Prevalence and impact of long COVID on health-related quality of life in previously hospitalized COVID-19 patients: a 2-year follow-up study

Abstract Long COVID is a major health concern, yet evidence from Southeast Asia remains limited. We evaluated the prevalence, predictors, and health-related quality of life (HRQoL) impact of long COVID among hospitalized adults in Thailand over two years. This single-center, ambidirectional cohort combined retrospective chart review with prospective follow-up. The cohort comprised 295 adults hospitalized for symptomatic COVID-19 between August and November 2021. Interviews occurred at three months, one year, and two years post-infection. Long-COVID prevalence was 49.8% at three months; among these, 64.4% reported persistent symptoms at one year, and 22% of the one-year symptomatic group had symptoms at two years. Common symptoms included breathlessness, fatigue, and memory disturbance. Logistic regression identified severe–critical acute illness as a risk factor (adjusted odds ratio [aOR] 2.06, 95% CI 1.23–3.46), while full vaccination was protective (aOR 0.48, 95% CI 0.25–0.90). Long COVID was associated with lower HRQoL across all EQ-5D-5L domains. Long COVID was frequent among hospitalized Thai patients, with symptoms persisting in a substantial proportion up to two years. Severity of acute COVID-19 and vaccination status predicted long COVID. Long COVID was linked to reduced HRQoL, underscoring the need for follow-up and further confirmation in larger, multicenter studies.