Long-term effects on survivors with COVID-19 – Authors’ reply
We agree that the professional questionnaires could provide the actual prevalence of psychiatric symptoms. However, these questionnaires are somewhat complex and time-consuming. It is challenging to integrate all these assessments into our follow-up study.
The EuroQol five-dimension five-level (EQ-5D-5L) questionnaire is commonly used to assess the quality of life from five domains in clinical studies. The EQ-5D-5L questionnaire used in our research is from the Chinese version of the EQ-5D user guide.
Zhao and colleagues point out that the EQ-5D-5L item on anxiety or depression was not validated in Chinese populations. However, to our knowledge, the reliability of the Chinese EQ-5D has been validated in China, and it has shown acceptable construct validity and fair-to-moderate levels of test–retest reliability.
Additionally, according to a large multinational study involving China, the EQ-5D-5L provided precise measurement at individual and group levels compared with the EQ-5D three-level, both in terms of descriptive system data and usefulness.
Hence, we believe that descriptive system data from the EQ-5D-5L questionnaire could well reflect the health status of our cohort.
We acknowledged that the low proportion of patients admitted to the intensive care unit in our cohort limits the generalisability of the study findings. Similarly, the findings cannot be generalised to those who were excluded from the study.
no statistically significant association between cytokine change (at discharge until 6 months) and fatigue or muscle weakness was apparent. However, because of the small number of patients with cytokine tests, these findings should be interpreted as exploratory and need to be validated in a larger sample population.
whether directly caused by COVID-19 or partly attributed to depression or anxiety, so it is appropriate to call it COVID-19-related sequelae symptoms.
We appreciate Zhao and colleagues’ suggestion to explore the post-traumatic stress disorder symptoms and stigma of patients recovered from COVID-19 in the future. In addition, Yang and colleagues pointed out that it is unclear whether patients with long COVID have an increased susceptibility to reinfection and whether COVID-19 vaccines could play a role in preventing long COVID. Answering these research questions will require the full breadth of scientific and high-quality clinical studies. The scientific and medical communities might wish to collaborate to explore the mechanism and pathogenesis of long COVID.
We declare funding by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS 2018-I2M-1–003 and 2020-I2M-CoV19–005), the National Natural Science Foundation of China (82041011/H0104), the National Key Research and Development Programme of China (2018YFC1200102), and Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis (2020ZX09201001). This Correspondence was also supported by the China Evergrande Group, Jack Ma Foundation, Sino Biopharmaceutical, Ping An Insurance Group, and New Sunshine Charity Foundation.
References
- 1.
1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study.
Lancet. 2021; 398: 747-758
- 2.
EQ-5D-5L user guide, version 3·0.
- 3.
Validation of the EQ-5D in a general population sample in urban China.
Qual Life Res. 2012; 21: 155-160
- 4.
Is EQ-5D-5L better than EQ-5D-3L? A head-to-head comparison of descriptive systems and value sets from seven countries.
Pharmacoeconomics. 2018; 36: 675-697
- 5.
Post-acute COVID-19 syndrome.
Nat Med. 2021; 27: 601-615
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Published: 20 November 2021
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