Determinants of Quality of Life among Post-COVID-19 Survivors in the Northeast of Thailand: A Cross-Sectional Analytical Study

Abstract

Background: The long-term impacts of Coronavirus Disease 2019 (COVID-19) may adversely affect survivors’ quality of life (QoL), particularly in low-resource settings. The objective was to identify factors associated with quality of life among COVID-19 survivors in the Northeast of Thailand. Methods: A cross-sectional study was conducted among 1,250 COVID-19 survivors selected using multistage sampling. Data were collected using structured questionnaires assessing sociodemographic characteristics, physical activity, COVID-19 prevention behavior, health literacy, COVID-19 knowledge, stress, healthcare and social support, and QoL measured by the WHOQOL-BREF-THAI. Generalized Linear Mixed Models (GLMM) with province-level random effects were used to identify factors associated with good QoL. Results: Overall, 34.56% of participants reported good QoL. Male gender (AOR = 1.64, 95% CI: 1.18-2.29), age <35 years (AOR = 1.71, 95% CI: 1.01-2.89), bachelor’s degree education (AOR = 1.92, 95% CI: 1.08-3.43), government employment (AOR = 2.11, 95% CI: 1.18-3.79), higher income, absence of comorbidities (AOR = 1.72, 95% CI: 1.28-2.31), good physical activity (AOR = 3.42, 95% CI: 1.71-6.84), excellent health literacy (AOR = 4.38, 95% CI: 2.89-6.65), high COVID-19 knowledge (AOR = 1.78, 95% CI: 1.16-2.74), mild-to-moderate stress, and high healthcare and social support (AOR = 1.96, 95% CI: 1.19-3.23) were significantly associated with good QoL. Conclusion: QoL among COVID-19 survivors is shaped by behavioral, cognitive, and psychosocial determinants. Public health interventions should prioritize health literacy enhancement, stress reduction, and strengthening community support systems.