AI Insight
This cross-sectional study of 773 patients with long COVID found that quality of life was substantially impaired across physical and mental health domains, but the presence of a functional somatic disorder (FSD) diagnosis did not significantly affect quality of life scores. Instead, lower quality of life was primarily associated with higher depressive and anxiety symptoms, lower physical activity, pain, female gender, hospitalization during acute COVID-19, and longer symptom duration, regardless of FSD diagnosis.
Why it matters
These findings suggest that functional somatic disorder diagnoses should not be used to predict quality of life outcomes in long COVID patients, and that clinical interventions should focus on addressing modifiable factors like depression, anxiety, pain management, and physical activity rather than diagnostic categorization. The results challenge potential stigmatization of patients diagnosed with FSD by demonstrating their symptom burden is comparable to other long COVID patients.
Understand the Science
by Clément Gouraud, Sabrina Guemouni, Patricia Thoreux, Charles Ouazana-Vedrines, Victor Pitron, Corentin Verot, Kewei Xiang, Florian Baudry, Brigitte Ranque, Cédric Lemogne, for the CASPer-COVID Study Group
Background
Long COVID is associated with poor health-related quality of life (QoL), with substantial interindividual variations. This study aimed to investigate the association between QoL and a diagnosis of functional somatic disorder (FSD) among patients seeking care for long COVID.
Methods
Data were drawn from the CASPer-COVID program, a multidisciplinary tertiary care program for patients with persistent symptoms following COVID-19. QoL was evaluated with the 36-Item Short-Form health survey (SF-36), yielding a Physical Component Summary (PCS) and a Mental Component Summary (MCS). Multivariable linear regression analyses were performed to investigate the associations between PCS or MCS scores and a diagnosis of FSD, adjusting for age, gender, body mass index, comorbidities, hospitalization for acute COVID-19, core persistent symptoms, symptom duration, depressive and anxiety symptoms, and physical activity.
Results
The analyses included 773 patients (median age [interquartile range (IQR)]: 44 [36−55] years; 64% women). QoL was markedly impaired (median PCS [IQR]: 44 [31−60]; median MCS [IQR]: 39 [31−49]). A diagnosis of FSD (76.5% of patients) was not associated with MCS (β [95% CI]: 1.11 [−1.30, 3.53]) or PCS (β [95% CI]: −1.60 [−3.88, 0.67]) scores in adjusted analyses. Lower PCS and MCS scores were associated with higher depressive and anxiety symptoms, lower physical activity levels, and pain. In addition, lower PCS scores were associated with female gender, hospitalization for acute COVID-19 and longer symptom duration.
Conclusion
In patients seeking care for long COVID in a tertiary care setting, QoL did not differ significantly between those diagnosed with FSD and other patients.