Informing the management of the post-COVID condition: insights from the Western Australian experience comparing those who tested positive and negative to early COVID-19 strains

Kristen Grove; Vinicius Cavalheri; HuiJun Chih; Varsha Natarajan; Meg Harrold; Sheeraz Mohd; Elizabeth Hurn; Lisa Van der Lee; Andrew Maiorana; Jessica Tearne; Carol Watson; Jane Pearce; Angela Jacques; Ann White; Caitlin Vicary; Caroline Roffman; Emma-Leigh Synnott; Ian Suttie; Ivan Lin; Jade Larsson; Louise Naylor; Linda Woodhouse; Mercedes Elliott; Paul Gittings; Peta Winship; Robyn Timms; Sheldon Wulff; Tracy Hebden-Todd; Dale W. Edgar

doi:10.1071/AH23271

RESEARCH ARTICLE (Open Access)

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Informing the management of the post-COVID condition: insights from the Western Australian experience comparing those who tested positive and negative to early COVID-19 strains

Kristen Grove ^A , Vinicius Cavalheri

^B ^C , HuiJun Chih ^D ^E , Varsha Natarajan ^F , Meg Harrold ^A ^C , Sheeraz Mohd ^G , Elizabeth Hurn ^H , Lisa Van der Lee ^C ^F ^H , Andrew Maiorana ^C ^I , Jessica Tearne ^J , Carol Watson ^A , Jane Pearce ^E ^K , Angela Jacques ^C ^L , Ann White ^E , Caitlin Vicary ^F , Caroline Roffman ^A ^C , Emma-Leigh Synnott ^M , Ian Suttie ^N , Ivan Lin ^O ^P , Jade Larsson ^A , Louise Naylor ^Q , Linda Woodhouse ^R ^S , Mercedes Elliott ^F , Paul Gittings ^F , Peta Winship ^F , Robyn Timms ^F , Sheldon Wulff ^A , Tracy Hebden-Todd ^H and Dale W. Edgar

^F ^L ^T ^U ^*

+ Author Affiliations

- Author Affiliations

^A Department of Physiotherapy, Royal Perth Bentley Group, East Metropolitan Health Service, Perth, WA, Australia.

^B Allied Health, South Metropolitan Health Service, Murdoch, WA, Australia.

^C Curtin School of Allied Health and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.

^D Curtin School of Population Health, Clinical Trials Enabling Platform (CTEP) and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.

^E Western Australian Health Translation Network, Perth, WA, Australia.

^F Department of Physiotherapy, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^G Research Support and Development Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^H Department of Physiotherapy, Sir Charles Gairdner Hospital, North Metropolitan Health Service, Nedlands, WA, Australia.

^I Department of Exercise Physiology, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^J Department of Clinical Psychology and Clinical Neuropsychology, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^K Consumer Advisory Council, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^L The Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.

^M State Rehabilitation Service, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^N Respiratory Medicine Service, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^O Western Australian Centre for Rural Health, The University of Western Australia, Crawley, WA, Australia.

^P Geraldton Regional Aboriginal Medical Service, Geraldton, WA, Australia.

^Q School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Crawley, WA, Australia.

^R School of Medicine, Tufts University, Boston, MA, USA.

^S Physical Therapy Department School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA.

^T Division of Surgery, Faculty of Medicine and Dentistry, University of Western Australia, Crawley, WA, Australia.

^U Fiona Wood Foundation, Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, WA, Australia.

^* Correspondence to: Dale.edgar@health.wa.gov.au

Australian Health Review https://doi.org/10.1071/AH23271

Submitted: 18 December 2023 Accepted: 10 July 2024 Published: 8 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

This study aimed to compare the relative physical recovery and symptoms after SARS-CoV-2 infection between groups confirmed positive or negative to early strains of COVID-19.

Methods

A prospective, longitudinal cohort study compared outcomes of metropolitan adults polymerase chain reaction-tested for COVID-19 between March and November 2020 in Western Australia. Control matching was attempted: inpatients (gender, age) and ambulatory clinic (gender, age, asthma, chronic pulmonary disease). One-year follow-up involved three repeated measures: physical function (grip strength and 1-min sit-to-stand) and patient-reported outcomes (Fatigue Severity Scale, modified Medical Research Council dyspnoea scale and Euroqol-5D-5L).

Results

Three hundred and forty-four participants were recruited (154 COVID+, age 54 ± 18 years, 75 females [49%]); 190 COVID−, age 52 ± 16 years, 67 females [35%]) prior to national vaccination roll-out. No between-group differences in physical function measures were evident at any time point. Fatigue (OR 6.62, 95% CI 2.74–15.97) and dyspnoea (OR 2.21, 95% CI 1.14–4.30) were higher in the COVID+ group at second assessment (T2). On Euroqol-5D-5L, no between-group differences were evident in the physical function domains of self-care, mobility or usual activities at any time point. However, COVID+ participants were less likely to report an absence of anxiety or depression symptoms at T2 (OR 0.41, 95% CI 0.19–0.89).

Conclusions

Neither statistical nor clinically meaningful differences in physical function were evident between COVID+ and COVID− participants to 12-months after acute illness. Symptoms of fatigue, dyspnoea, anxiety or depression were more prevalent in the COVID+ group til ~8 months after illness with between-group differences no longer evident at 1 year.

Keywords: anxiety, control group, COVID-19 virus infection, depression, dyspnoea, fatigue, pain, primary care, quality of life.

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