Association of long COVID with health-related quality-of-life outcomes

Gandhi, Malini M.; Moser, Carlee; Currier, Judith S.; Ritz, Justin; Eron, Joseph J.; Daar, Eric S.; Wohl, David A.; Fischer, William A.; Singh, Upinder; Hughes, Michael D.; Smith, Davey M.; Evering, Teresa H.; Chew, Kara W.

doi:10.1038/s41598-026-36189-8

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Published: 19 March 2026

Association of long COVID with health-related quality-of-life outcomes

Malini M. Gandhi¹,
Carlee Moser^2,3,
Judith S. Currier⁴,
Justin Ritz²,
Joseph J. Eron⁵,
Eric S. Daar⁶,
David A. Wohl⁵,
William A. Fischer II⁵,
Upinder Singh⁷,
Michael D. Hughes²,
Davey M. Smith⁸,
Teresa H. Evering⁹ &
Kara W. Chew⁴
for the ACTIV-2/A5401 Study Team

Scientific Reports , Article number: (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

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Abstract

The association of long COVID with health-related quality-of-life (HrQOL) has not been well-characterized. Participants who received blinded placebo in the ACTIV-2/A5401 outpatient COVID-19 treatment trial were included in an analysis of the association of long COVID with HrQOL (both pre-specified exploratory trial endpoints) 9 months after acute COVID-19. Long COVID was defined as presence of self-assessed COVID-19 symptoms and HrQOL was assessed with EQ-5D-5L and SF-36v2 questionnaires. Associations were evaluated by Fisher’s exact tests and Wilcoxon rank-sum tests. Of 546 participants, 13% had long COVID. Long COVID was associated with greater risk of reported problems in the EQ-5D-5L dimensions of mobility, usual activities, pain/discomfort, and anxiety/depression (risk ratios 3.45–6.00, all p < 0.001) and worse self-reported health scores (median 80 vs. 95, p < 0.001). Participants with long COVID also had worse SF-36v2 composite physical and mental component scores (both p < 0.001) and individual SF-36 domain scores (physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health; all p < 0.001). Associations were similar regardless of baseline (pre-COVID-19) medical history. Long COVID is associated with impaired HrQOL across multiple domains, highlighting the need to develop preventative and therapeutic interventions for this protean condition.

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Data availability

Data are available under restricted access. Access to the data is governed by ACTG policy. Access can be requested by submitting a data request at https://submit.mis.s-3.net/ and will require the written agreement of ACTG. Requests will be addressed as per ACTG standard operating procedures. Completion of an ACTG Data Use Agreement may be required.

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Acknowledgements

We thank the study participants, site staff, site investigators, and the entire ACTIV-2/A5401 study team; the ACTIV-2 Community Advisory Board; the ACTG, including Lara Hosey, Jhoanna Roa, and Nilam Patel; the University of Washington Virology Specialty Laboratory; the ACTG Laboratory Center; Frontier Science; Harvard Center for Biostatistics in AIDS Research and ACTG Statistical and Data Analysis Center, the National Institute of Allergy and Infectious Diseases/Division of AIDS; the Foundation for the National Institutes of Health and the ACTIV partnership; and the PPD clinical research business of Thermo Fisher Scientific.

Funding

This work was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Numbers UM1AI068636, UM1AI068634, UM1AI106701, and P30AI152501. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

A list of authors and their affiliations appears at the end of the paper.

