Work ability trajectories and sick leave in individuals with post COVID-19 condition: 3-year follow-up of a population-based cohort, Ballouz+, 2025

[Kalliope]

Summary​

Background​

Data on the longer-term impact of post COVID-19 condition (PCC) on work-related functioning is limited, despite evidence on the persistence of PCC for years after infection. This study aimed to describe changes in work ability and sick leave associated with PCC up to three years post-infection.

Methods​

We used data from 667 working-age individuals within a prospective population-based cohort following individuals infected with SARS-CoV-2 between August 2020 and January 2021. PCC was determined at 12 months and work ability was assessed biannually. The impact of SARS-CoV-2 on participants’ physical and mental work performance and COVID-19 related sick leave were assessed at three years.

Findings​

Participants with protracted COVID-19 related symptoms at 12 months after infection reported persistently lower work ability scores than those without symptoms, with no evidence of a difference in change over time (−0.12 points per year, 95% CI −0.29 to 0.07). Compared to recovered individuals, work ability scores among those with moderate health impairment improved by +0.72 points per year (95% CI −0.04 to 1.46), while trends were similar among those with mild or severe impairment. A higher proportion of participants with PCC reported worsening in physical and mental performance at work than those without PCC. Among those with PCC, 11.5% (9/78) reported taking COVID-19 related sick leave for one month or more, in contrast to 4.0% (13/327) among those without PCC.

Interpretation​

The study highlights the prolonged impact of PCC on work-related functioning and underscores the need for targeted occupational, clinical and social measures for those affected.

https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00328-X/fulltext

 

[Utsikt]

They talk about covid as if it’s a thing of the past, and they only focus on rehab post-infection instead of preventing the infection in the first place.

 

[SNT Gatchaman]

participants with moderate health impairment showed some improvement over timer elative to those fully recovered. A change of 1.5–2 points in work ability scores is considered to be the minimal important difference (MID) in individuals with chronic musculoskeletal or low back pain. While no such MID has been established for PCC, our observed increase of around 1.5 points over two years among participants with moderate health impairment approaches these previously established thresholds, suggesting a modest, but potentially meaningful, improvement in work ability.

The changes observed in our study may be related to coping strategies, reduction in symptom burden, or effective interventions over the follow-up period. On the other hand, the lack of substantial increase in work ability among those with severe impairment in our study indicates a longer-lasting impact on a small subset of the workforce. This may be due to a higher symptom burden or structural barriers that hinder full recovery, such as limited return-to-work support or workplace accommodations.

Or an absence of those effective interventions you thought existed.

As recovery appears to take place over years rather than weeks, future research should prioritise long term follow-up and establishing a PCC-specific MID to better evaluate occupational outcomes over time.

At a societal level, reduced work ability, and consequently lower labor market participation, may impose considerable direct and indirect costs including increased health utilization, productivity losses, and greater demands on social insurance systems. In many settings, PCC is not formally recognized as a work limiting condition, partly because the non-specific and fluctuating nature of its symptoms and lack of biomarkers make it difficult to assess within existing disability frameworks.

While some improvements were observed among those with moderate health impairment, persistently low work ability among those with severe health impairment point to a subgroup of people who are at a risk of experiencing longer-term occupational limitations. Recognizing the long-term impact of PCC on individuals’ work capacity and ensuring early access to appropriate rehabilitation services, workplace support measures, as well as adequate financial benefits when necessary, will be essential to mitigate long-term socioeconomic consequences and promote the full recovery and well-being of affected individuals.

Also research… research might just possibly help a bit more than rehabilitation. Adequate financial benefits would indeed by nice in the meantime.

 

[Trish]

And they keep on blindly repeating the mantra about access to rehab services, when there is no evidence rehab helps anybody with LC, especially those with PEM who may be harmed.