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Health‐Related Quality of Life of Adults With Long COVID: A Cross‐Sectional Study in Primary Care

ABSTRACT

Aims

To evaluate the health-related quality of life (HRQOL) of adults with Long COVID 2 years and beyond after COVID-19 illness.

Design

Cross-sectional study.

Methods

Health status was assessed using the EQ-5D-5L instrument among 226 adults diagnosed in primary care with mild-to-moderate COVID-19 during the 2021 pandemic. Data were collected through a cross-sectional survey using a standardized questionnaire with a set of validated clinical outcomes for Long COVID. The sample consisted of adults aged ≥ 18 years who attended the specified ambulatory settings, tested positive for SARS-CoV-2, and agreed to be interviewed; the response rate was 70%. Health utility scores were compared between adults with and without Long COVID. Multivariate logistic regressions were applied to investigate the relationship between Long COVID and health-related quality of life outcomes.

Data Sources

Primary data were collected from six public Family Health Care Units in João Pessoa, Brazil, between May 2023 and July 2024.

Results

Adults with Long COVID had statistically significantly lower median utility scores (0.784, IQR: 0.633–0.902) than those without persistent symptoms (1.0, IQR: 0.877–1.0). Poorer HRQOL was more evident among women, older adults, non-White individuals, participants with pre-existing chronic diseases, and those with lower educational attainment. Long COVID was associated with impairments in anxiety/depression, pain/discomfort and usual activities.

Conclusion

Adults with Long COVID experienced poorer HRQOL 2 years or longer after mild-to-moderate infection compared with those without persistent symptoms, regardless of sex, age, ethnicity, education level or comorbidities. These findings support the implementation of targeted interventions and rehabilitation services in primary care for individuals experiencing long-term health problems following COVID-19 illness.

Implications for the Profession and/or Patient Care

Identifying adults at greater risk of persistent health impairments following COVID-19 may help health professionals, caregivers and policymakers better address the aspects of patients' lives that lack quality and develop a multidisciplinary approach in primary care to managing this condition.

Impact

What problem did the study address? ○

This study examined the association between persistent symptoms 2 years or longer after non-severe COVID-19 illness and health-related quality of life.

What were the main findings? ○

Long COVID was associated with poorer health-related quality of life, particularly in the domains of anxiety/depression, pain/discomfort and usual activities.

Where and on whom will the research have an impact? ○

The findings highlight the need for multidisciplinary management of long-term health problems among adult COVID-19 survivors in primary care.

Reporting Methods

The STROBE checklist was followed.

Patient or Public Contribution

No patient or public contribution.

Barriers and facilitators to the implementation of the International Classification of Functioning, Disability and Health in health services: a scoping review protocol

Introduction

The International Classification of Functioning, Disability and Health (ICF) represents a major milestone in understanding functioning and disability and is widely used in clinical practice, management and health research. Despite its relevance, implementation of the ICF remains inconsistent across health services and care settings. Evidence on barriers and facilitators to implementation remains fragmented, limiting the development of effective, context-sensitive implementation strategies. This scoping review aims to map barriers and facilitators influencing ICF implementation in health services and to identify implementation strategies reported in the literature.

Methods and analysis

This scoping review protocol will follow the methodological recommendations of the Joanna Briggs Institute, Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Qualitative, quantitative and mixed-methods primary studies describing the implementation of the ICF in health services will be included with no language restrictions, published since 2001. Searches will be conducted in PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, SciELO and PEDro databases. Studies will be selected in two stages by two independent reviewers using the Rayyan platform. Disagreements will be resolved by consensus or by a third reviewer. Data will be extracted using a standardised form. Barriers and facilitators will be mapped and categorised according to the Consolidated Framework for Implementation Research (CFIR), enabling a theory-informed synthesis of implementation determinants across settings. Findings will be summarised using descriptive statistics and narrative synthesis, including implementation contexts, strategies, barriers and facilitators.

Ethics and dissemination

Ethical approval is not required because this review will use data from publicly available published studies and will not involve human participants. Findings will be disseminated through peer-reviewed publication, conference presentation and knowledge translation activities targeting researchers, healthcare professionals, service managers and policymakers.

Trial registration number

10.17605/OSF.IO/VRQPD.

Completeness of the COVID-19 vaccination schedule and associated factors among persons experiencing homelessness in Brazil: a national cross-sectional study

Por: Soares Tenorio de Araujo · J. · Berra · T. Z. · Tartaro · A. F. · Rosa · R. J. · Tavares · R. B. V. · Alves · Y. M. · Pelodan · M. E. P. · Moura · H. S. D. · Ferezin · L. P. · Ramos · A. C. V. · do Nascimento · M. C. · Lima de Freitas · G. · Arcencio · R. A.
Objectives

To analyse the completeness of the COVID-19 vaccination schedule and identify factors associated with vaccine uptake.

Design

Cross-sectional study.

Setting

Data were collected through face-to-face interviews conducted in all 26 Brazilian state capitals and the Federal District between 2022 and 2023, using a sequential sampling approach.

Participants

A total of 1392 individuals aged 18 years or older experiencing homelessness for at least 6 months were included.

Primary and secondary outcome measures

The primary outcome was the completeness of the COVID-19 vaccination schedule (complete vs incomplete), based on self-reported vaccination status. Secondary analyses examined sociodemographic, institutional and behavioural factors associated with vaccine uptake using binary logistic regression.

