Quality of life and respiratory symptoms in young adults with post covid-19 condition

Background: COVID-19 was diagnosed in ~5 million Canadians from 2020-2024, with 17% of diagnosed individuals aged 20-29. Following acute infection, some develop post-COVID Condition (PCC), characterized by persistent asthma-like symptoms impacting health-related quality of life (HR-QoL). Objective: This study explored the HR-QoL and respiratory symptoms of young adults (aged 18-30) with PCC and with or without concurrent asthma. Methods: In this cross-sectional study we recruited English-speaking Canadian residents aged 18–30 through convenience sampling from online forums. HR-QoL was assessed using the EuroQol 5 Dimensions Questionnaire (EQ-5D). Respiratory symptoms were assessed for participants with asthma using the Asthma Control Questionnaire (ACQ-6) or a modified version for those with PCC (mACQ-6). Independent t-tests were used to show differences between groups. Multiple linear regression were used to evaluate associations between patient characteristics and outcomes. Population weights balanced cohort characteristics to the general Canadian population. Hamilton integrated Research Ethics Board (HiREB; 16543). Results: Of the 227 (82% female) participating adults, 54 (24%) reported currently or previously having PCC and 41 (18%) reported having doctor-diagnosed asthma. More patients in the PCC group had asthma (N=17; 32%), compared to the non-PCC group (N=24; 14%). Mean HR-QoL was significantly different between those with and without PCC (Mean Difference [MD] -13.5, [-9.1, -17.9]) and between subgroups with or without concomitant asthma (MD -16.9 utilities, [-8.1, -25.7]. PCC was a significant predictor of low HR-QoL scores (mean -23 utilities [ -31.9, -14.2]) when adjusted for comorbid asthma, smoking, university attendance, and sex. Interaction effects between sex and PCC were noted: being male was significantly associated with worse HR-QoL (p<0.01). Diagnosed asthma was not associated with differences in symptoms from PCC or PCC-asthma overlap. Conclusions: Patients with PCC have lower quality of life than patients without , and respiratory symptoms in PCC patients are not statistically different from patients with asthma (with or without comorbid PCC).