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Meta-Analysis
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Dec 25, 2025; 14(4): 113507
Published online Dec 25, 2025. doi: 10.5501/wjv.v14.i4.113507
Post-COVID-19 health-related quality of life in India: A systematic review and meta-analytic assessment of recovery outcomes
Shubhanjali Roy, Puja Samanta, Archita Sen, Arka Ghosh, Saurav Basu
Shubhanjali Roy, Puja Samanta, Archita Sen, Arka Ghosh, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurugram 122102, Haryana, India
Saurav Basu, Department of Community Medicine, ESI-PGIMSR Medical College and Hospital-Joka, Kolkata 700104, West Bengal, India
Author contributions: Roy S was responsible for conceptualization, methodology, data curation, validation, investigation, formal analysis, software, and writing (original draft); Samanta P was responsible for methodology, data curation, validation, investigation, and writing (original draft); Sen A was responsible for methodology, data curation, validation, investigation, writing review and editing; Ghosh A was responsible for methodology, data curation, visualization, software, and writing review and editing; Basu S was responsible for conceptualization, methodology, supervision, visualization, and writing review and editing; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Saurav Basu, Assistant Professor, Department of Community Medicine, ESI-PGIMSR Medical College and Hospital-Joka, Diamond Harbor Road, Kolkata 700104, West Bengal, India. saurav.basu1983@gmail.com
Received: September 3, 2025
Revised: October 9, 2025
Accepted: December 16, 2025
Published online: December 25, 2025
Processing time: 114 Days and 2.1 Hours
Abstract
BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had profound physical, psychological, and social consequences, with lasting effects on health-related quality of life (HRQoL) among people with a history of COVID-19.

AIM

To synthesize the current evidence on HRQoL and long-term health outcomes among people with a history of COVID-19 in India.

METHODS

We incorporated studies from India reporting post-COVID HRQoL outcomes using validated instruments, including the 5-level EuroQol 5-Dimensional questionnaire, the EuroQol Visual Analogue Scale, the Short Form-36 Health Survey, the World Health Organization Quality of Life-Brief Version, and the European Health Interview Survey-Quality of Life. Pooled mean 5-level EuroQol 5-Dimensional questionnaire scores with 95%CIs were calculated for HRQoL. Adjusted odds ratios were pooled for comorbidity, disease severity, intensive care unit admission, age, sex, and vaccination status using random-effects models.

RESULTS

Three studies (n = 1526) reported EuroQol instruments, with the 5-level EuroQol 5-Dimensional questionnaire utility scores suitable for quantitative pooling. The pooled mean utility was 0.83 (95%CI: 0.75-0.92), although heterogeneity was high because the included studies represented clinically distinct populations. Across all studies, several determinants were consistently associated with impaired HRQoL. Older adults (≥ 60 years) had higher odds of poor HRQoL [pooled odds ratio (OR) = 1.83, 95%CI: 1.43-2.35], and females were more likely to experience impaired HRQoL (pooled OR = 1.74, 95%CI: 1.44-2.10), whereas males had a lower risk (pooled OR = 0.58, 95%CI: 0.48-0.70). Being unvaccinated increased the likelihood of persistent symptoms or reduced HRQoL (pooled OR = 1.60, 95%CI: 1.21-2.14). Comorbidity (pooled OR = 1.94, 95%CI: 1.43-2.63) and severe acute COVID-19 or intensive care unit admission (pooled OR = 2.77, 95%CI: 2.13-3.59) were also strongly associated with poorer HRQoL Six additional studies utilizing disparate instruments (EuroQol Visual Analogue Scale, Short Form-36 Health Survey, World Health Organization Quality of Life-Brief Version, European Health Interview Survey-Quality of Life) were excluded from quantitative synthesis due to measurement heterogeneity.

CONCLUSION

Post-COVID HRQoL in people with a history of COVID-19 in India is suboptimal, with greater impairment observed among older adults, females, patients with comorbidities or severe disease, and unvaccinated individuals. These findings highlight the need for targeted rehabilitation and preventive strategies.

Keywords: Health-related quality of life; Post-COVID-19; Recovery outcomes; Meta-analysis; Quality of life; COVID-19 survivors

Core Tip: This systematic review and meta-analysis is the first to comprehensively assess post- coronavirus disease 2019 health-related quality of life in India using validated instruments such as 5-level EuroQol 5-Dimensional questionnaire, Short Form-36 Health Survey, World Health Organization Quality of Life-Brief Version, and St. George’s Respiratory Questionnaire. Findings highlight that overall health-related quality of life recovery was suboptimal, especially among vulnerable groups including older adults, women, and patients with chronic conditions who experienced disproportionately poorer outcomes. The study underscores the importance of targeted, multidisciplinary rehabilitation strategies that address physical, psychological, and social domains of health to improve long-term recovery in post- coronavirus disease 2019 populations.