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. 2024 Jul 29;19(7):e0300947.
doi: 10.1371/journal.pone.0300947. eCollection 2024.

The association between prolonged SARS-CoV-2 symptoms and work outcomes

Arjun K Venkatesh  1   2 , Huihui Yu  2 , Caitlin Malicki  1 , Michael Gottlieb  3 , Joann G Elmore  4 , Mandy J Hill  5 , Ahamed H Idris  6 , Juan Carlos C Montoy  7 , Kelli N O'Laughlin  8 , Kristin L Rising  9   10 , Kari A Stephens  11   12 , Erica S Spatz  13   14 , Robert A Weinstein  15   16 ; INSPIRE Group
Affiliations

The association between prolonged SARS-CoV-2 symptoms and work outcomes

Arjun K Venkatesh et al. PLoS One. .

Abstract

While the early effects of the COVID-19 pandemic on the United States labor market are well-established, less is known about the long-term impact of SARS-CoV-2 infection and Long COVID on employment. To address this gap, we analyzed self-reported data from a prospective, national cohort study to estimate the effects of SARS-CoV-2 symptoms at three months post-infection on missed workdays and return to work. The analysis included 2,939 adults in the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) study who tested positive for their initial SARS-CoV-2 infection at the time of enrollment, were employed before the pandemic, and completed a baseline and three-month electronic survey. At three months post-infection, 40.8% of participants reported at least one SARS-CoV-2 symptom and 9.6% of participants reported five or more SARS-CoV-2 symptoms. When asked about missed work due to their SARS-CoV-2 infection at three months, 7.2% of participants reported missing ≥10 workdays and 13.9% of participants reported not returning to work since their infection. At three months, participants with ≥5 symptoms had a higher adjusted odds ratio of missing ≥10 workdays (2.96, 95% CI 1.81-4.83) and not returning to work (2.44, 95% CI 1.58-3.76) compared to those with no symptoms. Prolonged SARS-CoV-2 symptoms were common, affecting 4-in-10 participants at three-months post-infection, and were associated with increased odds of work loss, most pronounced among adults with ≥5 symptoms at three months. Despite the end of the federal Public Health Emergency for COVID-19 and efforts to "return to normal", policymakers must consider the clinical and economic implications of the COVID-19 pandemic on people's employment status and work absenteeism, particularly as data characterizing the numerous health and well-being impacts of Long COVID continue to emerge. Improved understanding of risk factors for lost work time may guide efforts to support people in returning to work.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: AHI receives research grant funding from the University of Texas Southwestern Medical Center outside of the submitted work. AKV receives grants from the Agency for Healthcare Research and Quality and the SAEM Foundation outside the submitted work. ESS receives grant funding from the National Heart, Lung, and Blood Institute (R01HL151240), and the Patient Centered Outcomes Research Institute (HM-2022C2-28354). JCCM receives research grant funding from SAMHSA (1H79TI084428-01 and 1H79TI085981-01, PI LeSaint), FDA (75F40122C00116, PI Anderson), NIH-NINDS (U24NS129501, PI Rodriguez) outside the submitted work. JE is Editor-in-chief of the Adult Primary Care topics at UpToDate. KLR receives research grant funding from Abbott Diagnostics, DermTech, MeMed, Prenosis, Siemens Healthcare Diagnostics, PROCOVAXED funded by NIAID 1R01AI166967, and PREVENT funded by CDC U01CK00048 outside the submitted work. KNO receives research grant funding for PROCOVAXED funded by NIAID R01 AI166967, PI: Rodriguez outside the submitted work. MG receives grant funding from the Biomedical Advanced Research and Development Authority Research Grant, the Bill and Melinda Gates Foundation, and the Society of Directors of Research in Medical Education Grant outside the submitted work. MJH receives research grant funding from an Investigator Award from Merck, MISP 100099, PI: Hill outside the submitted work. The following authors have declared that no competing interests exist: HY, KAS, RAW. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. INSPIRE participant flow diagram.
*No portal connection: Did not share medical records through electronic health portal, which was an eligibility requirement through 3/21/22. ^Invalid test results: Did not provide proof of SARS-CoV-2 test and/or had a positive SARS-CoV-2 test >42 days ago.
Fig 2
Fig 2. Comparison of work outcomes stratified by the number of symptoms at 3-months post- SARS-CoV-2 infection.
CI, confidence interval. Figure excludes the following participants: Missing responses for symptoms at 3-month follow-up (n = 11); Missing or not applicable responses for “10+ workdays missed” (n = 185) and “Did not return to work” (n = 154). Logistic regression models adjusted for age, gender, race, ethnicity, income, marital status, education, clinical comorbidity count, and SARS-CoV-2 variant time period.
Fig 3
Fig 3. Prevalence of individual symptoms at 3-months post-SARS-CoV-2 infection by missed workdays and return to work status.
Fig 4
Fig 4. Distribution of number of symptoms at 3-months post-SARS-CoV-2 infection by missed workdays and return to work status.
See this image and copyright information in PMC

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