Authors and Affiliations

Department of Internal Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA
Malini M. Gandhi
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Carlee Moser (Statistician), Justin Ritz (Statistician) & Michael D. Hughes (Lead Statistician)
Sanofi, Bridgewater, USA
Carlee Moser (Statistician)
Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 911 Broxton Avenue, Suite 200, Los Angeles, CA, 90024, USA
Judith S. Currier (Protocol Investigator and ACTG Chair) & Kara W. Chew (Co-Chair)
Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Joseph J. Eron (Protocol Investigator and ACTG Vice Chair), David A. Wohl (Vice Chair) & William A. Fischer II (Protocol Critical Care Specialist)
Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
Eric S. Daar (Vice Chair) & Katya Corado (Protocol Investigator)
University of Iowa Carver College of Medicine, Iowa City, IA, USA
Upinder Singh
Department of Medicine, University of California, La Jolla, San Diego, CA, USA
Davey M. Smith
Department of Medicine, Weill Cornell Medicine, New York, NY, USA
Teresa H. Evering (Protocol Investigator)
University of California, La Jolla, San Diego, CA, USA
Davey Smith (Co-Chair)
NIH Division of AIDS (DAIDS) Clinical Representative, National Institutes of Health, Rockville, MD, USA
Arzhang Cyrus Javan
Harvard T.H. Chan School of Public Health, Boston, MA, USA
Mark Giganti (Statistician)
AIDS Clinical Trials Group (ACTG) Network Coordinating Center, Social & Scientific Systems, a DLH Company, Silver Spring, MD, USA
Lara Hosey (Clinical Trials Specialist), Jhoanna Roa (Clinical Trials Specialist) & Nilam Patel (Clinical Trials Specialist)
NIH/DAIDS Pharmaceutical Affairs Branch, Rockville, MD, USA
Kelly Colsh (DAIDS Pharmacist), Irene Rwakazina (DAIDS Pharmacist) & Justine Beck (DAIDS Pharmacist)
Case Western Reserve University, Cleveland, OH, USA
Scott Sieg (Protocol Immunologist)
Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
Jonathan Li (Protocol Virologist)
University of Nebraska Medical Center, Omaha, NE, USA
Courtney Fletcher (Protocol Pharmacologist)
University of Washington, Seattle, WA, USA
Rachel Bender Ignacio (Protocol Investigator) & Joan Dragavon (Laboratory Technologist)
Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
Sandra Cardoso (Protocol Investigator)
Stanford University School of Medicine, Palo Alto, CA, USA
Prasanna Jagannathan (Protocol Investigator) & Upinder Singh (Protocol Investigator)
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Nikolaus Jilg (Protocol Investigator)
Los Alamos National Laboratory, Los Alamos, NM, USA
Alan Perelson (Protocol Investigator)
Enhancing Care Foundation, Durban, KwaZulu-Natal, South Africa
Sandy Pillay (Protocol Investigator)
GHESKIO Center, Port-Au-Prince, Haiti
Cynthia Riviere (Protocol Investigator)
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Babafemi Taiwo (Protocol Investigator)
Vanderbilt University Medical Center, Nashville, TN, USA
Joan Gottesman (Field Representative)
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
Matthew Newell (Field Representative) & Susan Pedersen (Field Representative)
Northwestern University, Chicago, IL, USA
Cheryl Jennings (Laboratory Technologist), Babafemi O. Taiwo (PI), Claudia Hawkins & Baiba Berzins
Ohio State University, Columbus, OH, USA
Brian Greenfelder (Laboratory Technologist)
ACTG Laboratory Center, University of California, Los Angeles, Los Angeles, CA, USA
William Murtaugh (Laboratory Specialist)
Case Western University Clinical Research Site, North Royalton, OH, USA
Jan Kosmyna (ACTG Community Scientific Subcommittee Representative)
ACTG Network Coordinating Center, Social & Scientific Systems, a DLH Company, Durham, NC, USA
Morgan Gapara (International Site Specialist)
ACTG Network Coordinating Center, Social & Scientific Systems, a DLH Company, Silver Spring, MD, USA
