Estimating Impact of SARS-CoV-2 Infection on Health-Related Quality of Life Among Persons Aged 8 Years and Older, August 2020–July 2022

Background: Severe COVID-19 results in substantial economic burden and impacts quality of life. Assessing how mild COVID-19 impacts health utilities during acute infection and long term is important to estimate the full economic impact of SARS-CoV-2 infection. Methods: We analyzed EQ-5D-3L survey data from SARS-CoV-2 infected adults (aged ≥16 years) and children (aged 8-15 years) from 3 community and household cohorts in the United States (2020-2022). EQ-5D-3L scores were analyzed at 3 time points after symptom onset or first positive SARS-CoV-2 test result and converted to health utilities on a scale of 0-1 (1 = perfect health). Among adults, regression models were used to compare differences in health utility by demographic/clinical characteristics. Results: Among 575 participants with SARS-CoV-2 infections and EQ-5D-3L surveys, mean utilities were nearly 1 throughout the observation period. During days 0-14 after symptom onset, vaccinated participants had higher health utilities (beta, 0.57; 95% CI: 0.07, 1.07). Seeking medical care and having gastrointestinal symptoms (vs none), were associated with lower health utilities (beta, -0.96; 95% CI: -1.60, -0.31; and beta, -0.76; 95% CI: -1.30, -0.21, respectively). During days 15-30 after onset, unemployment was associated with lower health utility (beta, -0.64; 95% CI: -1.15, -0.14). During days 31-90 after onset, underlying conditions were associated with lower health utilities (beta, -0.32; 95% CI: -0.54, -0.09). Results for children were similar to those for adults. Conclusion: Mild COVID-19 may have minimal overall impact on quality of life; however, health utilities differed by vaccination status, presence of gastrointestinal symptoms, employment status, and presence of underlying conditions. Vaccination may play an important role in minimizing illness impact from SARS-CoV-2 infection.