Health-related adverse work outcomes associated with post COVID-19 condition: a cross-sectional study

Introduction: Symptoms from post COVID-19 condition (PCC) can impair functioning in working-age adults. However, there is uncertainty about the relationship between PCC and work outcomes. This study aimed to assess health-related adverse work outcomes in individuals with a PCC history compared with others who had COVID-19. Methods: This was a cross-sectional study in which participants in British Columbia (BC) completed an online questionnaire. Participants comprised adults who tested positive for SARS-CoV-2 by PCR at least 2 years before questionnaire completion and were working age (18-64) at the time of infection. PCC status was determined by self-report. The health-related adverse work outcomes evaluated included change in occupation or employer, reduced workload, increased sick days compared with before COVID-19, early retirement and indefinite sick leave. Analyses were weighted to reflect the characteristics of individuals who had COVID-19 in BC. Propensity score overlap weighting was used to adjust for relevant sociodemographic and clinical covariates. Results: Among 1106 participants, 966 (87.3%) were employed when they contracted SARS-CoV-2 and included in analyses. Of these participants, 47.8% were female, the median age was 37 and 46.9% had a PCC history. Compared with other individuals who had COVID-19, those with a PCC history were more likely to have had a health-related adverse work outcome (46.5% vs 24.9%; adjusted OR (aOR) 2.6 (95% CI 1.7 to 4.0)) and reported a greater number of sick days in the first 2 years since contracting SARS-CoV-2 (adjusted mean difference 43 days (95% CI 20 to 65)). The risk of a health-related adverse work outcome was especially high in those with post-COVID-19 fatigue (aOR 4.6 (95% CI 2.7 to 7.9)), fever (aOR 4.0 (95% CI 1.7 to 9.6)), weakness (aOR 3.8 (95% CI 2.2 to 6.3)), palpitations (aOR 3.3 (95% CI 2.0 to 5.0)) and brain fog (aOR 3.2 (95% CI 2.0 to 5.0)). Conclusions: PCC is associated with health-related adverse work outcomes. This is an important consideration for clinicians, employers and health system leaders.