Akbar Shahkolahi (International Site Specialist)
Brii Biosciences, Durham, NC, USA
David Margolis
Lilly Research Laboratories, San Diego, CA, USA
Paul Klekotka
AstraZeneca, Gaithersburg, MD, USA
Robert A. Gasser Jr
SAB Biotherapeutics, Cambridge, MA, USA
Rick Finnegan
Bristol Myers Squibb, Lawrenceville, NJ, USA
Edgar Charles
Sagent Pharmaceuticals, Schaumburg, IL, USA
Bob Szurgot
Synairgen Research Ltd, Southampton, UK
Mark J. Main
Fundación Sanatorio Güemes, Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
Verónica Lacal (PI), Diego Salusso & Sebastian Nuñez
Hospital Universitario Austral, Derqui, Pilar, Argentina
Marcelo Rodrigo Rodriguez (PI), Luciana Laborde & Marcelo Papasidero
Instituto Ave Pulmo, Mar del Plata, Argentina
Luis Wehbe (PI), Mariana Gonzalez & Felicitas Fernandez Voena
Instituto Médico de La Fundación Estudios Clínicos, Rosario, Santa Fe, Argentina
Tomas Alvarez (PI), Amaru Lopez & Virginia Huhn
Instituto Médico Río Cuarto, Río Cuarto, Córdoba, Argentina
Ulises D´Andrea Nores (PI), Pablo Dieser & Fernando Bordese
Hospital Das Clinicas da Faculdade de Medicina de Ribeirão Preto – USP, Ribeirão Preto, São Paulo, Brazil
Marisa Mussi (PI), Rodrigo de Carvalho Santana & Adriana Aparecida Tiraboschi Bárbaro
Hospital Nossa Senhora da Conceicao, Porto Alegre, Rio Grande Do Sul, Brazil
Breno Santos (PI), Rita de Cássia Alves Lira & Andre Luiz Machado da Silva
Instituto de Pesquisa Clínica Evandro Chagas – FIOCRUZ, Rio De Janeiro, Rio de Janeiro, Brazil
Sandra Wagner Cardoso (PI), Maria Pia Diniz Ribeiro & Nathália Soliva
L2 Ip - Instituto de Pesquisas Clinicas Ltda – ME, Brasília, Distrito Federal, Brazil
Eduardo Vasconcellos (PI), Jorge Eurico Ribeiro & Miriam Amaral Enéas
SOM Federal University Minas Gerais Brazil, Belo Horizonte, Minas Gerais, Brazil
Jorge Pinto (PI), Julia Fonseca de Morais Caporali & Flávia Gomes Faleiro Ferreira
Oaxaca Site Management Organization (OSMO), Oaxaca, Distrito Federal, Mexico
Norma Erendira Rivera Martinez (PI) & Victor Casildo Bohorquez Lopez
De La Salle Health Sciences Institute, Cavite City, Cavite, Philippines
Melchor Victor Frias (PI), Krystle Fetalvero & Alyxzza Maranan
CLINRESCO, ARWYP Medical Suites, Johannesburg, Gauteng, South Africa
Jennifer Rosa (PI), Thomas Coetzer & Maureen Mohata
Durban International Clinical Research Site, Durban, Kwazulu – Natal, South Africa
Umesh Lalloo (PI), Sandy Pillay & Penelope Madlala
Global Clinical Trials Sunnyside, Pretoria, Gauteng, South Africa
Larisha Pillay-Ramaya (PI)
Helen Joseph Hospital, Johannesburg, Gauteng, South Africa
Jaclyn Ann Bennet (PI), Noluthando Mwelase & Nokuphiwa Mbhele
Mzansi Ethical Research Centre, Steve Tshwete, Mpumalanga, South Africa
Frederick Petrick (PI) & Leonard Joubert
Peermed Clinical Trial Center, Ekurhuleni, Gauteng, South Africa
Rose Mbali, Natasha Joseph (PI) & Mmatsie Manentsa
Roodepoort Medicross, Johannesburg, Gauteng, South Africa
Eugene van der Walt (PI) & Mduduzi Sandile Lawrance Masilela (PI)
Setshaba Research Centre, Pretoria, Gauteng, South Africa
Zinhle Zwane & Tendai Chiperera
Soweto ACTG Clinical Research Site, Johannesburg, Gauteng, South Africa
Lerato Mohapi (PI), Suri Moonsamy & Usha Singh
TASK Eden, George, Western Cape, South Africa
Kirsten McHarry (PI), Elizma Snyman & Pieter Lennox
The Aurum Institute Klerksdorp Clinical Research Centre, Klerksdorp, North – West, South Africa
James Craig Innes (PI), Oteng Letlape & Olebogeng Jonkane
The Aurum Institute NPC Rustenburg Clinical Research Site, Rustenburg, North – West, South Africa
William Brumskine (PI), Tania Adonis & Ni Ni Sein
The Aurum Institute Tembisa Clinical Research Site, Johannesburg, Gauteng, South Africa
Modulakgotla Sebe (PI)
Welkom Clinical Trial Centre, Matjhabeng, Free State, South Africa
Yacoob Vahed (PI)