Results

Completion of the vaccination schedule was positively associated with receiving government aid (OR: 1.58; 95% CI 1.09 to 2.30), visits from street clinic health agents (OR: 3.19; 95% CI 1.95 to 5.36), prior COVID-19 diagnosis (OR: 5.77; 95% CI 3.17 to 11.15), support for mandatory vaccination (OR: 3.76; 95% CI 2.48 to 5.76), trust in vaccine efficacy (OR: 3.92; 95% CI 2.63 to 5.89), seeking information from community sources (OR: 1.91; 95% CI 1.01 to 3.88) and trust in federal authorities (OR: 1.57; 95% CI 1.06 to 2.31).

Conclusions

This study identified structural, social and individual factors associated with complete COVID-19 vaccination among people experiencing homelessness in Brazil. Although overall coverage was substantial, gaps in vaccination completeness persisted. Social support, healthcare outreach and trust in vaccines were associated with higher uptake, highlighting important barriers and facilitators to vaccination in socially vulnerable populations.

COVID-19 Nursing Staff Sizing Technology

imageThis study shows the development of a software for calculating the number of nursing team members required for providing care during the coronavirus disease 2019 pandemic. Study about the development of a technology based on the literature about data and indicators. The indicators were systematized in the following dimensions: institutional, professional, and occupational structure, all with a focus on coronavirus disease 2019. The software was created to be used on the Web, client-server, in browsers such as Internet Chrome, Explorer, and/or Mozilla Firefox, accessing via an Internet address and also allowing access by Windows, Android, and Linux operating systems, with MySQL database used for data storage. The data and indicators related to the institutional structure for coronavirus disease 2019 were systematized with 10 dimensions and indicators, and the professional and occupational structure, with 14 dimensions and indicators. The construction of computer requirements followed the precepts of software engineering, with theoretical support from the area. In the evaluation of the software, data simulation revealed points that had to be adjusted to ensure security, data confidentiality, and easy handling. The software provides to calculate the size and quality of the team, nursing sizing required due to the needs generated by the coronavirus disease 2019 pandemic.

Development, Validation, and Usability of the Chatbot ESTOMABOT to Promote Self-care of People With Intestinal Ostomy

imageThis study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P

Eficacia de un instrumento interdisciplinario para la reducción de la infección relacionada con la asistencia

Objetivo: Evaluar la efectividad de un instrumento interdisciplinario, desarrollado y aplicado en una unidad de cuidados intensivos de adultos para reducir las infecciones asociadas a la atención de la salud. Metodología: Estudio transversal, cuantitativo, realizado de enero de 2018 y junio de 2019, en una UCI de un Hospital de Paraná-Brasil. Resultados: Se evaluaron 759 pacientes. Antes de la aplicación del instrumento, las medias eran respectivamente: 1,00 para IRAS CVC; 6.78 ID IPCS; 3,22 VAP; 21,62 DIPAV y 0,88 para IRAS CVD, después con la aplicación del Fast Checklist:  0,11 para IRAS CVC (p = 0,11); 0,86 ID IPCS (p = 0,017); 0,33 VAP (p = 0,001); 2,83 DIPAV (p = 0,003) y 0,00 para IRAS ECV (p = 0,0002). Conclusión principal: El estudio demostró que la implementación y aplicación diaria de la Lista de Verificación Rápida fue efectiva para la reducción de las IRAS en la Unidad de Cuidados Intensivos.

Producción de cuidados para mujeres embarazadas con VIH: la historia de Vicky

Objetivo: conocer la producción diaria de atención para mujeres embarazadas que viven con infección por el síndrome de inmunodefi-ciencia humana en una ciudad del estado de Río de Janeiro. Método: esta es una investigación cualitativa, descriptiva. Empleados como herramientas de producción de datos: la guía del usuario y el diario desde la perspectiva del Análisis Institucional. El análisis del material se realizó en función de la identificación de núcleos de significado en el contenido recopilado. Resultados: se construyó un diagrama de flujo, que presenta el recorrido del usuario en la red y los núcleos de significado, caracterizados como: tensión entre la demanda y el tiempo en servicio, yendo y viniendo de la producción burocrática y el vínculo entre la usuaria y los profesionales. Conclusión: un estudio señala la necesidad de reuniones en la construcción de una red de apoyo para mujeres embarazadas con el síndrome de inmunodefi-ciencia humana, que es una posibilidad de reflexión sobre el proceso de atención, centrado en la usuaria.

Gestión de Residuos en Unidades Hospitalarias: Una Revisión Integradora

Objetivo principal: identificar las producciones científicas sobre manejo de residuos procedentes de los servicios de salud (RSS) por el equipo de salud en unidades hospitalarias, y analizarlas a la luz de las buenas prácticas. Metodología: revisión integrativa con búsqueda en las bases LILACS, WEB OF SCIENCE, BDENF, MEDLINE / PUBMED. Criterios de inclusión: estudios realizados en unidades hospitalarias y que aborden la gestión en ese contexto. Resultados principales: se seleccionaron 24 publicaciones para representar la muestra de la encuesta. Gran parte de los profesionales no realizan la práctica de segregación y manejo correctamente. La falta de conocimiento de los profesionales es un factor agravante. Conclusión principal: es de extrema importancia la capacitación de los profesionales acerca del manejo adecuado y mayor inversión del gobierno para mejoras en la implantación de regulaciones y fiscalización para la gestión de RSS.

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