Long COVID and its associations with burnout, anxiety, and depression among U. S. healthcare workers in the United States

Abstract

Background: Data on Long COVID and its associations with burnout, anxiety and depression among healthcare workers (HCW) in the United States (U. S.) is limited.

Methods: This study utilized cross-sectional data from the final survey conducted in July 2023, which was part of a longitudinal cohort study assessing COVID-19-related burnout and wellbeing among healthcare workers (HCWs) in a large tertiary academic healthcare system in the Chicago area. The survey included questions on self-reported Long COVID status, as well as the Oldenburg Burnout Inventory (OLBI) to measure burnout and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CAT) to assess anxiety and depression. A total of 1,979 HCWs participated in the survey, yielding a response rate of 56.1%.

Results: The analysis included 1,678 respondents with complete data, of whom 1,171 (70%) self-reported having had COVID-19. Of these, 90 (7.7%) reported Long COVID, with 53% indicating that their most bothersome symptoms persisted for more than 6 months, while 50% reported no longer experiencing those symptoms at the time of the survey. Multivariable linear regression analyses revealed that Long COVID was significantly associated with higher OLBI scores (β = 2.20, p = 0.004), PROMIS anxiety scores (β = 2.64, p = 0.001) and PROMIS depression scores (β = 1.98, p = 0.011) compared to those who had COVID-19 but not Long COVID. Similar patterns of associations were observed when comparing the Long COVID group to those who never had COVID-19. No significant differences were found between those who never had COVID-19 and those who had COVID-19 without developing Long COVID.

Conclusion: Long COVID was associated with higher levels of burnout, depression, and anxiety among healthcare workers compared to those who had COVID-19 alone or were never infected, despite its lower prevalence during the endemic phase. These findings underscore the need for continued prevention efforts and targeted support strategies in healthcare settings.

Keywords: anxiety; burnout; depression; healthcare workers; long COVID; mental health.

Figure 1

Self-reported COVID-19 and long COVID prevalence in analysis sample.

Figure 2

Prevalence of burnout, depression, and anxiety by prior COVID-19 and long COVID status. COVID+/LC+, had COVID-19 with Long COVID; COVID+/LC-, had COVID-19 without Long COVID; COVID+/LC?, had COVID-19 but unsure about Long COVID; COVID-/LC-, never had COVID-19; Burnout was defined as having both OLBI-Exhaustion score ≥ 2.25 and OLBI-Disengagement score ≥ 2.1; Depression and anxiety defined as PROMIS T-scores ≥55. p: p-value for overall group comparisons based on Chi-square tests.