Worthwhile Clinical Trials, Ekurhuleni, Gauteng, South Africa
Nazreen Jeewa Hussen (PI) & Ismail Mitha
Agile Clinical Research Trials, LLC, Atlanta, GA, USA
Vasundhara Cheekati (PI) & Purna Cheekati
Allegiance Research Specialists, Wauwatosa, WI, USA
Christie Lummus, Samuel Idarraga (PI) & Andrew Kim
Allianz Research Institute Inc, Westminster, CA, USA
David N. Pham (PI) & Wei-Hsin Kao
Allied Biomedical Research Institute, Miami, FL, USA
Michael M. Pfeffer (PI) & Miriam Batule Dominguez
Ascension St. John Clinical Research Institute, Tulsa, OK, USA
Anju Malik (PI), Anna Bryan & Melanie Arnold
Best Quality Research, Inc, Hialeah, FL, USA
Idania Fernandez (PI), Cinzia Karpf & Aniuska Ruiz
Bozeman Health Deaconess Hospital, Bozeman, MT, USA
David Taylor (PI)
Bradenton Research Center Inc, Bradenton, FL, USA
Eric Folkens (PI)
Brigham and Women’s Hospital Therapeutics, Boston, MA, USA
Jennifer Manne (PI), Sigal Yawetz & Cheryl Keenan
Carolina Clinical Research, Charlotte, NC, USA
Emeka Eziri (PI)
Cincinnati Clinical Research Site, Cincinnati, OH, USA
Carl Fichtenbaum (PI), Jenifer Baer & Sarah Trentman
Clinical Research Partners LLC, Richmond, VA, USA
Robert Call (PI) & Leroy Vaughan
Clinical Trials Center of Middle Tennessee, Franklin, TN, USA
Aaron Milstone (PI), Jamie Alex Slandzicki & Jessica Wallan
Clinical Trials of America, LLC, Monroe, LA, USA
Clinton Guillory (PI), Nancy Andrews & Leslie Hughes
Cornell Clinical Trials Unit, New York Presbyterian Hospital-Weill Cornell Uptown, New York, NY, USA
Teresa H. Evering (PI), Jonathan Berardi & Celine Arar
Cullman Clinical Trials, Cullman, AL, USA
Randall Quinn (PI)
D&H National Research Centers, Miami, FL, USA
Jorge P. Amaya (PI)
Doctors Hospital at Renaissance Health Institute for Research and Development, Edinburg, TX, USA
Marissa Gomez-Martinez (PI), Luis Cantu & Monica Betancourt-Garcia
Duke University Medical Center, Durham, NC, USA
Nwora Lance Okeke (PI) & Charles M. Burns
Fadi A. Haddad, MD, Inc, La Mesa, CA, USA
Fadi Haddad (PI) & Victoria Haddad
FOMAT Medical Research - FOMAT – HyperCore, Oxnard, CA, USA
Augusto Focil (PI), Griselda Rosas & Susana Moyano
Gonzalez MD & Aswad MD Health Services, Miami, FL, USA
Yaneicy Gonzalez Rojas (PI) & Ahmad Aswad
Great Lakes Clinical Trials, Chicago, IL, USA
Yevgeniy Bukhman (PI), Manish Jain & Eugene Bukhman
Hannibal Clinic, Hannibal, MO, USA
Humam Farah (PI) & Rebekah McClain
Harbor UCLA Clinical Research Site, Torrance, CA, USA
Eric Daar (PI) & Sadia Shaik
Houston Methodist Hospital, Houston, TX, USA
Timothy Hatlen & Deepa Gotur (PI)
IACT Health – Roswell – IACT – HyperCore, Columbus, GA, USA
Joseph Surber (PI), Jeffrey Kingsley & April Pixler
Imagine Research of Palm Beach County, Boynton Beach, FL, USA
Alex Zopo (PI), Jack Herman & Craig Herman
International Medical Investigational Center (IMIC) Inc., Palmetto Bay, FL, USA
Ramon Leon (PI) & Boris Nikolov
Innovative Health Medical Center, Hollywood, FL, USA
Fernando Gonzalez Vergara (PI), Ana I. Gonzalez & Noemi Gonzalez
James J Peters VA Medical Center - (CRS) – NAVREF, Bronx, NY, USA
Michael Gelman (PI), Olga Andriunas & Zarema Jagizarov
Jasper Summit Research LLC, Jasper, AL, USA
Jan Westerman (PI), David Davis & Donna Sherer
Johns Hopkins University, Baltimore, MD, USA
Kelly Dooley (PI), Becky Becker & Adaliah Wilkins
Lakes Research, Miami Lakes, FL, USA
Jose Pérez (PI), Eloy Roman & Heriberto Fernández
Las Vegas Medical Research, Las Vegas, NV, USA
Bharat Mocherla (PI), Kelly Beck & Valarie Maldonado
Loma Linda University Health, Loma Linda, CA, USA
Jennifer Veltman (PI)
Massachusetts General Hospital, Boston, MA, USA
Rajesh Gandhi (PI), Katrina Shea & Matthew Planchon
Medtrial, LLC, Columbia, SC, USA
Laura Bogan Herpel (PI), Kaushlendra K. Tripathi & Donald C. Day Sr.
Mercury Street Medical Group, Butte, MT, USA
John Pullman (PI), Erin Williams-Leber & Misty Johnson
