Available Online at http://www.recentscientific.

com
International Journal of
CODEN: IJRSFP (USA)
Recent Scientific
International Journal of Recent Scientific Research Research
Vol. 12, Issue, 07 (C), pp. 42363-42367, July, 2021
ISSN: 0976-3031 DOI: 10.24327/IJRSR
Research Article
QUALITY OF LIFE AFTER NOVEL CORONAVIRUS INFECTION (COVID-19)- AN
OBSERVATIONAL STUDY
Simran Kundnani1* and Jalpa Parikh2
1Physiotherapy (Neuroscience), Ahmedabad Institute of Medical Sciences, Gujarat University,
Ahmedabad, Gujarat, India
2Ahmedabad Institute of Medical Sciences, Gujarat University, Ahmedabad, Gujarat, India

DOI: http://dx.doi.org/10.24327/ijrsr.2021.1207.6082

ARTICLE INFO ABSTRACT

Article History: Objectives: - Coronavirus has put impact on both physical and mental health of the person. It is
th
expected that patients with home isolation or hospital stay for long isolation period due to covid-19
Received 14 April, 2021 infection show reduction in quality of life. So, the aim of study was to find out quality of life after
Received in revised form 29th novel coronavirus infection (COVID-19).
May, 2021 Methodology: 88 subjects with age of 18-35 years were included. To assess quality of life EQ-5D-
Accepted 05th June, 2021 5L Questionnaire was used which include 5 components (mobility, selfcare, usual activities,
Published online 28th July, 2021 pain/discomfort, anxiety/depression)
Results: Slight reduction was seen in overall quality of life in individuals after covid-19 infection.
Key Words: Conclusion: According to this study there is slight reduction in overall quality of life of post covid-
COVID-19, Quality of life, EQ-5D-5L 19 subjects, main component involved are pain/discomfort and anxiety/depression.

Copyright © Simran Kundnani and Jalpa Parikh, 2021, this is an open-access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided
the original work is properly cited.

INTRODUCTION persist for week to months, it may lead to a more negative

impact on patients’ QoL. Quality of life is an important
Since December 2019, a novel coronavirus, Severe Acute measure that is used for assessing the impact of diseases,
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has disorders, or disabilities on the physical, mental, and social
emerged in Wuhan, Hubei Province, China. The outbreak of domains of patient health.
this infection caused by SARS-CoV-2 was officially named as
Coronavirus Disease 2019 (COVID-19) by the World Health The assessment will help healthcare providers to identify the
Organization (WHO).(1) The main clinical characteristics of factors affecting QoL and recognize the aspects of COVID-19
COVID-19 are fever, cough and shortness of breath.(2)and a management that needs to be enhanced for improving the QoL
proportion of patients may accompany with new loss of taste or of patients. (8) COVID-19 patients are isolated for longer time
smell(3), diarrhoea, nausea, vomiting and other symptoms.(4) and because of the post covid symptoms, there is affection in
mental and physical health of the patient with assuming
According to WHO, some people who have had COVID-19, decrease in quality of life. The 5-level EQ-5D version (EQ-5D-
whether they have needed hospitalization or not, continue to 5L) was introduced by the EuroQol Group in 2009.The
experience symptoms, including fatigue, respiratory and descriptive system comprises five dimensions: mobility, self-
neurological symptoms. Lasting symptoms of coronavirus can care, usual activities, pain/discomfort, and anxiety/depression.
include fatigue, breathlessness, cough, chest pain, palpitations, EQ VAS records the patient’s self-rated health on a vertical
headache, joint pain, myalgia and weakness, insomnia, pins and visual analogue scale, where the endpoints are labelled ‘The
needles, diarrhoea, rash or hair loss, impaired balance and gait, best health you can imagine’ and ‘The worst health you can
neurocognitive issues including memory and concentration imagine’. The VAS can be used as a quantitative measure of
problems (5). General, immobilisation during acute illness can health outcome that reflect the patient’s own judgement.(9)Since
cause loss of physical functions with impact on activities of the pandemic began, the EQ-5D-5L has been used to assess
daily living (ADL)(6)and post COVID-19 symptoms affect QoL in the Netherlands,(10) Germany,(11) France,(12)
quality of life Moreover, inflammation may persistently exist Morocco, (13)
China,(14)
Hong Kong,(15) Vietnam,(16) and
after viral clearance (7). Since the symptoms after covid-19 (17)
Spain in various contexts including the general public, those

