the second-most impacted by COVID-19 but the least fearful—termed “moderately impacted yet not fearful”—comprised 23% of individuals. Patients who were least impacted by COVID-19 and less fearful of the disease or the pandemic were labeled as “less impacted and less fearful,” and comprised 19% of participants. Lastly, patients making up the largest group, representing 31.7% of the sample, represent those mildly impacted by COVID-19, but were the second-most fearful.1
Data indicated that survivors in the “fearful and highly impacted” group had the highest percentage of severe-to-extremely severe difficulties in several domains of life during the pandemic, with about a third of them experiencing challenges joining group activities and emotional impacts. Notably, 80% of patients in this group felt uncomfortable or afraid of losing their lives due to COVID-19. An important contrast emerged in the observation: survivors in the “less impacted and less fearful” cohort had the lowest impact score and lowest level of fear among all groups, indicating the association between fear and HRQoL scores.1
The study authors postulated that this trial was one of the few to explore heterogeneity in fear and impact of COVID-19 in a large sample of survivors. Other trials that examined this potential association experienced limitations, including some that were faced early-pandemic restrictions and small study populations. While this current trial is not without its own limitations—the cross-sectional study design means stakeholders should interpret the results with careful consideration—the large sample size and their methods to determine COVID-19 fear and impact provide a thorough understanding of how patients deal with the aftermath of a COVID-19 infection.1,2,3
“Our findings provide a foundation for tailoring interventions and support for this population, recognizing the need for a holistic understanding of their experiences,” the study authors concluded.1
REFERENCES
1. Do TX, Quach HL, Hoang TNA, et al. Fear and impact of COVID-19 among post-infected adults: Types and associations with quality of life and post-traumatic stress symptoms. J Epidemiol Glob Health. 2024;14:1748-1763. doi:10.1007/s44197-024-00333-2
2. Demirbas N, Kutlu R. Effects of COVID-19 fear on society’s quality of life. Int J Ment Health Addiction. 2022;20:2813-2822. doi:10.1007/s11469-021-00550-x
3. Olapegba PO, Chovwen CO, Ayandele O, et al. Fear of COVID-19 and preventive health behavior: Mediating role of post-traumatic stress symptomology and psychological distress. Int J Ment Health Addiction. 2022;20:2922-2933. doi:10.1007/s11469-021-00557-4
4. Michelen M, Manoharan L, Elkheir N, et al. Characterizing long COVID: a living systematic review. BMJ Global Health. 2021;6:e005427. doi:10.1136/bmjgh-2021-005427
