Post-covid-19 condition (i.e. long covid) impacts individual?s health and activities of daily living (ADL), however the true burden remains a point of debate. The aim of this population-based cohort study is to compare health and ADL in SARS-CoV-2 positive adults with and without post-covid-19 condition with negative controls.

All adults that tested positive via PCR for SARS-CoV-2 at the Public Health Service South Limburg (Netherlands) between June 1 2020 and Nov 1 2021 and PCR tested negative controls (matched 2:1 on age, sex, year-quarter of test & district) were invited for this online survey. Health and ADL impairment were assessed using EuroQol visual analogue scale (EQVAS; 0-100 points) and the Work Productivity and Activity Impairment questionnaire, respectively. Positive individuals were classified as (not) having post-covid-19 condition based on the WHO case definition. Multivariable regression models were performed to assess outcomes, adjusting for sex, age, comorbidities, time since test and health prior to test.

8409 individuals (53±15 years, 43% male; 6381 positive & 2028 negative) were included. 39% of positives met the WHO case definition for post-covid-19 condition. They had on average 7.0 points lower EQVAS (95%CI [-8.0,-5.9]; p<.001) and 16.7% higher score on ADL impairment (95%CI [15.0,18.4]; p<.001) than negative controls. Controls were similar to positives without post-covid-19 condition on health and ADL impairment.

Individuals with post-covid-19 condition had a substantially worse health and more ADL impairment than individuals without post-covid-19 condition, confirming the large impact of post-covid-19 condition as an emerging public health problem.