Return to Work, Demographic Predictors, and Symptomatic Analysis Among Healthcare Workers Presenting for COVID-19 Testing: A Retrospective Cohort From a United States Academic Occupational Medicine Clinic

Abstract

Introduction We sought to determine time to return to work (RTW) among healthcare workers (HCWs) with mild/moderate coronavirus disease 2019 (COVID-19) and identify predictors of COVID-19 test positivity and illness duration. Methods A retrospective review of HCWs presenting for COVID-19 testing/evaluation in December 2020 was performed to examine demographics, clinical characteristics, and RTW. Results Of 250 exposure incidents, 107 employees (42.80%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No significant differences between COVID-19 positive and negative HCWs were noted in terms of key demographics, including age, gender, and CDC risk scores. Cough (77.57% vs 56.64%, p = 0.001), fatigue (66.36% vs 51.05%, p = 0.015), fever/chills (65.42% vs 37.06%, p < 0.001), myalgia (57.01% vs 35.66%, p = 0.008), and change in smell/taste (38.32% vs 13.29%, p < 0.001) were more prevalent among COVID-19 positive versus negative HCWs. Change in smell/taste (p < 0.001, OR 3.592), cough (p = 0.001, OR 2.966), and fever/chills (p = 0.019, OR 2.107) were independently associated with COVID-19 test positivity. Mean time to RTW from symptom onset was 13.09 days for COVID-19 positive HCWs. Female gender (p = 0.020, + 3.20 days), older age (p = 0.014, + 2.22 days), and myalgia (p = 0.021, + 2.23 days) were predictive of longer illness duration. Conclusion Change in taste/smell, cough, and fever/chills were independently associated with COVID-19 test positivity. Among HCWs with mild/moderate COVID-19 infection, the mean time to RTW was approximately 13 days with female gender, older age, and myalgia being predictive of delayed RTW.

Keywords: covid-19; employees; healthcare workers; occupational health; return to work; sars-cov-2.

Figure 1. Top 10 occupations among employees with symptomatic COVID-19.

COVID-19: coronavirus 2019; RN: registered nurse; PCA: patient care assistant; ER tech: emergency room technician; PTA: physical therapy assistant; RT: respiratory therapist; Res MD: resident physician; attending MD: attending physician

Figure 2. Demographic and clinical predictors of COVID-19 positivity.

COVID-19: coronavirus disease 2019; Occ: occupational