Self-reported anxiety, depression, and health-related quality of life during two years following hospitalization for covid-19: a longitudinal study

Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Health-related quality of life (HRQoL) has been observed to decline after COVID-19 hospitalization, with anxiety and depression contributing to reduced HRQoL and emphasizing the need for research on long-term outcomes. The aim of the study was to longitudinally explore self-reported symptoms of anxiety, depression, and associated factors of HRQoL during 2 years after hospital-treated COVID-19, and to compare differences based on age, sex, and initial disease severity. Participants were included from the Life in the Time of COVID study in Gothenburg, comprising individuals hospitalized with COVID-19 during the first and second waves of the pandemic in Sweden. This prospective study includes follow-ups at 3 months, 1 year, and 2 years after discharge, using patient-reported outcomes assessing symptoms of anxiety, depression, HRQoL, and clinical data. The study comprised 125 participants, of whom 111 were eligible for longitudinal analysis. Two years after COVID-19, individuals with initial moderate infection reported higher levels of anxiety (p = 0.031) and pain/discomfort (p = 0.039) than did those with severe infection. Symptoms of anxiety did not change significantly over the study period. Depressive symptoms increased significantly between 3 and 12 months after COVID-19 (Z = − 2.957, p = 0.003). Older age was significantly associated with lower HRQoL (B = − 0.003, 95% CI [–0.004, − 0.001], p = 0.010). Symptoms of anxiety remained generally within the normal range throughout the two-year follow-up after hospital-treated COVID-19. Symptoms of depression were lower at 3 months after hospitalization but subsequently stabilized at a higher, yet still normal, level. At two years after COVID-19, lower HRQoL was associated with older age, highlighting the importance of addressing age-related vulnerabilities in long-term follow-up care.