Factors Associated with Health-related Quality of Life after Hospitalization for COVID-19 in Diabetic and Non-diabetic Patients: A Cross-sectional Study

Abstract

Background: Diabetes is a non-communicable disease with fatal complications. Diabetic patients are highly susceptible to COVID-19 side effects and persistent post-discharge symptoms that impact health-related quality of life (HRQoL). Objectives: This study aimed to assess HRQoL and examine factors affecting diabetic and non-diabetic COVID-19 patients after hospitalization. Methods: In a cross-sectional study, 220 diabetic and non-diabetic COVID-19 patients were randomly selected after hospitalization in Sirjan, Iran, from January 2020 to October 2021. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to measure HRQoL as a dependent variable and its dimensions (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) as independent variables. In addition, a checklist was used to identify determinants of HRQoL, including age, gender, education, family income, household ownership, occupation, number of family members, and access to health services, that might affect the HRQoL participants. Results: The mean HRQoL score in COVID-19 diabetics (0.766±0.110) was significantly lower than that in their non-diabetic counterparts (0.859±0.077). The EQ-5D-5L scores in the diabetic group were significantly higher in younger participants, men, employed subjects, patients with higher educational levels, higher income, higher health status, supplemental insurance, access to health services, and fewer family members. According to the results of the Betamix model, education and diabetes were significant independent predictors of HRQoL scores. Conclusion: Diabetic COVID-19 cases experienced a significant decrease in HRQoL after hospitalization. This drop might have been due to more side effects of COVID-19 in diabetic patients and lower utilization of health services during this period. It is suggested that the health sector changes the management of diabetics during the COVID-19 epidemic by taking measures such as using telemedicine, providing home services, or prescribing medications for a longer period.