This cross-sectional study appraised the HRQOL of adult COVID-19 patients in the local context of Bangladesh. Following the case definition of COVID-19 mentioned in the national guideline of Bangladesh, the study enrolled COVID-19 patients confirmed by the RT-PCR test . The current study was the pioneering invention to assess the health-related quality of COVID-19 patients using CDC-HRQOL on national and international platforms. The HRQOL comprised general health condition, physical illness, mental illness, and usual activity limitation following the experiences of the COVID-19 patients in the one-month clinical course of the disease since diagnosis. The study findings preserve potential policy implications to contrive expedient guidelines for effective clinical management of the patients to refurbish their quality of life and health condition. The study also conserves enormous academic and research implications to track the clinical course of the COVID-19 and its impacts on the physical and mental health of the patients. Accordingly, the study could contribute to the reform and redesign of the healthcare delivery system for the COVID-19 patients.
In the present study, around three-fourth of the COVID-19 patients were males, and the rest were females. This finding indicates that males were at a higher risk of being infected by COVID-19 than females. In this regard, other studies conducted in China  and Vietnam  revealed reverse findings where females were affected more than males. It may be due to the divergence of the socio-cultural context of Bangladesh, which is different from those countries. In the existing social and cultural frame of the country, males are more involved in outdoor activities than females. So, the chance of exposure and being affected are higher in males than the females. Around half of the COVID-19 patients were young adults (age group 30–49 years) and only 11.0% of the patients were elderly (age group 60–90 years). The demographic profile of Bangladesh depicts that 40.07% of the population belongs to the age group of 25–54 years and only 6.42% belongs to the age group > 60 years . In this regard, it could be claimed that the age distribution of the patients is in alignment with the national age distribution.
An almost equal number of the COVID-19 patients reported from the urban (50.2%) and rural (49.8%) communities. Another study conducted by Islam MZ et al in Bangladesh  revealed different findings where patients were reported more from the urban communities. Though these two studies were conducted in the same country, a different result may be due to differences in the study periods. The former study was conducted earlier in comparison to the current one. At the beginning of the COVID-19 pandemic, the diagnostic facility was limited in the urban setting of Bangladesh. Moreover, rural people of the country were less aware of the COVID-19 diagnosis and personal protection. As a result, the former study found more patients reported from the urban setting than our study.
In respect of occupation, nearly half of the patients were service holders. In this respect, the study conducted by Islam MZ et al  also found the majority of the patients as service holders but it was relatively lower (32.5%) than the current study. It could be justified by the reality that a remarkable segment of the people of Bangladesh are involved in diverse private and public jobs for their survival, and they have to move outside to attend their job stations. As a result, the service holders are more vulnerable to the get infected by COVID-19 than other occupational groups. It could also be mentioned that during the early period of the pandemic, people were restricted to social movement due to lockdown, shut down, quarantine, and the panic situation caused by the disease. It could be a valid reason for comparatively fewer service holders in the former study than the current study.
Among all the patients under the current study, more than four-fifth (86.0%) had various types of symptoms of COVID-19. This finding indicates that the majority of the patients were symptomatic and attended health facilities for diagnosis of the disease. It was also revealed that a sensible part (14.0%) of the patients were asymptomatic but attended the health facilities for diagnosis of the disease due to their exposure history, treatment of comorbidity, travel history, and other indications related to COVID-19 infection. The present study also portrayed that more than one-third (35.5%) of the COVID-19 patients had different comorbidities including hypertension, diabetes mellitus, ischaemic heart disease, chronic lung, kidney, and liver diseases. The former study conducted by Islam MZ et al  also identified nearly the same proportion (33.9%) of the COVID-19 patients having comorbidities including hypertension, coronary heart disease, diabetes mellitus, cancers, chronic lung, kidney, and lier diseases. The comorbid patients were at higher risk of worse morbidity and mortality consequences of COVID-19, and they were referred to health facilities to exclude COVID-19.
We retrieved the data of the COVID-19 patients who had completed their one-month duration of illness using their laboratory records. At the end of one month, the general health condition was excellent/very good/good in 70.1% patients while it was fair/poor in the rest 29.8% patients. Fair/poor health condition was significantly associated with having a symptom (OR = 33.22, CI = 8.17–135.1) and having any comorbidity (OR = 1.573, CI = 1.18–2.10). It could be explained by the fact that the symptoms aggravate the morbidity severity and illness feelings of the patients, and thus interfere with their general health condition.
The current study estimated the average duration of physical illness around ten days, and this duration increased proportionately with the increase in age of the patients. On the other hand, the average duration of mental illness was around eight days, and this duration was significantly higher among females and ever-married patients. Arguably it could be mentioned that the females and elderly ever married patients conserve relatively less body immunity to protect the illness progression and its clinical severity. As a result, their duration of suffering lasts longer than their counterpart males and younger adults. The mean duration of the usual activity limitation was around seven days, and it was significantly higher in the age group 50–59 years. The presence of comorbidity poses an incremental effect on the disease progression and worsens their health condition. In the present study, patients` need for help for routine needs was also significantly higher in the patients having a symptom (OR = 2.730, CI = 1.82–4.09) and comorbidity (OR = 1.536, CI = 1.18-2.0). The duration of limited health-related activity was also significantly higher in the age group 50–59 years and the patients having symptoms and comorbidity. All items of the healthy days’ core module (duration of physical and mental illness, usual activity limitation) were significantly higher among patients` having a symptom and comorbidity. Several clinical manifestations of symptoms along with comorbidity deteriorate both the physical and mental health condition of the patients, which decrease their ability to performing daily usual activities.
The mean duration (in days) of feeling pain was significantly higher in the patients having symptoms and comorbidity. The mean duration of feeling sad, blue, or depressed was significantly higher in the ever married patients, and patients having symptoms and comorbidity. On the contrary, the mean duration of feeling worried was significantly higher in female patients and the patients having symptoms. The mean duration of feeling worried was significantly higher in the ever married patients while the mean duration of not getting enough rest was significantly higher in females and the patients having symptom and comorbidity. The mean duration of feeling very healthy was significantly lower in the age group 50–59 years, and the patients having symptoms and comorbidity. The findings of the present study revealed that the mean duration of symptoms was significantly higher in the females, ever married, and the patients having symptoms and comorbidity. All these findings entice special attention of the health policymakers and healthcare managers to invent prioritized medical measures for the COVID-19 patients to improve their HRQOL and general health condition.