Background and Objective:
Prolonged and persistent symptoms following acute SARS-CoV-2 infection has been widely reported, but the impact of individual symptoms reported post-COVID-19 on subjective well-being (SWB) is unknown. We described associations between SWB and selected reported symptoms following SARS-CoV-2 infection.

Methods:
We analysed reported symptoms and subjective well-being from 2295 participants (of which 576 reported previous infection) in an ongoing longitudinal cohort study taking place in Israel, in which participants regularly report their health status. We measured SWB using the WHO-5 standardized tool and estimated changes in SWB associated with reported selected symptoms at three follow-up time points (3-6, 6-12, and 12-18 months post-infection) among participants reporting previous SARS-CoV-2 infection, adjusting for key demographic variables, using linear regression.

Results:
Our results suggest that the biggest and most sustained changes in SWB stems from non-specific symptoms (fatigue −7.7 percentage points (pp), confusion/ lack of concentration −10.7 pp, and sleep disorders −11.5pp, p<0.005), whereas the effect of system-specific symptoms, such as musculoskeletal symptoms (weakness in muscles and muscle pain) on SWB, are less profound and more transient. Each symptom was individually associated with a decrease of SWB after adjusting for other symptoms.

Conclusion:
Post-acute COVID19 symptoms can have a profound and lasting effect on well-being, especially among individuals experiencing several symptoms. Taking a similar approach for other symptoms and following individuals over time to describe trends in SWB changes attributable to specific symptoms will help understand the post-acute phase of COVID-19 and how it should be defined and better managed.