ABSTRACT
The lingering effects of COVID-19 may impair survivors' long-term health-related quality of life (HRQoL). However, multicentre studies focusing on the Omicron variant, particularly in middle- and low-income settings, are scarce. We conducted a prospective cohort study across 24 Brazilian hospitals between December 2021 and March 2024, when Omicron was the predominant variant. Adult COVID-19 survivors were followed for 12 months via telephone interviews. The primary outcome was HRQoL at 12 months, assessed using the EuroQol five-dimension three-level questionnaire (EQ-5D-3L; range −0.17 to 1.0). All-cause mortality was a secondary outcome. Among 649 participants (47.9% women; median age 71 years), the median EQ-5D-3L utility score at 12 months was 0.69 (IQR 0.41–0.80), and survival was 86.6%. Factors associated with lower HRQoL included female sex, age ≥ 60 years, Charlson comorbidity index ≥ 1, and need for respiratory support. Mortality was associated with age ≥ 60 years (HR 2.81), CCI ≥ 2 (HR 2.17), need for low-flow oxygen therapy (HR 2.03), and BMI ≥ 25 kg/m² (HR 0.58). One year after hospitalization, Omicron survivors in Brazil showed impaired HRQoL and high mortality. Older age, comorbidities, and need for oxygen therapy were linked to worse outcomes. Long-term support strategies are needed for these vulnerable populations.