{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:57:44Z","timestamp":1787803064737,"version":"build-2784847793"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histories of COVID-19 infection.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study used data from the US Veterans Affairs (VA) and included 186 veterans who had COVID-19 between October 2020 and April 2021 (ie, COVID-19 cohort) and 186 matched comparators who did not have documented COVID-19 infections (ie, control cohort). This match balanced the risk of COVID-19 based on 39 variables measured in the 24 months before infection or match, using principles of target trial emulation. Data were analyzed from December 2022 to December 2023.<\/jats:p><\/jats:sec>Exposure<\/jats:title>First documented COVID-19.<\/jats:p><\/jats:sec>Main Outcome and Measures<\/jats:title>The differences in self-reported everyday functioning 18 months after COVID-19 infection were estimated and compared with their matched comparators. Within\u2013matched pair logistic and linear regressions assessed differences in outcomes and were weighted to account for sampling and nonresponse.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 186 matched pairs of participants, their weighted mean age was 60.4 (95% CI, 57.5 to 63.2) years among veterans in the COVID-19 cohort (weighted sample, 91\u202f459 of 101\u202f133 [90.4%] male; 30\u202f611 [30.3%] Black or African American veterans; 65\u202f196 [64.4%] White veterans) and 61.1 (95% CI, 57.8 to 64.4) years among their comparators in the control cohort (91\u202f459 [90.4%] male; 24\u202f576 [24.3%] Black or African American veterans; 70\u202f157 [69.4%] White veterans). A high proportion of veterans in the COVID-19 cohort (weighted percentage, 44.9% [95% CI, 34.2% to 56.2%]) reported that they could do less than what they felt they could do at the beginning of 2020 compared with the control cohort (weighted percentage, 35.3%; [95% CI, 25.6% to 46.4%]; within\u2013matched pair adjusted odds ratio [OR], 1.52 [95% CI, 0.79 to 2.91]). There was no association of documented COVID-19 infection with fatigue, substantial pain, limitations in either activities of daily living and instrumental activities of daily living, severely curtailed life-space mobility, employment, or mean health-related quality of life on a utility scale.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of veterans with and without documented COVID-19, many reported a substantial loss of everyday functioning during the pandemic regardless of whether or not they had a documented infection with COVID-19. Future work with larger samples is needed to validate the estimated associations.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.0869","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T11:31:14Z","timestamp":1709292674000},"page":"e240869","source":"Crossref","is-referenced-by-count":3,"title":["Self-Reported Everyday Functioning After COVID-19 Infection"],"prefix":"10.1001","volume":"7","author":[{"given":"Theodore J.","family":"Iwashyna","sequence":"first","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"},{"name":"Department of Medicine, University of Michigan Medical School, Ann Arbor"},{"name":"School of Medicine, Johns Hopkins University, Baltimore, Maryland"},{"name":"School of Public Health, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina"},{"name":"Department of Medicine, Duke University, Durham, North Carolina"},{"name":"Department of Population Health Sciences, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Seelye","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S. B.","family":"Bohnert","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"},{"name":"Departments of Anesthesiology, Epidemiology, and Psychiatry, University of Michigan Medical School, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington"},{"name":"University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Hynes","sequence":"additional","affiliation":[{"name":"VA Portland Healthcare System, Center to Improve Veteran Involvement in Care, Portland, Oregon"},{"name":"College of Health, and Center for Quantitative Life Sciences, Oregon State University, Corvallis"},{"name":"School of Nursing, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George N.","family":"Ioannou","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"},{"name":"VA Puget Sound Health Care System Hospital and Specialty Medicine Service and Seattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina"},{"name":"Department of Medicine, Duke University, Durham, North Carolina"},{"name":"School of Nursing, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"O\u2019Hare","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle"},{"name":"VA Puget Sound Health Care System Hospital and Specialty Medicine Service and Seattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Viglianti","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"},{"name":"Department of Medicine, University of Michigan Medical School, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore S.","family":"Berkowitz","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Pura","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Womer","sequence":"additional","affiliation":[{"name":"School of Medicine, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee A.","family":"Kamphuis","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max L.","family":"Monahan","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan"},{"name":"School of Medicine, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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