Chronic Disease Self-Management of Post-Acute Sequelae of COVID-19 Among Older Adults: A Mixed-Methods Analysis

Apr 21, 2023Clinical interventions in aging

How Older Adults Manage Long-Term Symptoms After COVID-19 Using Self-Care

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Abstract

Nineteen individuals with reported high levels of fatigue and cognitive problems.

Approximately 20-30% of individuals who contract COVID-19 develop longer term complications known as Post-Acute Sequelae of SARS-CoV-2 infection (PASC).
Participants described disruptions in everyday life and varied physical symptoms, including significant cognitive issues like brain fog.
Quantitative analysis showed a notable reduction in health-related quality of life among participants.
Correlation analyses indicated a relationship between individual interview responses and self-reported symptoms on standardized questionnaires.
Findings suggest that self-report questionnaires may effectively capture the experiences of individuals with PASC.

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INTRODUCTION: Approximately 20-30% of individuals who contract acute coronavirus disease (COVID-19) infection develop longer term complications of their initial infection, referred to as (PASC). PASC is characterized by chronic, varying symptomatology.

METHODS: Using a mixed methods study design, we aimed to gain insight into individuals' experience with PASC, including cognitive issues, fatigue, and sleep disturbances. We explored whether our previously developed application (app), aimed at improving self-management skills among individuals with chronic diseases, is relevant for individuals with PASC and gained information to adapt the app for individuals with PASC. The study included 19 individuals, aged 40 years and older, recruited from our research participant database, Nova Southeastern University clinics, and community locations. We included this age range because older adults are more likely to have comorbid conditions, allowing us to better understand the impact of COVID-19 infection in these individuals. Participants completed seven standardized self-report questionnaires online, and an individual semi-structured interview via videoconferencing. Quantitative data were assessed using descriptive statistics and calculating individuals' scores in relation to norms. Qualitative data were analyzed using a thematic analysis approach. Triangulation of the data was accomplished by calculating correlations between participants' responses on self-report scales and themes found in semi-structured interviews.

RESULTS: Themes included disruption of everyday life, diverse physical symptoms, and cognitive problems including brain fog, fatigue, coping, and emotional upset. Quantitative analysis demonstrated that participants experienced high levels of fatigue, negative mood, cognitive problems, and overall reduction in health-related quality of life (HRQOL). Correlation analyses revealed that individual interview responses were related to participants' self-report of symptoms on standard questionnaires.

DISCUSSION: Findings indicate that self-report questionnaires may reflect the experience of individuals with PASC and its impact. Additionally, further efforts to expand our prior mobile app are warranted among individuals with PASC.

Key numbers

84%

Common Symptoms During Acute Illness

Percentage of participants reporting fever during acute COVID-19 infection.

10.9 months

Average Duration of Persistent Symptoms

Average time participants experienced ongoing symptoms after acute COVID-19 infection.

19 of 19

Disruption in Daily Life

All participants reported disruption in daily routines due to symptoms.

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Chronic Disease Self-Management of Post-Acute Sequelae of COVID-19 Among Older Adults: A Mixed-Methods Analysis

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