Abstract
PURPOSE: The long-term effects of SARS-CoV-2 infection are increasingly recognized, with heterogeneous physical and psychological symptoms that may persist for months, significantly affecting Health Related Quality of Life (HRQoL), functional capacity, and psychosocial well-being. This study explores distinct profiles of HRQoL and psychological symptoms in former COVID-19 inpatients and assesses the impact of clinical variables at admission on long-term outcomes. METHODS: Patients hospitalised for COVID-19 at Molinette Hospital in Turin were contacted several months post-discharge (between June 2022 and June 2023) to complete a questionnaire assessing long-term HRQoL, sleep quality, depression, anxiety, stress, and fatigue. Clinical data at the time of hospitalisation were also available for each participant. A Latent Profile Analysis (LPA) was conducted on these physical and psychological variables, followed by multinomial logistic regression to examine how selected indicators of baseline COVID-19 severity and patient characteristics predicted profile membership. RESULTS: The sample consisted of 601 patients. LPA identified three health-related profiles: Fit-Vital (n = 289), Frail-Weak (n = 229), and Shattered-Broken (n = 83). Neither ICU admission nor pneumonia showed significant associations with more severe physical and psychological conditions. Key predictors of membership in the more severe profiles included the presence of comorbidities and altered clinical parameters reflecting overall physical status. Female gender was identified as a risk factor for poorer outcomes. CONCLUSION: This study highlights a wide spectrum of post-COVID-19 conditions, ranging from good to severely compromised physical and mental health. Female gender, presence of comorbidities, and elevated early warning scores at hospital admission are risk factors for worse outcomes, emphasizing the need for comprehensive long-term care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11136-026-04206-y.