ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Validity of EQ-5D-5L breathing and cognition bolt-ons in non-hospitalized patients after COVID-19.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
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1 citing paper in PubMed.
- Psychometric validation of a cognition and social participation bolt-on for the EQ-5D-5L in SARS-CoV-2 infected German healthcare workers.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
Corrections and comments
- Erratum issued
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe EQ-5D has been criticized for lacking dimensions for breathing and cognition. In acute COVID-19 and Long COVID, breathing problems and cognitive complaints are common. This study evaluated the inclusion of EQ-5D-5L (bolt-on) items that assess these dimensions.
methodsIn a follow-up of community-based non-hospitalized patients with COVID-19 in 2020 (n = 450), we used respiratory and cognitive bolt-on items alongside other questionnaires about 30 months later (n = 220). We assessed data quality and construct validity for the bolt-ons, including comparison with concurrently used instruments' domain and item scores. Bolt-on scores were correlated with pulmonary function tests and tablet-based cognitive tests about 1 year earlier. Finally, we assessed the contribution of the bolt-ons to variability of the EQ VAS.
resultsMost patients had none or slight problems with breathing and cognition. The breathing problems bolt-on had an 8% lower ceiling effect, but otherwise a similar response distribution to the mMRC. Cognition bolt-on and four DSQ-SF item scores relating to frequency and severity were similar, except 2-13% higher ceiling effects for the former. The breathing bolt-on had a rank correlation of 0.54 with mMRC scores and higher correlations with Dyspnoea-12 scale scores. EQ-5D-5L dimensions explained 54% of variation in EQ VAS scores; the breathing bolt-on contributed a further 2%, but the cognition bolt-on contributed very little.
conclusionThe results support the validity of the two bolt-ons in follow-up of non-hospitalized patients after COVID-19. Adding items of respiratory and cognitive symptoms may enhance the EQ-5D's appropriateness in respiratory and cognitive research and clinical practice.
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