Occurrence Of Long COVID In Healthcare Workers At A University Hospital And Challenges In Insurance And Compensation Evaluation

Abstract

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), developed in 2019, led to the outbreak of the COVID-19 pandemic state, which have significantly impacted on healthcare systems worldwide. During the pandemic state, in addition to all the problems related to high mortality and morbidity during the active phase of the disease, it had to deal with a condition known as "Long-COVID". Long-COVID includes both persistent symptomatic forms, where signs and symptoms last between 4 and 12 weeks, and post-COVID syndrome, where symptoms persist beyond 12 weeks. The evaluation system categorizes COVID-19 outcomes into four classes based on the degree of biological validity impairment: mild, moderate, moderate-severe, and severe. In the insurance field, this new "entity" led to difficulties related to damages compensation for infections developed in workplace, which has not completely been clarified nor today.

Methods: The study was conducted on a sample of 3,127 health-care workers employed at the "G. Martino" University Hospital, in Messina. The percentage of individuals who contracted COVID-19 was analysed, evaluating how many were infected at workplace. Among those who contracted the virus at work, we further examined how many healthcare professionals were eligible for compensation under insurance frameworks related to Long- COVID.

Results: The data analysis reveals that, out of the entire sample examined, 10 healthcare workers developed Long-COVID syndrome, with a severity classified as moderate (Biological Damage according to social insurance of healthcare workers: 1-15%). The lingering ef-fects included persistent asthenia, anosmia, stress-induced dyspnoea, outcomes of instrumentally documented pneumonia and myocarditis, as well as neuromuscular disorders. The collected data confirms that healthcare professionals had the highest percentage of COVID-19 infections (Fig. 1), with an infection rate of 23%, more than half of which occurred in the workplace.

Discussion and conclusions: The definition of long-COVID is still quite complicated, as the ever-increasing number of symptoms that are attributable to this pathology, and the variability in the times of its onset, make its nosographic framework extremely difficult. In addition to the clinical-scientific difficulties arising from this condition, the impossibility of adequately classifying the pathology is associated with an equally complex management of the costs that the State must bear to restore the damage, as it usually happens in case of sequelae of infections contracted at workplace.

Keywords: Healthcare Workers; Legal Medicine; Long Covid; Occupational Medicine.