*Corresponding author: Simran Kundnani

Physiotherapy (Neuroscience), Ahmedabad Institute of Medical Sciences, Gujarat University, Ahmedabad, Gujarat, India
Simran Kundnani and Jalpa Parikh., Quality of Life After Novel Coronavirus Infection (COVID-19)-
( An Observational Study

with specific diseases, and healthcare providers; these studies anxious/depression and 6.7% indicating moderately
have shown an overall decline in QoL, and pronounced anxious/depression.
worsening of anxiety and depression.
In EQ VAS,, out of 88 subjects, 15 subjects have marked score
There is lack of research for Quality of life aspect of post between (85-90)
90) health they can imagine, 36 subjects have
COVID-19 subjects in India, Therefore present study was done marked score between (90-95)
95) health they can imagine, 37
to find out quality of life after novel coronavirus infection subjects have marked score between (95
(95-100) health they can
(COVID-19)
19) with the objectives to assessing overall health imagine.
related quality of life of post COVID-1919 subjects within 2
months with 5 components mobility, selfcare,
selfcare usual activities,
anxiety/depression, pain/discomfort.
MATERIALS AND METHODS
The observational study was performed among 88 subjects of
age 18-35 years with post COVID-19 19 infection (within 2
months), including both male and female and who are
educated.. The study was approved by Ethical review
committee. Random sampling was done.
The exclusion criteria were subjects with immunological
problems like (GBS, multiple sclerosis, psoriasis etc), any other
systematic illness(blood pressure, flu etc), visual and
a hearing
problem.
The materials used were EQ-5D-5L 5L questionnaire it was filled
and submitted through google form and interview method.
Consent form was kept prior filling the questionnaire on google
form. Sample size was calculated according to power analysis.
Outcome measures is EQ-5D-5L.
EQ-5D-5L
The scale comprises of 5 dimensions. Each dimension has 5
levels: no problems, slight problems, moderate problems,
severe problems and extreme problems. The patient is asked to
indicate his/her health statee by ticking the box next to the most
appropriate statement in each of the five dimensions. This
decision results in a 1-digit
digit number that expresses the level
selected for that dimension. The digits for the five dimensions
can be combined into a 5-digit number mber that describes the
patient’s health state.EQ VAS scale is numbered from 0-100. 0
100 means the best health you can imagine and zero means
worst health you can imagine. Mark X on the scale to indicate
how your health is today and then write number you marked
ma on
the scale in the box below. (9)
RESULTS
In the 1st component MOBILITY, 86.4% indicating no
problem, 11.4%indicating slight problem and 2.2% indicating
moderate problem.
In the 2nd component SELF-CARE,84.1% 84.1% indicating no
problem,11.4% indicating slight problem and 4.5% indicating
moderate problem.
In the 3rd component USUAL ACTIVITIES, 73.7% indicating
no problem, 24% indicating slight problem and 2.3% indicating
moderate problem.
In the 4th component PAIN/DISCOMFORT, 61.7% indicating
no pain/discomfort, 34.8% indicating slight pain/discomfort,
2.4% indicating moderate pain/discomfort and 1.1% indicating
severe pain/discomfort.
In the 5th component ANXIETY/DEPRESSION,57.8%
ANXIETY/DEPRESSION,
indicating no anxious/depression, 35.5% indicating
indic slight
42364 | P a g e
 International Journal of Recent Scientific Research Vol. 12, Issue, 07 (C), pp. 42363-42367,
42367, July, 2021