MetroHealth Medical Center, Cleveland, OH, USA
Michelle Hecker (PI) & Ann Avery
Miami Clinical Research, Miami, FL, USA
Keila Hoover (PI)
Moore Clinical Research, Inc. - Brandon – HyperCore, Brandon, FL, USA
George W. Monlux Jr (PI), Elizabeth Juneja & Arthur Wernick
New Generation Medical Research, Hialeah, FL, USA
Karelia Ruiz (PI), Maureen Hernández & Yadilys Pérez
Ohio State University Medical Center, Columbus, OH, USA
Carlos Malvestutto (PI), Heather Harber & Robyn Cicarella
Orlando Immunology Center Clinical Research Site, Orlando, FL, USA
Edwin DeJesus (PI) & Charlotte-Paige Rolle
Pinnacle Research Group, Anniston, AL, USA
Almena L. Free (PI) & Sallie D. Pulliam
PPD Virtual - Science 37, Inc, Culver City, CA, USA
Debra Weinstein (PI)
Pro Live Medical Research Corp, Miami, FL, USA
Rosa M. Suarez (PI), Ezequiel Socorro & Estefania Socorro
Quantum Clinical Trials, Miami Beach, FL, USA
Gene Neytman (PI), Jack Herman & Craig Herman
Renew Health Clinical Research, LLC, Snellville, GA, USA
Raymond Easley (PI)
Rush University Medical Center, Chicago, IL, USA
Mariam Aziz (PI) & Joan Swiatek
Sanford Health, Fargo, ND, USA
Avish Nagpal (PI), Breanna Kompelien & Kathryn McEvoy
Sanford USD Medical Center, Sioux Falls, SD, USA
Susan E. Hoover (PI), Allison Lutz & Jessica Just
Savin Medical Group LLC, Miami Lakes, FL, USA
Manuel Hernandez (PI), Yanly B. Victoria & Gabriel Rodriguez
Stanford University, Palo Alto, CA, USA
Upinder Singh (PI), Prasanna Jagannathan & Divya Pathak
STAT Research, Springboro, OH, USA
Joshua J. Ordway (PI) & Megan Heffner
Synergy Healthcare, Bradenton, FL, USA
Patrick Weston (PI) & Khalilah Weston
The University of Pittsburgh, Pittsburgh, PA, USA
Madhu Choudhary (PI) & Jennifer Sullivano
Triple O Research Institute PA, West Palm Beach, FL, USA
Olayemi Osiyemi (PI), Myriam Izquierdo & Odelsey Torna
Emergency Medicine, University at Buffalo, Buffalo, NY, USA
Brian Clemency (PI), Renoj Varughese & Joshua Lynch
University of California Los Angeles, Los Angeles, CA, USA
Kara Chew (PI), Aleen Khodabakhshian & Samantha Fortier
University of California San Diego, La Jolla, San Diego, CA, USA
Christopher Coyne (PI) & Alexandrea Cronin
University of California San Diego Antiviral Research Center, San Diego, CA, USA
Constance Benson (PI), Steven Hendrickx & Rosemarie Ramirez
University of California San Francisco, San Francisco, CA, USA
Anne Luetkemeyer (PI), Suzanne Hendler & Dennis Dentoni-Lasofsky
University of Florida Jacksonville, Jacksonville, FL, USA
Mobeen Rathore (PI), Saniyyah Mahmoudi, Amna Riaz & Mario Castro (PI)
Medical Center, University of Kansas, Kansas City, KS, USA
Leslie Spikes & Chase Hall
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
David Wohl (PI), Jonathan Oakes & Amy James Loftis
University of Pennsylvania, Philadelphia, PA, USA
Pablo Tebas (PI), William Short & Michael P. Dube (PI)
University of Southern California, Los Angeles, CA, USA
Saahir Khan & Luis M. Mendez
University of Washington AIDS Clinical Trials, Seattle, WA, USA
Rachel Bender Ignacio (PI), Sarah McGuffin & Chris Jonsson
UT Southwestern HIV/ID Clinical Trials Unit, Dallas, TX, USA
Mamta K. Jain (PI), Smruthi Senthil & Kimberly Turner-Gray
VA San Diego Health System – NAVREF, San Diego, CA, USA
Sanjay Mehta (PI), David Davey Smith & Mary Lewinski
Valley Clinical Research Inc, Northridge, CA, USA
Masoud Azizad (PI), Christopher Chow & Lisa Nakatani
Vida Clinical Studies, Dearborn, MI, USA
Derrick Williamson (PI), Hisham Atriss & Matthew Caloura
W VA University Mary Babb Randolph Cancer Center, Morgantown, WV, USA
Midhun Malla (PI) & Hannah Hazard-Jenkins
Wake Forest University Health Sciences, Winston Salem, NC, USA
Aimee Wilkin (PI), Jamraus Fayssoux & Hannah Seagle
Washington University School of Medicine, Saint Louis, MO, USA
Rachel Presti (PI) & Alem Haile

