Larsson, Alexandra C2025-04-092025-04-092025-04-09978-91-8115-011-7 (PDF)978-91-8115-010-0 (Print)https://hdl.handle.net/2077/85330ABSTRACT Background: In 2020, the novel SARS-CoV-2 virus triggered the COVID-19 pandemic, overwhelming healthcare systems worldwide and causing significant suffering. At the time, the long-term consequences of COVID-19 on affected individuals were unknown. Aim: This thesis aims to describe functioning during the first year after hospitalization for COVID-19 from a biopsychosocial perspective, using both qualitative and quantitative methods. Methods: Three quantitative studies and one qualitative study were conducted with a cohort of 211 participants who were assessed at hospital discharge, three months, and one-year after hospitalization using patient-reported outcome measures and clinical assessments. Additionally, 11 out of the 211 participants were interviewed, and their experiences were analyzed using thematic analysis. Results: In Study I, participants exhibited impairments in body functions and limitations in daily activities at hospital discharge, with older individuals and those who had received intensive care treatment being more affected. In Study II, three months after discharge, participants reported persistent challenges in body functions, activities, and participation. However, no major differences in functioning were observed based on age, sex, or prior hospital care level. One year after discharge, Study IV found that participants continued to experience functional impairments due to COVID-19, although some assessments, such as muscle strength, showed improvement. Older age, female sex, and early fatigue at three months were associated with lower functioning at one year. In Study III, four themes were developed from interviews describing daily life experiences in the year following hospitalization. Patients described using familiar strategies but in new ways when managing COVID-19, as well as highlighting the support from employers and colleagues in the return-to-work process. Participants struggled with lacking energy and persistent fatigue, which impacted various aspects of life, and encountered difficulties accessing healthcare and rehabilitation. Conclusion: After hospitalization for COVID-19, many individuals were discharged with impairments requiring rehabilitation and follow-up care, particularly older adults and those individuals who had been treated in intensive care. Recovery was complex and varied, with the heterogeneous findings of Study II suggesting that rehabilitation should be individualized. Study IV highlights the need for in-depth assessments to identify functional impairments and rehabilitation needs. Considering factors such as age, sex, and fatigue may facilitate long-term rehabilitation planning. Study III revealed that some support could be found from colleagues and employers when returning to work along with one’s own strategies for managing COVID-19 symptoms. Still persistent fatigue and challenges in accessing healthcare and rehabilitation shaped life after COVID-19. This emphasizes the need for ongoing healthcare and rehabilitation support throughout the first year of recovery after hospitalization due to COVID-19.engtext