Health-related quality of life in young adults with acute respiratory infections

Abstract

BACKGROUND: Acute respiratory infections (ARIs) caused by influenza virus infections and other respiratory pathogens are common acute illnesses in all age groups. Although most ARI episodes are transient and self-limiting without serious complications, its clinical illness often results in restriction of daily activity with substantial associated economical and societal lost from work or study. Few studies have evaluated the health-related quality of life (HRQOL) among otherwise healthy young adults with ARIs and to understand this aspect of disease impact. METHOD: In a randomized controlled trial conducted to assess the effect of fever suppression by antipyretics in naturally-occurring influenza infections, we recruited healthy young adults aged 18-30 years presenting with acute ARIs within 48 hours of symptom in the setting of an university health clinic. We assessed health-related quality of life (HRQOL) of all recruited participants using the Acute Form of the Short Form-36, version 2 (SF-36v2). RESULTS: 767 patients were enrolled into the trial (day 1), all of whom had at least two of the ARI symptoms. 140 (18 %) were indicated to have influenza virus infection by rapid tests and further participated in the subsequent RCT. All patients had lower SF-36v2 scores than population norm, in both the physical component summary (SF36-PCS) (mean=45.9; 95% CI=45.2, 46.5) and the mental component summary (SF36-MCS) (mean=44.7 ; 95% CI=43.8, 45.5). When adjusted for other confounding factors in multiple linear regression, female and having symptoms of fever ≥37.8 C, myalgia and rhinorrhoea were the four factors significantly associated with a lower SF36-PCS score. On the other hand, having fever ≥37.8oC was associated with a better HRQOL in the mental component. Compared with the other patients, the patients with influenza infection indicated by rapid tests had considerably lower SF36-PCS score (43.6 vs 46.4, p=0.004) but the SF36-MCS score was no different. Among 140 participants with influenza indicated by the rapid test, 134 participants were followed-up again on day 10 and day 28 after enrollment as part of the main trial and both scores had gradually improved from 43.2 (day 1) to 49.6 (day 10) to 54.5 (day 28) (P<0.001) in SF36-PCS and from 43.7 (day 1) to 44.8 (day 10) to 51.8 (day 28) (P<0.001) in SF36-MCS. CONCLUSION: ARIs have substantial negative impact on HRQOL among healthy young adults especially during acute phase of the illness. Further study should be directed to assess and quantify the burden due to ARIs to provide a more comprehensive picture of the impact among this population.