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Malini M. Gandhi
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Carlee Moser
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Judith S. Currier
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Justin Ritz
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Joseph J. Eron
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Eric S. Daar
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David A. Wohl
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William A. Fischer II
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Upinder Singh
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Michael D. Hughes
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Davey M. Smith
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Teresa H. Evering
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Kara W. Chew
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Consortia

for the ACTIV-2/A5401 Study Team

Carlee Moser
, Judith S. Currier
, Justin Ritz
, Joseph J. Eron
, Eric S. Daar
, David A. Wohl
, William A. Fischer II
, Michael D. Hughes
, Teresa H. Evering
, Kara W. Chew
, Davey Smith (Co-Chair)
, Arzhang Cyrus Javan
, Mark Giganti (Statistician)
, Lara Hosey (Clinical Trials Specialist)
, Jhoanna Roa (Clinical Trials Specialist)
, Nilam Patel (Clinical Trials Specialist)
, Kelly Colsh (DAIDS Pharmacist)
, Irene Rwakazina (DAIDS Pharmacist)
, Justine Beck (DAIDS Pharmacist)
, Scott Sieg (Protocol Immunologist)
, Jonathan Li (Protocol Virologist)
, Courtney Fletcher (Protocol Pharmacologist)
, Rachel Bender Ignacio (Protocol Investigator)
, Sandra Cardoso (Protocol Investigator)
, Katya Corado (Protocol Investigator)
, Prasanna Jagannathan (Protocol Investigator)
, Nikolaus Jilg (Protocol Investigator)
, Alan Perelson (Protocol Investigator)
, Sandy Pillay (Protocol Investigator)
, Cynthia Riviere (Protocol Investigator)
, Upinder Singh (Protocol Investigator)
, Babafemi Taiwo (Protocol Investigator)
, Joan Gottesman (Field Representative)
, Matthew Newell (Field Representative)
, Susan Pedersen (Field Representative)
, Joan Dragavon (Laboratory Technologist)
, Cheryl Jennings (Laboratory Technologist)
, Brian Greenfelder (Laboratory Technologist)
, William Murtaugh (Laboratory Specialist)
, Jan Kosmyna (ACTG Community Scientific Subcommittee Representative)
, Morgan Gapara (International Site Specialist)
, Akbar Shahkolahi (International Site Specialist)
Industry Representatives
- David Margolis
- , Paul Klekotka
- , Robert A. Gasser Jr
- , Rick Finnegan
- , Edgar Charles
- , Bob Szurgot
- & Mark J. Main
ACTIV-2/A5401 Participating Sites, Investigators, Study Personnel
- Verónica Lacal (PI)
- , Diego Salusso
- , Sebastian Nuñez
- , Marcelo Rodrigo Rodriguez (PI)
- , Luciana Laborde
- , Marcelo Papasidero
- , Luis Wehbe (PI)
- , Mariana Gonzalez
- , Felicitas Fernandez Voena
- , Tomas Alvarez (PI)
- , Amaru Lopez
- , Virginia Huhn
- , Ulises D´Andrea Nores (PI)
- , Pablo Dieser
- , Fernando Bordese
- , Marisa Mussi (PI)
- , Rodrigo de Carvalho Santana
- , Adriana Aparecida Tiraboschi Bárbaro
- , Breno Santos (PI)
- , Rita de Cássia Alves Lira
- , Andre Luiz Machado da Silva