It may be that relapse is triggered by mechanisms associated

with inflammatory processes associated with QoL changes.
Moreover, inflammation may persistently exist after viral
clearance.(20) As expected, SARS
SARS-CoV-2 particles spread
through the respiratory mucosa and infected other cells, causing
changes in peripheral immune cells and eliciting a cascade of
immune responses, finally resulting a detrimental cytokine
storm.(21) Recent evidence has suggested that clinical symptoms
were associated with inflammatory factor storms and elevated
CRP levels in COVID-19 19 patients.(22) It hypothesised that QoL
through its psychological, physical and social features predicts
chronic inflammation
flammation in schizophrenia. Several studies
reported that psychosocial factors, including poor wellwell-being,
were predictors of chronic inflammation and poor health. (23)
From this perspective, clinicians should be encouraged to think
and do future research about chronic inflammation in patients
reporting poor QoL.
Physical well-being
being may result from the physical fitness of
individuals, which is also involved in inflammatory processes.
Physically fit individuals demonstrate lower inflammatory
responses to mental stress. (24) Moreover, regular exercise has
been consistently associated with anti anti-inflammatory effects,
whereas sedentary behaviour is now considered an important
risk factor for inflammation and many health conditions
independent of physical activi activity levels.(25) Eve Garrigues
conducted study on post-discharge
discharge persistent symptoms and
health-related
related quality of life after hospitalization for COVID
COVID-19
on patients managed in hospital ward without needing intensive
care were compared with those who were transferred in
intensive care units (ICU) and results were Comparisons
between ward- and ICU patients led to no statistically
significant differences regarding those symptoms. In both
group, EQ-5D 5D (mobility, self-
self-care, pain, anxiety or depression,
usual activity)
tivity) was altered with a slight difference in pain in the
ICU group. (26)
In this study EQ-5D-5L 5L questionnaire was used to find out
quality of life in post COVIDCOVID-19 subjects and there is
substantial decline has been noted in overall quality of life.
Plenty
nty of studies has been done which suggest decline in
quality of life in post COVI
COVID-19 subjects. Limitation of the
(This scale is numbered from 0-100.
100. 100 means the best health study is relatively smaller sample size taken.
you can imagine and 0 means worst health you can imagine)
CONCLUSION
DISCUSSION Based on the results, this study concludes that there is slight
The main findings in this study were that in post COVID-19
COVID affection in quality of life of post COVID
COVID-19 subjects,
subjects exhibited slight decline in quality of life and maximum affected component like pain/discomfort and
pronounced in components of anxiety/depression and anxiety/depression have been seen.
pain/discomfort. Mechanism to this was loneliness and Acknowledgement
inactiveness reduced mobility during quarantine period this
was proved in the study, Yi Zhu. They conducted study on Sincerely thankful to my guide for always helping throughout
Factors associated with mental health outcomes among patients the study, Authors would like to thank all subjsubjects who
with COVID-19 19 treated in the Fangcang shelter hospital in participate in the study and special thanks to my family for
China and concluded that “patients
patients reported high rates of always motivating me.
symptoms of posttraumatic tic stress, anxiety, depression, Conflict of Interest: None
insomnia, and perceived stress.(18) Grazia Maugeri conducted
study on, the impact of physical activity on psychological Source of Funding: None
health during Covid-19 19 pandemic in Italy and concluded that Ethical Approval: Approved
reduction of total physical activity had a profoundly negative
impact on psychological health and well-being well of
population.(19)

42365 | P a g e
Simran Kundnani and Jalpa Parikh., Quality of Life After Novel Coronavirus Infection (COVID-19)- An Observational Study

