{
  "abstract": "Introduction Immunocompromised individuals have suboptimal COVID-19 vaccine responses and may continue physically distancing to avoid COVID-19. The EAGLE Study aimed to quantify physical distancing behaviours and associations with health-related quality of life (HRQoL) and related measures in immunocompromised adults.Methods EAGLE was a cross-sectional, observational online survey study of US and UK immunocompromised adults, children and those children’s caregivers, with adult analyses reported here. Multichannel enrolment and self-reported data collection occurred from December 2022 to June 2023. Immunocompromising diagnosis confirmation using medical records was requested from a randomly selected subset. Physical distancing (in past 4 weeks) was measured using the Physical Distancing Scale for COVID-19 Avoidance (PDS-C19). HRQoL and related measures were the 12-item Short Form Health Survey version 2 (SF-12v2) (includes Short-Form 6-Dimensions), Quality of Life Disease Impact Scale-7-item (QDIS-7), Direct Measure of Loneliness, EQ-5D-5L, Hospital Anxiety and Depression Scale and Work Productivity and Activity Impairment plus Classroom Impairment Questions: Specific Health Problem (WPAI+CIQ:SHP). Associations between PDS-C19 and HRQoL and related measures were assessed using Pearson correlation, linear regression (potential confounders-adjusted) and preliminary structural equation modelling (SEM).Results 2320 immunocompromised adults fully completed the survey. Confirmation of diagnosis was requested from 27% and confirmed for 90% of responders. 68% of participants reported moderate to high physical distancing. Physical distancing had low correlations with SF-12v2-measured HRQoL domains (range |r|=0.18 to 0.39) and medium correlations with QDIS-7 (r=0.78) and WPAI+CIQ:SHP-measured activity impairment (r=0.68) and presenteeism (r=0.51). In SEM, direct PDS-C19 relationships explained most activity correlations: QDIS, β=0.46 (SE=0.02); activity impairment, β=0.40 (0.02); presenteeism, β=0.29 (0.04). Unstandardised PDS-C19 confounder-adjusted linear regression coefficients were similar to those of SEM.Conclusions Over 3 years after COVID-19 emergence, a disproportionate number of immunocompromised adults reported substantially physically distancing to avoid COVID-19. Higher physical distancing intensities were associated with greater HRQoL impairments, suggesting such challenges coexist as ongoing concerns for immunocompromised adults.",
  "authors": [
    {
      "affiliations": [
        "IQVIA, Courbevoie, France",
        "Global Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden"
      ],
      "name": "Paul Williams"
    },
    {
      "affiliations": [
        "Medical Evidence, Epidemiology, Vaccine & Immune Therapies, BioPharmaceuticals Medical, AstraZeneca US, Wilmington, Delaware, USA"
      ],
      "name": "Timothy A Herring"
    },
    {
      "affiliations": [
        "Epidemiology & Pharmacovigilance, P95, Leuven, Belgium"
      ],
      "name": "Renata T C Yokota"
    },
    {
      "affiliations": [
        "BPM Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK"
      ],
      "name": "Sudhir Venkatesan"
    },
    {
      "affiliations": [
        "Health Economic & Payer Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden"
      ],
      "name": "Sofie Arnetorp"
    },
    {
      "affiliations": [
        "Severens HTA Consultancy, Venray, Netherlands"
      ],
      "name": "Johan L Severens"
    },
    {
      "affiliations": [
        "SCHARR, University of Sheffield, Sheffield, UK",
        "Philip A Powell Consulting, Sheffield, UK"
      ],
      "name": "Philip A Powell"
    },
    {
      "affiliations": [
        "IQVIA, Washington, District of Columbia, USA"
      ],
      "name": "James C Marcus"
    },
    {
      "affiliations": [
        "IQVIA, Reading, UK"
      ],
      "name": "Stephanie Philpott"
    },
    {
      "affiliations": [
        "IQVIA, Madrid, Spain"
      ],
      "name": "Sara Bestea"
    },
    {
      "affiliations": [
        "IQVIA, New York, New York, USA"
      ],
      "name": "Jeffrey M Rohay"
    },
    {
      "affiliations": [
        "IQVIA, Porto Salvo, Portugal"
      ],
      "name": "Tiago Maia"
    },
    {
      "affiliations": [
        "Medical Evidence, Vaccine & Immune Therapies, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK"
      ],
      "name": "Sylvia Taylor"
    },
    {
      "affiliations": [
        "IQVIA, Amsterdam, Netherlands"
      ],
      "name": "Marieke Krol"
    },
    {
      "affiliations": [
        "John Ware Research Group, Watertown, Massachusetts, USA"
      ],
      "name": "John E Ware, Jr"
    }
  ],
  "title": "Assessing the association of physical distancing to avoid COVID-19 with health-related quality of life in immunocompromised adults: results from the cross-sectional observational EAGLE study",
  "uid": "0dda5d5c-de37-5611-9eee-0a9ad7cb1459"
}