OBJECTIVES : To identify patient-reported outcome measures (PROs) of health-related quality of life (HRQoL) used in studies of disease outbreaks and natural disasters; to examine the impacts of such crises on HRQoL; and to inform the study design of future studies of crises.

METHODS : A literature review was conducted following a pre-specified protocol. PubMed was searched for publications reporting the impacts of disease outbreaks and natural disasters on HRQoL, assessed by PROs, using Medical Subject Headings (MeSH) terms and keywords: disease outbreaks (MeSH) + infectious, natural disasters (MeSH), quality of life, HRQoL, and health status. Studies were included if they provided a method of comparison, such as pre- and post-crisis comparisons (within-subjects), or using an unexposed control group (between-subjects). After two rounds of screening, information was extracted on study characteristics, PRO(s) used, and impacts on HRQoL.

RESULTS : 226 abstracts were retrieved from the PubMed search; 15 met the criteria for inclusion. Five focused on disease outbreaks (SARS, MERS, H1N1, and COVID-19) and 10 on natural disasters (hurricanes, earthquakes, tsunamis, wildfires, and avalanches). Nine studies used an unexposed control group design and 7 studies used a pre- and post-crisis design. Multiple PROs were identified that captured HRQoL, including the EQ-5D and SF-36. Compared to control groups, people exposed to crisis reported lasting HRQoL impairment, particularly in mental health domains. In several of the longitudinal studies reviewed, pre-crisis measures of mental health predicted post-crisis impacts on HRQoL.

CONCLUSIONS : This literature review identified PROs commonly used in crisis research, demonstrated impacts of crises on physical and mental health domains of HRQoL, and supported the value of establishing a pre-crisis baseline measure of mental health. Findings from this review can help guide the design of future studies that aim to evaluate HRQoL assessed by PROs during crises, such as the ongoing COVID-19 pandemic.