{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T09:57:55Z","timestamp":1766138275959,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T00:00:00Z","timestamp":1678579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study evaluated the impact of COVID-19 and other factors on the health-related quality of life (HRQoL) of Saudi patients during infection and after recovery using the EQ-5D-5L and EQ-VAS instruments. An observational prospective study was conducted in November 2022, during which 389 COVID-19 patients were surveyed during their visit to a medical center. Two weeks after their recovery, they were contacted again to re-evaluate their HRQoL (192 patients either refused to participate or withdrew). The mean of the EQ-5D-5L index and EQ-VAS scores significantly increased from (0.69 \u00b1 0.29 and 63.16 \u00b1 24.9) during infection to (0.92 \u00b1 0.14 and 86.96 \u00b1 15.3) after recovery. Specifically, COVID-19 patients experienced improvement of several HRQoL dimensions post recovery, such as better mobility, enhanced self-care, returning to usual activities, less pain\/discomfort, and alleviated anxiety\/depression. Multiple linear regression analyses showed that having a normal weight, being employed, not being anemic, and previously taking the BCG vaccine were positively associated with a greater change in the HRQoL. An interaction between being asthmatic and taking the influenza vaccine positively predicted a lower change in the HRQoL. Having a normal weight positively predicted a greater change in the perceived health state after recovery. Increasing the consumption of natural supplements (honey and curcuma) did not improve the HRQoL or the perceived health state. Based on these findings, COVID-19 mildly impacted the HRQoL of Saudis with varying effects depending on some socio-demographic\/clinical characteristics of the patients.<\/jats:p>","DOI":"10.3390\/ijerph20065026","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T04:35:41Z","timestamp":1678682141000},"page":"5026","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of COVID-19 on the Health-Related Quality of Life of Patients during Infection and after Recovery in Saudi Arabia"],"prefix":"10.3390","volume":"20","author":[{"given":"Menyfah Q.","family":"Alanazi","sequence":"first","affiliation":[{"name":"Drug Policy & Economic Centre, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Abdelgawwad","sequence":"additional","affiliation":[{"name":"College of Management, Midocean University, Moroni 6063, Comoros"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1508-8693","authenticated-orcid":false,"given":"Thamer A.","family":"Almangour","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatma","family":"Mostafa","sequence":"additional","affiliation":[{"name":"College of Management, Midocean University, Moroni 6063, Comoros"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Almuheed","sequence":"additional","affiliation":[{"name":"National Center for Artificial Intelligence (NCAI), Riyadh 12391, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Szajkowski, S., Pasek, J., Dwornik, M., and Cie\u015blar, G. (2022). The Impact of Coronavirus Infection on Health-Related Quality of Life in Amateur CrossFit Athletes. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192416409"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"De Matos, D.G., Aidar, F.J., de Almeida-Neto, P.F., Moreira, O.C., de Souza, R.F., Mar\u00e7al, A.C., Marcucci-Barbosa, L.S., Martins J\u00fanior, F.d.A., Lobo, L.F., and dos Santos, J.L. (2020). The impact of measures recommended by the government to limit the spread of coronavirus (COVID-19) on physical activity levels, quality of life, and mental health of Brazilians. Sustainability, 12.","DOI":"10.3390\/su12219072"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Alanazi, M.Q., AlQahtani, H., Almangour, T.A., Aleanizy, F.S., and Alqahtani, F.Y. (2022). Evaluation of the Clinical Outcome and Cost Analysis of Antibiotics in the Treatment of Acute Respiratory Tract Infections in the Emergency Department in Saudi Arabia. Antibiotics, 11.","DOI":"10.3390\/antibiotics11111478"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lubetkin, E.I., Long, D., Haagsma, J.A., Janssen, M.F., and Bonsel, G.J. (2022). Health inequities as measured by the EQ-5D-5L during COVID-19: Results from New York in healthy and diseased persons. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0272252"},{"key":"ref_6","unstructured":"WHO (2022, November 03). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Poudel, A.N., Zhu, S., Cooper, N., Roderick, P., Alwan, N., Tarrant, C., Ziauddeen, N., and Yao, G.L. (2021). Impact of COVID-19 on health-related quality of life of patients: A structured review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0259164"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/jmv.27309","article-title":"Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)\u2014A systematic review and meta-analysis","volume":"94","author":"Malik","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/S0277-9536(98)00009-4","article-title":"The World Health Organization quality of life assessment (WHOQOL): Development and general psychometric properties","volume":"46","author":"Group","year":"1998","journal-title":"Soc. Sci. Med."},{"key":"ref_10","unstructured":"World Health Organization (2023, January 31). WHOQOL: Measuring Quality of Life: World Health Organization. Available online: https:\/\/www.who.int\/tools\/whoqol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1007\/s11136-019-02214-9","article-title":"A systematic review of quality of life research in medicine and health sciences","volume":"28","author":"Haraldstad","year":"2019","journal-title":"Qual. Life Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.2147\/PPA.S277367","article-title":"Evaluation of health-related quality of life in women with community-acquired urinary Tract infections using the EQ-5D-3L in Saudi Arabia","volume":"14","author":"Alanazi","year":"2020","journal-title":"Patient Prefer. Adherence"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s40258-017-0310-5","article-title":"EQ-5D and the EuroQol group: Past, present and future","volume":"15","author":"Devlin","year":"2017","journal-title":"Appl. Health Econ. Health Policy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2478\/sjph-2020-0024","article-title":"Crosswalk EQ-5D-5L value set for Slovenia","volume":"59","author":"Rupel","year":"2020","journal-title":"Slov. