Burden of post-acute COVID-19 sequelae in healthcare workers and its course over a 30-month period-results from a prospective multicentre cohort

Abstract

Purpose: As healthcare workers (HCW) have been disproportionally affected by COVID-19, its post-acute sequelae (PASC) in HCW can impact healthcare systems. We assessed the burden and course of PASC in HCW over a 30-month period.

Methods: In a prospective multicentre HCW cohort in Switzerland, PASC surveys were conducted in 03/2021, 09/2021, 06/2022, 04/2023, and 10/2023. Stratified by viral variant at first infection, the prevalence of PASC symptoms, self-experienced PASC and the Post-COVID Functional Status (PCFS) were analysed cross-sectionally in 10/2023, self-perceived success of therapeutic measures used was assessed. The evolution of PASC symptoms and PCFS in Wild-type and non-Wild-type infected HCW compared to uninfected controls was analysed longitudinally across all surveys.

Results: In cross-sectional analysis, 1704 HCW (median age 47 years, 82.2% female) were included. Thereof, 30.7% reported ≥ 1 PASC symptom in 10/2023, with 115 (6.7%) stating to have or have had PASC. Both were most common after Wild-type infection compared to other variants. Overall, 17/115 (15%) indicated relevant/severe restrictions in their daily activities and of 85 (74%) that tried ≥ 1 measure against their symptoms, 69 (81%) reported having benefitted. Longitudinal analysis (n = 653) showed a significantly higher proportion of Wild-type infected HCW to report PASC symptoms compared to controls in 03/2021 (+ 21%, 95% CI 4-39), with decreasing trend (+ 7%, 95%CI -10-25 in 10/2023). This effect was not evident for non-Wild-type infected HCW.

Conclusions: Over a 30 month period, overall PASC burden in our HCW cohort decreased, although 1% still experience relevant restrictions in their daily life; Wild-type infected individuals show the highest disease burden.

Keywords: Disease burden; Healthcare workers; Long COVID; Post-acute sequelae of COVID-19; SARS-CoV-2.

Fig. 1

Overview study timeline and elements included in the analyses. ^adata on demographics, health and social determinants. ^bpresence of PASC symptoms, Fatigue Severity Scale, SARS-CoV-2 vaccination and infection history

Fig. 2

A Prevalence of PASC symptoms in healthcare workers in October 2023 and B self-reported PASC experience (current or resolved PASC) by dominating viral variant at first infection. Percentage difference in relation to the uninfected control group and 95% CI were derived from standard two-sample proportion tests and t-tests

Fig. 3

Longitudinal analysis showing A proportion of healthcare workers with any PASC symptoms, and B mean fatigue severity score by viral variant across the five questionnaires. Unadjusted ratios between Wild-type infected and uninfected participants with 95% CI were were derived from standard two-sample proportion tests and t-tests. Other viral variants: Non-Wild-type viral variants were pooled and are shown without statistics for the sake of clarity

Fig. 4

Evolution of Post Covid Functional Scale (PCFS) from September 2021 to October 2023 A in the longitudinal cohort (n = 653), B in Wild-type infected participants of the longitudinal cohort, and C in participants first infected by other viral variants. Participants were asked whether they currently suffer from PASC, and if so, how much their daily life was affected (PCFS)