- , Sandra Wagner Cardoso (PI)
- , Maria Pia Diniz Ribeiro
- , Nathália Soliva
- , Eduardo Vasconcellos (PI)
- , Jorge Eurico Ribeiro
- , Miriam Amaral Enéas
- , Jorge Pinto (PI)
- , Julia Fonseca de Morais Caporali
- , Flávia Gomes Faleiro Ferreira
- , Norma Erendira Rivera Martinez (PI)
- , Victor Casildo Bohorquez Lopez
- , Melchor Victor Frias (PI)
- , Krystle Fetalvero
- , Alyxzza Maranan
- , Jennifer Rosa (PI)
- , Thomas Coetzer
- , Maureen Mohata
- , Umesh Lalloo (PI)
- , Sandy Pillay
- , Penelope Madlala
- , Larisha Pillay-Ramaya (PI)
- , Jaclyn Ann Bennet (PI)
- , Noluthando Mwelase
- , Nokuphiwa Mbhele
- , Frederick Petrick (PI)
- , Leonard Joubert
- , Rose Mbali
- , Natasha Joseph (PI)
- , Mmatsie Manentsa
- , Eugene van der Walt (PI)
- , Mduduzi Sandile Lawrance Masilela (PI)
- , Zinhle Zwane
- , Tendai Chiperera
- , Lerato Mohapi (PI)
- , Suri Moonsamy
- , Usha Singh
- , Kirsten McHarry (PI)
- , Elizma Snyman
- , Pieter Lennox
- , James Craig Innes (PI)
- , Oteng Letlape
- , Olebogeng Jonkane
- , William Brumskine (PI)
- , Tania Adonis
- , Ni Ni Sein
- , Modulakgotla Sebe (PI)
- , Yacoob Vahed (PI)
- , Nazreen Jeewa Hussen (PI)
- , Ismail Mitha
- , Vasundhara Cheekati (PI)
- , Purna Cheekati
- , Christie Lummus
- , Samuel Idarraga (PI)
- , Andrew Kim
- , David N. Pham (PI)
- , Wei-Hsin Kao
- , Michael M. Pfeffer (PI)
- , Miriam Batule Dominguez
- , Anju Malik (PI)
- , Anna Bryan
- , Melanie Arnold
- , Idania Fernandez (PI)
- , Cinzia Karpf
- , Aniuska Ruiz
- , David Taylor (PI)
- , Eric Folkens (PI)
- , Jennifer Manne (PI)
- , Sigal Yawetz
- , Cheryl Keenan
- , Emeka Eziri (PI)
- , Carl Fichtenbaum (PI)
- , Jenifer Baer
- , Sarah Trentman
- , Robert Call (PI)
- , Leroy Vaughan
- , Aaron Milstone (PI)
- , Jamie Alex Slandzicki
- , Jessica Wallan
- , Clinton Guillory (PI)
- , Nancy Andrews
- , Leslie Hughes
- , Teresa H. Evering (PI)
- , Jonathan Berardi
- , Celine Arar
- , Randall Quinn (PI)
- , Jorge P. Amaya (PI)
- , Marissa Gomez-Martinez (PI)
- , Luis Cantu
- , Monica Betancourt-Garcia
- , Nwora Lance Okeke (PI)
- , Charles M. Burns
- , Fadi Haddad (PI)
- , Victoria Haddad
- , Augusto Focil (PI)
- , Griselda Rosas
- , Susana Moyano
- , Yaneicy Gonzalez Rojas (PI)
- , Ahmad Aswad
- , Yevgeniy Bukhman (PI)
- , Manish Jain
- , Eugene Bukhman
- , Humam Farah (PI)
- , Rebekah McClain
- , Eric Daar (PI)
- , Sadia Shaik
- , Timothy Hatlen
- , Deepa Gotur (PI)
- , Joseph Surber (PI)
- , Jeffrey Kingsley
- , April Pixler
- , Alex Zopo (PI)
- , Jack Herman
- , Craig Herman
- , Ramon Leon (PI)
- , Boris Nikolov
- , Fernando Gonzalez Vergara (PI)
- , Ana I. Gonzalez
- , Noemi Gonzalez
- , Michael Gelman (PI)
- , Olga Andriunas
- , Zarema Jagizarov
- , Jan Westerman (PI)
- , David Davis
- , Donna Sherer
- , Kelly Dooley (PI)
- , Becky Becker
- , Adaliah Wilkins
- , Jose Pérez (PI)
- , Eloy Roman
- , Heriberto Fernández
- , Bharat Mocherla (PI)
- , Kelly Beck
- , Valarie Maldonado
- , Jennifer Veltman (PI)
- , Rajesh Gandhi (PI)
- , Katrina Shea
- , Matthew Planchon
- , Laura Bogan Herpel (PI)
- , Kaushlendra K. Tripathi
- , Donald C. Day Sr.
- , John Pullman (PI)
- , Erin Williams-Leber
- , Misty Johnson
- , Michelle Hecker (PI)
- , Ann Avery
- , Keila Hoover (PI)