References 13. Azizi A, Achak D, Aboudi K, Saad E, Nejjari C, Nouira

Y, Hilali A, Youlyouz-Marfak I, Marfak A. Health-
1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe related quality of life and behavior-related lifestyle
acute respiratory syndrome coronavirus 2 (SARS-CoV- changes due to the COVID-19 home confinement:
2) and coronavirus disease-2019 (COVID-19): The Dataset from a Moroccan sample. Data in brief. 2020
epidemic and the challenges. International journal of Oct 1;32:106239.
antimicrobial agents. 2020 Mar 1;55(3):105924. 14. Ping W, Zheng J, Niu X, Guo C, Zhang J, Yang H, Shi
2. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Y. Evaluation of health-related quality of life using EQ-
Wang J, Liu Y, Wei Y, Yu T. Epidemiological and 5D in China during the COVID-19 pandemic. PloS one.
clinical characteristics of 99 cases of 2019 novel 2020 Jun 18;15(6):e0234850.
coronavirus pneumonia in Wuhan, China: a descriptive 15. Wong EL, Ho KF, Wong SY, Cheung AW, Yau PS,
study. The lancet. 2020 Feb 15;395(10223):507-13. Dong D, Yeoh EK. Views on workplace policies and its
3. Dawson P, Rabold EM, Laws RL, Conners EE, impact on health-related quality of life during
Gharpure R, Yin S, Buono SA, Dasu T, Bhattacharyya coronavirus disease (COVID-19) pandemic: cross-
S, Westergaard RP, Pray IW. Loss of taste and smell as sectional survey of employees. International journal of
distinguishing symptoms of COVID-19. Clinical health policy and management. 2020 Aug 3.
Infectious Diseases. 2020 Jun 21. 16. Tran BX, Nguyen HT, Le HT, Latkin CA, Pham HQ, Vu
4. Kim J, Thomsen T, Sell N, Goldsmith AJ. Abdominal LG, Le XT, Nguyen TT, Pham QT, Ta NT, Nguyen QT.
and testicular pain: An atypical presentation of COVID- Impact of COVID-19 on economic well-being and
19. The American journal of emergency medicine. 2020 quality of life of the Vietnamese during the National
Jul 1;38(7):1542-e1. social distancing. Frontiers in psychology. 2020;11.
5. Raveendran AV, Jayadevan R, Sashidharan S. Long 17. Lara B, Carnes A, Dakterzada F, Benitez I, Piñol‐Ripoll
COVID: an overview. Diabetes & Metabolic Syndrome: G. Neuropsychiatric symptoms and quality of life in
Clinical Research & Reviews. 2021 Apr 20. Spanish patients with Alzheimer’s disease during the
6. Aarden JJ, van der Schaaf M, van der Esch M, Reichardt COVID‐19 lockdown. European journal of neurology.
LA, van Seben R, Bosch JA, Twisk JW, Buurman BM, 2020 Sep;27(9):1744-7.
Engelbert RH, Hospital-ADL study group. Muscle 18. Gu Y, Zhu Y, Xu F, Xi J, Xu G. Factors associated with
strength is longitudinally associated with mobility mental health outcomes among patients with COVID‐19
among older adults after acute hospitalization: The treated in the Fangcang shelter hospital in China.
Hospital-ADL study. Plos one. 2019 Jul Asia‐Pacific Psychiatry. 2021 Jun;13(2):e12443.
5;14(7):e0219041. 19. Maugeri G, Castrogiovanni P, Battaglia G, Pippi R,
7. Ameri H, Yousefi M, Yaseri M, Nahvijou A, Arab M, D'Agata V, Palma A, Di Rosa M, Musumeci G. The
Akbari Sari A. Mapping the cancer-specific QLQ-C30 impact of physical activity on psychological health
onto the generic EQ-5D-5L and SF-6D in colorectal during Covid-19 pandemic in Italy. Heliyon. 2020 Jun
cancer patients. Expert review of pharmacoeconomics & 1;6(6):e04315.
outcomes research. 2019 Jan 2;19(1):89-96. 20. Peiris JS, Chu CM, Cheng VC, Chan KS, Hung IF, Poon
8. Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, LL, Law KI, Tang BS, Hon TY, Chan CS, Chan KH.
Parkin D, Bonsel G, Badia X. Development and Clinical progression and viral load in a community
preliminary testing of the new five-level version of EQ- outbreak of coronavirus-associated SARS pneumonia: a
5D (EQ-5D-5L). Quality of life research. 2011 prospective study. The Lancet. 2003 May
Dec;20(10):1727-36. 24;361(9371):1767-72.
9. Available from: URL: https://euroqol.org/eq-5d- 21. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y,
instruments/eq-5d-5l-about/ Wang J, Liu Y, Wei Y, Yu T. Epidemiological and
10. Cohen A, Selles RW, De Ridder WA, Ter Stege MH, clinical characteristics of 99 cases of 2019 novel
Souer JS, Wouters RM, Hand–Wrist Study Group coronavirus pneumonia in Wuhan, China: a descriptive
Collaborators. What Is the Impact of the COVID-19 study. The lancet. 2020 Feb 15;395(10223):507-13.
Pandemic on Quality of Life and Other Patient-reported 22. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L,
Outcomes? An Analysis of the Hand-Wrist Study Fan G, Xu J, Gu X, Cheng Z. Clinical features of
Cohort. Clinical Orthopaedics and Related Research®. patients infected with 2019 novel coronavirus in Wuhan,
2021 Feb 1;479(2):335-45. China. The lancet. 2020 Feb 15;395(10223):497-506.
11. Bäuerle A, Steinbach J, Schweda A, Beckord J, 23. Morozink JA, Friedman EM, Coe CL, Ryff CD.
Hetkamp M, Weismüller B, Kohler H, Musche V, Socioeconomic and psychosocial predictors of
Dörrie N, Teufel M, Skoda EM. Mental health burden of interleukin-6 in the MIDUS national sample. Health
the COVID-19 outbreak in Germany: predictors of psychology. 2010 Nov;29(6):626.
mental health impairment. Journal of primary care & 24. Hamer M, Steptoe A. Association between physical
community health. 2020 Aug;11:2150132720953682. fitness, parasympathetic control, and proinflammatory
12. Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, responses to mental stress. Psychosomatic medicine.
Gouze H, Doucet L, Berkani S, Oliosi E, Mallart E, 2007 Sep 1;69(7):660-6.
Corre F. Post-discharge persistent symptoms and health-
related quality of life after hospitalization for COVID-
19. Journal of Infection. 2020 Dec 1;81(6):e4-6.

42366 | P a g e
 International Journal of Recent Scientific Research Vol. 12, Issue, 07 (C), pp. 42363-42367, July, 2021

25. Berk M, Williams LJ, Jacka FN, O’Neil A, Pasco JA, 26. Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A,
Moylan S, Allen NB, Stuart AL, Hayley AC, Byrne ML, Gouze H, Doucet L, Berkani S, Oliosi E, Mallart E,
Maes M. So depression is an inflammatory disease, but Corre F. Post-discharge persistent symptoms and health-
where does the inflammation come from?. BMC related quality of life after hospitalization for COVID-
medicine. 2013 Dec;11(1):1-6. 19. Journal of Infection. 2020 Dec 1;81(6):e4-6.

How to cite this article:

Simran Kundnani and Jalpa Parikh.2021, Quality of Life After Novel Coronavirus Infection (COVID-19)- An Observational
Study. Int J Recent Sci Res. 12(07), pp. 42363-42367. DOI: http://dx.doi.org/10.24327/ijrsr.2021.1207.6082

*******

42367 | P a g e