BACKGROUND: Older people are particularly vulnerable to severe COVID-19 . Little is known about long-term consequences of COVID-19 on health-related quality of life (HR-QoL) and functional status in older people, and the impact of age in this context . We aimed to study age-related change in health-related quality of life, functional decline and mortality among older patients 6 months following hospitalisation due to COVID-19 .

METHODS: This was a cohort study including patients aged 60 years and older admitted to four general hospitals in South-Eastern Norway due to COVID-19, from March 1 up until July 1 , 2020 . Patients who were still alive were invited to attend a six-month follow-up . Change in HR-QoL and functional status compared to before the COVID-19 hospitalisation were assessed using the EuroQol 5-dimensional-5 levels questionnaire (EQ . 5D-5L). A change in visual analogue scale (VAS) score of 7 or more was considered clinically relevant .

RESULTS: Out of 216 patients aged 60 years and older that were admitted to hospital due to COVID-19 during the study period , 171 were still alive 180 days after hospital admission, and 106 patients (62 %) attended the six-month follow-up . Mean age was 74.3 years , 27 patients (26 %) had experienced severe COVID-19 . Fifty-seven participants (54 %) reported a decrease in the EQ . 5D-5L VAS score after 6 months, with no significant difference between persons aged 75 years and older compared to younger . Seventy participants (66 %) reported a negative change in any of the dimensions of the EQ . 5D-5L, with impaired ability to perform activities of daily life (35 %), reduced mobility (33 %) and having more pain or discomfort (33 %) being the most commonly reported changes . Forty-six participants (43 %) reported a negative change in cognitive function compared to before the COVID-19 hospitalisation . Six-month mortality was 21%, and increased with increasing age .

CONCLUSIONS: More than half of the patients reported a negative change in HR-QoL 6 months following hospitalisation due to COVID-19, and one out of three experienced a persistently impaired mobility and ability to carry out activities of daily living . The results suggest awareness of long-term functional decline in older COVID-19 patients.