[Developing and Validating the Long COVID-19 Symptom Severity Index (LCSSI) for Patients With Chronic Obstructive...

Existing tools for assessing Long COVID are primarily designed for the general population. Few instruments adequately capture the needs and vulnerabilities of high-risk groups such as patients with chronic obstructive pulmonary disease (COPD), who have structurally vulnerable lungs.

This study was designed to develop and validate the Long COVID Symptom Severity Index (LCSSI), a concise and clinically sensitive instrument designed specifically for use on patients with respiratory diseases.

The study was conducted in two phases. In Phase I, item generation was based on a literature review and expert panel discussion involving six pulmonologists. In Phase II, a cross-sectional validation study was conducted in the chest medicine wards and outpatient clinics of a medical center in southern Taiwan. The psychometric properties of the LCSSI were examined.

One hundred and twenty-eight patients with COPD (93% male) were enrolled, of whom 63.3% were classified under GOLD (global initiative for chronic obstructive lung disease) Group E. The most prevalent symptoms found were cough/sputum (100%), fatigue/weakness (90.6%), and dyspnea (88.3%). The LCSSI demonstrated excellent internal consistency (Cronbach's α = .88), and correlated positively with the COPD Assessment Test (p < .01) and negatively with the 15D Health-Related Quality of Life scale (p < .01). Mean LCSSI scores differed significantly across GOLD groups, with Group E showing higher mean total and core symptom scores (all p < .01), supporting construct validity.

Based on this sample, the results indicate the LCSSI has acceptable internal consistency and validity, supporting its use as a reference tool for symptom assessment in patients with COPD during the late recovery phase for Long COVID.