- , George W. Monlux Jr (PI)
- , Elizabeth Juneja
- , Arthur Wernick
- , Karelia Ruiz (PI)
- , Maureen Hernández
- , Yadilys Pérez
- , Babafemi O. Taiwo (PI)
- , Claudia Hawkins
- , Baiba Berzins
- , Carlos Malvestutto (PI)
- , Heather Harber
- , Robyn Cicarella
- , Edwin DeJesus (PI)
- , Charlotte-Paige Rolle
- , Almena L. Free (PI)
- , Sallie D. Pulliam
- , Debra Weinstein (PI)
- , Rosa M. Suarez (PI)
- , Ezequiel Socorro
- , Estefania Socorro
- , Gene Neytman (PI)
- , Jack Herman
- , Craig Herman
- , Raymond Easley (PI)
- , Mariam Aziz (PI)
- , Joan Swiatek
- , Avish Nagpal (PI)
- , Breanna Kompelien
- , Kathryn McEvoy
- , Susan E. Hoover (PI)
- , Allison Lutz
- , Jessica Just
- , Manuel Hernandez (PI)
- , Yanly B. Victoria
- , Gabriel Rodriguez
- , Upinder Singh (PI)
- , Prasanna Jagannathan
- , Divya Pathak
- , Joshua J. Ordway (PI)
- , Megan Heffner
- , Patrick Weston (PI)
- , Khalilah Weston
- , Madhu Choudhary (PI)
- , Jennifer Sullivano
- , Olayemi Osiyemi (PI)
- , Myriam Izquierdo
- , Odelsey Torna
- , Brian Clemency (PI)
- , Renoj Varughese
- , Joshua Lynch
- , Kara Chew (PI)
- , Aleen Khodabakhshian
- , Samantha Fortier
- , Christopher Coyne (PI)
- , Alexandrea Cronin
- , Constance Benson (PI)
- , Steven Hendrickx
- , Rosemarie Ramirez
- , Anne Luetkemeyer (PI)
- , Suzanne Hendler
- , Dennis Dentoni-Lasofsky
- , Mobeen Rathore (PI)
- , Saniyyah Mahmoudi
- , Amna Riaz
- , Mario Castro (PI)
- , Leslie Spikes
- , Chase Hall
- , David Wohl (PI)
- , Jonathan Oakes
- , Amy James Loftis
- , Pablo Tebas (PI)
- , William Short
- , Michael P. Dube (PI)
- , Saahir Khan
- , Luis M. Mendez
- , Rachel Bender Ignacio (PI)
- , Sarah McGuffin
- , Chris Jonsson
- , Mamta K. Jain (PI)
- , Smruthi Senthil
- , Kimberly Turner-Gray
- , Sanjay Mehta (PI)
- , David Davey Smith
- , Mary Lewinski
- , Masoud Azizad (PI)
- , Christopher Chow
- , Lisa Nakatani
- , Derrick Williamson (PI)
- , Hisham Atriss
- , Matthew Caloura
- , Midhun Malla (PI)
- , Hannah Hazard-Jenkins
- , Aimee Wilkin (PI)
- , Jamraus Fayssoux
- , Hannah Seagle
- , Rachel Presti (PI)
- & Alem Haile

Contributions

KWC, THE, CM, and MDH conceived and designed the present study. CM, JSC, JJE, ESD, DAW, WF, US, MDH, DMS, THE, and KWC were involved with parent study design and implementation. CM, JR, and MDH conducted statistical analyses. MMG, CM, JR, MDH, and KWC interpreted the data. MMG and KWC drafted the manuscript. All authors reviewed, edited, and approved the manuscript.

Corresponding authors

Correspondence to Malini M. Gandhi or Kara W. Chew.

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Competing interests

DMS has consulted for the following companies: Model Medicines and Hyundai Biosciences. The remaining authors have no conflicts of interest relevant to this publication.

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Gandhi, M.M., Moser, C., Currier, J.S. et al. Association of long COVID with health-related quality-of-life outcomes. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36189-8

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Received: 12 August 2025
Accepted: 09 January 2026
Published: 19 March 2026
DOI: https://doi.org/10.1038/s41598-026-36189-8