Post-Covid-19 symptoms, subjective work ability and sick leave 2 years after acute infection…, 2025, Braig+

[SNT Gatchaman]

Post-Covid-19 symptoms, subjective work ability and sick leave 2 years after acute infection—results from a population-based long COVID study

Spoiler: Authors

Braig, Stefanie; Peter, Raphael S; Nieters, Alexandra; Kräusslich, Hans-Georg; Brockmann, Stefan O; Göpel, Siri; Merle, Uta; Steinacker, Jürgen M; Kern, Winfried V; Rothenbacher, Dietrich

BACKGROUND
The post-COVID syndrome (PCS) is associated with reduced work ability, increased sick leave and delayed return to work. Yet, the relationship is complex due to a heterogeneous set of PCS symptoms and the multifaceted nature of work ability.

METHODS
Based on a population-based longitudinal study (n = 5422, 18–65 years) conducted in the Southwest of Germany, we describe the evolution of work ability (mWAI1), task-related work ability (mWAI2), and sick leave 6–12 and 24 months after a SARS-CoV-2 index infection and confirmed by Polymerase Chain Reaction. Descriptive analyses on mWAI1 and mWAI2 and adjusted linear regression analyses were performed.

RESULTS
1.1% of our population was continuously on sick leave since the initial SARS-CoV-2 infection (about 24 months after the infection). Pre-infection mWAI1 was not regained due to persisting or newly occurring symptoms of fatigue, neurocognitive impairment and anxiety/depression/sleep disorders that were related also to lower mWAI2. Effect modifiers of the associations between risk factors and mWAI1 or mWAI2 were age, working tasks, and comorbid mental conditions. Further SARS-CoV-2 infections were associated with poorer mWAI2 in physically (regression coefficient, 95% confidence intervals: -3.45 (-6.15,-0.74) but not mentally working participants (0.20 (-0.54,0.95)) and age proved to be a stronger risk factor for mWAI2 in physically working subjects.

CONCLUSIONS
We confirmed known risk factors but further emphasized effect modifiers like working task or comorbid mental disorders for work ability and described variables related to sick leave after SARS-CoV-2 infection.

Web | DOI | PDF | BMC Public Health | Open Access

 

[SNT Gatchaman]

In our population-based cohort of 5244 predominantly mentally working participants, assessed at about 6-12 months after a SARS-CoV-2 infection, a significant decrease in work ability was observed compared to pre-infection of which a large proportion remained even after 24 months. Post-COVID related symptoms such as fatigue, neurocognitive impairment and, to a lesser extent, anxiety/depression/sleep disorders were important risk factors for a lower overall and task-related work ability.

In our population-based cohort study, 1.1% of participants had been continuously on sick leave since the initial infection, while 3.7% experienced recurrent sick leave at 24 months. According to data from a German health insurance company, approximately 0.4% of employees were wholly or partially withdrawn from the labour market due to PCS. Similarly, over a 30-month period, PCS burden decreased, but 1% still experienced significant restrictions in their daily lives. In our study, a proportion of 4.0% were not employed at follow-up, highlighting the potential economic burden of PCS. Variation in labour market withdrawal across studies likely reflects differences in populations and work environments.

The central role of fatigue in PCS symptoms is well described. Moreover, it was highlighted that, despite rehabilitation, PCS symptoms such as fatigue, neurocognitive impairments, and muscle/joint pain persisted, whereas dyspnea and chest pain showed significant improvement. Our findings confirmed the detrimental impact of fatigue and neurocognitive impairment, with the latter being the most harmful.