Long-term multidimensional patient-centred outcomes after hospitalisation for COVID-19: do not only focus on disease severity.

Objectives: To investigate the association between COVID-19 disease severity during hospitalisation for COVID-19 and long-term multidimensional patient-centred outcomes up to 12 months post-hospitalisation. The secondary objective was to identify other risk factors for these long-term outcomes.

Methods: In this multicentre prospective cohort study, we categorised COVID-19 disease severity using the maximal level of respiratory support as proxy into (1) conventional oxygen therapy (COT), (2) high-flow nasal oxygen (HFNO) and (3) invasive mechanical ventilation (IMV). The primary outcome health-related quality of life (HRQoL), and the secondary outcomes self-reported symptoms and recovery were collected at 6 and 12 months post-hospitalisation.

Results: Data from 777 patients were analysed, with 226 (29%) receiving COT, 273 (35%) HFNO and 278 (36%) IMV. Patients reported impaired HRQoL, persistence of symptoms and poor recovery. Multivariable generalised estimating equations analysis showed that COVID-19 disease severity was not associated with HRQoL and inconsistently with symptoms; the HFNO group reported poorer recovery. Overall, female sex, younger age and pulmonary history were independent risk factors for outcomes.

Conclusions: COVID-19 disease severity was associated with self-perceived recovery, but not with HRQoL and inconsistently with symptoms. Our findings suggest that age, sex and pulmonary history are more consistent risk factors for long-term multidimensional outcomes and offer better guidance for aftercare strategies.