Biopsychosocial factors associated with health-related quality of life in long COVID: a matched case-control study in primary care.

Publication date: Jun 24, 2026

Long COVID is associated with persistent symptoms, functional impairment, and reduced health-related quality of life (HRQoL), but the factors most strongly associated with poorer HRQoL remain incompletely characterized. This study compared adults with long COVID and recovered controls and identified variables independently associated with worse HRQoL. We conducted a case-control analysis of the ARALONGCOV 2022 dataset including 170 adults with prior COVID-19: 85 with long COVID and 85 recovered controls without persistent symptoms. HRQoL was assessed with the 12-item Short Form Health Survey (SF-12) total score. Additional measures included depressive symptoms (Patient Health Questionnaire-9, PHQ-9), fatigue severity (Fatigue Severity Scale, FSS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), pain catastrophizing, post-COVID functional status (PCFS), physical activity, and distance completed during the six-minute walk test (6MWT-D). Between-group comparisons used Mann-Whitney U tests for continuous variables and chi-squared or Fisher exact tests for categorical variables. Univariable and multivariable linear regression models were fitted within long COVID cases to identify factors independently associated with SF-12 total score. Compared with recovered controls, participants with long COVID had markedly worse HRQoL (median SF-12 28. 75 [IQR 21. 25-39. 17] vs 73. 96 [62. 81-77. 50]; p 

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Concepts Keywords
Biopsychosocial Cluster analysis
Covid Depression
Depressive Fatigue
Recovered Long COVID
Primary care
SF-12

Semantics

Type Source Name
disease MESH long COVID
disease MESH COVID-19
disease MESH included
disease MESH fatigue
disease MESH FSS
disease MESH pain
disease MESH David
pathway REACTOME Reproduction

Original Article

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