title: Long-term Follow-up of Patients With Lyme Disease: Longitudinal Analysis of Clinical and Quality-of-life Measures.
abstract: Lyme disease is the most common vector-borne disease in the United States. Some patients report persistent or intermittent subjective symptoms of mild to moderate intensity after antibiotic treatment for Lyme disease. We sought to evaluate trends in clinical and quality-of-life (QOL) measures in a cohort of patients with Lyme disease enrolled in a natural history study at the National Institutes of Health from 2001-2014.
  
  
  
  QOL was measured using the self-administered 36-item Short Form Health Survey (SF-36) during study follow-up. Primary outcomes included mean physical (PCS) and mental (MCS) health QOL composite scores and reporting long-term (≥2 years) symptoms, adjusted for Lyme disease stage and severity at diagnosis.
  
  
  
  Overall, 101 patients with an average follow-up time of 3.9 years (range, 0.5-11.3 years) were included. At first visit, overall mean QOL scores were below the US population mean for both PCS (45.6 ± 10.4) and MCS (47.3 ± 11.5) but increased to just above the national average after 3 years of follow-up for both PCS (50.7 ± 9.6) and MCS (50.1 ± 10.0). Baseline QOL scores were lowest in those with late disease (P < 0.01) but also increased by the end of follow-up to national averages. In multivariate analysis, the only factors significantly associated with long-term symptoms or lower QOL scores were other comorbidities unrelated to Lyme disease.
  
  
  
  Comorbid conditions can play a role in the reporting of long-term symptoms and overall QOL of Lyme disease patients and should be considered in the evaluation of these patients.
  
  
  
  NCT00028080.
authors.affiliation: Epidemiology Unit.|Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.
authors.forename: Aprielle B
authors.initials: AB
authors.lastname: Wills
authors.affiliation: Epidemiology Unit.|Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.
authors.forename: Alicen B
authors.initials: AB
authors.lastname: Spaulding
authors.affiliation: Epidemiology Unit.|Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.|US Public Health Service, Commissioned Corps, Rockville.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Adjemian
authors.affiliation: Epidemiology Unit.|Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.
authors.forename: D Rebecca
authors.initials: DR
authors.lastname: Prevots
authors.affiliation: Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.
authors.forename: Siu-Ping
authors.initials: SP
authors.lastname: Turk
authors.affiliation: Clinical Monitoring Research Program, Leidos Biomedical Research Inc., National Cancer Institute, Frederick, Maryland.
authors.forename: Carla
authors.initials: C
authors.lastname: Williams
authors.affiliation: Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda.
authors.forename: Adriana
authors.initials: A
authors.lastname: Marques
mesh_terms: D000328:Adult; D025065:Borrelia burgdorferi; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008193:Lyme Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
keywords: Borrelia burgdorferi; Lyme disease; epidemiology; longitudinal analysis; quality of life