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s40273-018-0615-8","article-title":"German value set for the EQ-5D-5L","volume":"36","author":"Ludwig","year":"2018","journal-title":"Pharmacoeconomics"},{"key":"ref_16","unstructured":"EuroQol Research Foundation (2023, January 31). EQ-5D-5L User Guide. Available online: https:\/\/euroqol.org\/publications\/user-guides\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2050312116671725","DOI":"10.1177\/2050312116671725","article-title":"SF-36 total score as a single measure of health-related quality of life: Scoping review","volume":"4","author":"Lins","year":"2016","journal-title":"SAGE Open Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/j.jval.2021.03.009","article-title":"Mapping EQ-5D-3L to EQ-5D-5L","volume":"24","author":"Shaw","year":"2021","journal-title":"Value Health"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Devlin, N., Finch, A.P., and Parkin, D. (2022). Value Sets for EQ-5D-5L: A Compendium, Comparative Review & User Guide, Springer International Publishing.","DOI":"10.1007\/978-3-030-89289-0"},{"key":"ref_21","first-page":"79","article-title":"Herbal medication to enhance or modulate viral infections","volume":"56","author":"Tahmasbi","year":"2021","journal-title":"Nurs. Clin."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6374","DOI":"10.1016\/j.vaccine.2020.08.018","article-title":"The effect of Bacillus Calmette\u2013Gu\u00e9rin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic","volume":"38","author":"Yitbarek","year":"2020","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Soares, S., Bornet, M., Grosso, C., Ramalhosa, M.J., Gouvinhas, I., Garcia, J., Rodrigues, F., and Delerue-Matos, C. (2022). Honey as an Adjuvant in the Treatment of COVID-19 Infection: A Review. Appl. Sci., 12.","DOI":"10.3390\/app12157800"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ping, W., Zheng, J., Niu, X., Guo, C., Zhang, J., Yang, H., and Shi, Y. (2020). Evaluation of health-related quality of life using EQ-5D in China during the COVID-19 pandemic. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0234850"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Azizi, A., Achak, D., Saad, E., Hilali, A., Nejjari, C., Khalis, M., Youlyouz-Marfak, I., and Marfak, A. (2022). Health-Related Quality of Life of Moroccan COVID-19 Survivors: A Case-Control Study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19148804"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1002\/jmv.26368","article-title":"Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation","volume":"93","author":"Halpin","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2003448","DOI":"10.1183\/13993003.03448-2020","article-title":"Dyspnoea, lung function and CT findings 3 months after hospital admission for COVID-19","volume":"57","author":"Lerum","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Meys, R., Delbressine, J.M., Go\u00ebrtz, Y.M., Vaes, A.W., Machado, F.V., Van Herck, M., Burtin, C., Posthuma, R., Spaetgens, B., and Franssen, F.M. (2020). Generic and respiratory-specific quality of life in non-hospitalized patients with COVID-19. J. Clin. Med., 9.","DOI":"10.3390\/jcm9123993"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent Symptoms Patients after Acute COVID-19","volume":"324","author":"Bernabei","year":"2020","journal-title":"JAMA"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Jacobs, L.G., Gourna Paleoudis, E., Lesky-Di Bari, D., Nyirenda, T., Friedman, T., Gupta, A., Rasouli, L., Zetkulic, M., Balani, B., and Ogedegbe, C. (2020). Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243882"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"106197","DOI":"10.1016\/j.rmed.2020.106197","article-title":"Seguimiento de pacientes con enfermedad grave por coronavirus 2019 (COVID-19): Secuelas de enfermedad pulmonar y extrapulmonar","volume":"174","author":"Daher","year":"2020","journal-title":"Respir. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Althumiri, N.A., Basyouni, M.H., AlMousa, N., AlJuwaysim, M.F., Almubark, R.A., BinDhim, N.F., Alkhamaali, Z., and Alqahtani, S.A. (2021). Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions. Healthcare, 9.","DOI":"10.3390\/healthcare9030311"},{"key":"ref_33","unstructured":"WHO (2023, January 31). World Health Organization Diabetes Country Profiles. Available online: https:\/\/www.who.int\/publications\/m\/item\/diabetes-sau-country-profile-saudi-arabia-2016."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3389\/fendo.2022.780872","article-title":"Association of obesity with COVID-19 severity and mortality: An updated systemic review, meta-analysis, and meta-regression","volume":"13","author":"Singh","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1080\/02770903.2020.1857396","article-title":"COVID-19 severity in asthma patients: A multi-center matched cohort study","volume":"59","author":"Robinson","year":"2022","journal-title":"J. Asthma"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.2174\/1389557522666220104152634","article-title":"Tuberculosis, BCG Vaccination, and COVID-19: Are They Connected?","volume":"22","author":"Borges","year":"2022","journal-title":"Mini Rev. Med. Chem."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2131166","DOI":"10.1080\/21645515.2022.2131166","article-title":"Coadministration of seasonal influenza and COVID-19 vaccines: A systematic review of clinical studies","volume":"18","author":"Janssen","year":"2022","journal-title":"Hum. Vaccines Immunother."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/5026\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:53:23Z","timestamp":1760122403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/6\/5026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,12]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20065026"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20065026","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2023,3,12]]}}}