Twelve-Month Health-Related Quality of Life Recovery Following COVID-19 Hospitalization: A Prospective Cohort Study...

Background and Objectives: As SARS-CoV-2 transitions toward endemic circulation, understanding long-term health impacts on quality of life (HRQoL) is critical for healthcare planning. While most longitudinal HRQoL studies originate from Western settings, data from Central and Eastern Europe remain scarce. This study aimed to track HRQoL changes over 12 months and explore the sociodemographic and clinical predictors of recovery in Lithuania. Materials and Methods: We conducted a prospective cohort study of 93 adults hospitalized with severe or critical COVID-19 at Vilnius University Hospital from October 2021 to October 2022. HRQoL was assessed at 3, 6, and 12 months post-discharge using the Short Form-36 Health Survey (SF-36). Longitudinal changes were analyzed using non-parametric tests, with minimal clinically important differences (MCIDs) applied. Multivariable regression identified predictors of 12-month outcomes. Results: Ninety-three participants (mean age 58.2 years; 53.8% female; 60.2% with critical disease; 95.7% unvaccinated) completed all follow-up visits. Seven of eight SF-36 domains showed clinically meaningful improvement over 12 months, most notably Bodily Pain (+18.8 points, r = 0.41), General Health (+14.6, r = 0.42), and Social Functioning (+10.4, r = 0.38). Role-Emotional improved minimally (+3.6, r = 0.16). Better Physical Functioning at 12 months was independently associated with male sex, employment, and fewer comorbidities. HRQoL scores remained below age-matched population norms. Only 12.9% accessed structured (Stage II) rehabilitation. Conclusions: This is the first comprehensive 12-month SF-36-based HRQoL assessment among hospitalized COVID-19 survivors in Central and Eastern Europe. Most domains improved significantly; however, emotional and social deficits persisted. Interpretation is limited by the single-center design, absence of pre-COVID baseline data, and use of a generic HRQoL measure. Low rehabilitation uptake underscores gaps in post-COVID care, highlighting the need for integrated, equity-focused recovery programs.