Long COVID among healthcare workers: a narrative review of definitions, prevalence, symptoms, risk factors and impacts, Dempsey et al, 2024

Abstract

Introduction
Long COVID (LC) occurs when people experience symptoms for weeks, months or even years after a COVID-19 infection. This review looks at research exploring the LC definitions, prevalence, symptoms, risk factors, and associated impacts in research on healthcare workers (HCWs).

Data sources
We systematically searched five electronic databases (CINAHL, EMBASE, Medline, PsycInfo and PubMed) and compiled a narrative literature review based on 56 relevant studies.

Areas of agreement
LC is prevalent among HCWs who become infected by COVID-19. Many of the most frequent symptoms associated with LC in the general population are also reported among HCWs. Some risk factors for LC are also similar to those in the general population, such as female sex, older age, and having a pre-existing respiratory illness.

Areas of controversy
The mechanism(s) responsible for LC remains unknown. A variety of terms, timeframes and symptoms are used to define LC, creating difficulties in comparing results across studies. Much of the research is cross-sectional and fails to explore the impacts that prolonged symptoms have on HCWs’ personal and professional lives.

Growing points
The need to support HCWs with LC is clear. Identifying the mechanism(s) responsible for LC is a key priority, as this will inform treatments.

Areas for developing research
Future research should move towards a standard definition for LC. Greater attention should be paid to longitudinal and qualitative studies, which could give insights into prognosis, lived experience and work participation. Finally, studies evaluating treatments suitable for people with LC are timely.


https://academic.oup.com/bmb/advance-article/doi/10.1093/bmb/ldae008/7740889?login=false

 

Some quotes:

Given the increased risk of COVID-19 infection among HCWs, particularly in the first year of the pandemic, they are presumably at high risk of LC. We also acknowledge that this is likely not unique to HCWs, as several other occupational groups, e.g. educators, bus and coach drivers, and police and protective services staff, have also been found to be at an increased risk of COVID-19 infection in the UK compared with the general population.15,16


...

Cross-sectional research also identified some impacts related to LC. Compared to HCWs who were infected by COVID-19 but did not experience prolonged symptoms, six studies found increased functional impairments47,61,67 and burnout,26 and lower quality of life53 and workability76 among HCWs with LC. Of work participation, an Italian study found that 168 HCWs who became infected by COVID-19 (47.7% of the sample) required 35 or more days off work,25 a study which included HCWs from 21 Latin American countries found that 16% required a modification before returning to work,75 a study from the UK found that 18% of doctors with LC had not returned to work due to illness, while 40% of those who had returned to work required a phased return, with reduced hours or duties,56 and another UK-based study found that three HCWs (4.9% of those who had PCS) required a period of additional sick leave following their initial isolation period,.36Furthermore, 69% of HCWs with PCS in the latter study felt that they were struggling to cope with their symptoms36.

Both qualitative studies, conducted in 2020 in the UK, provided more information on the HCWs’ lived experience of LC. One study included a range of HCWs,30 while the second sampled only doctors.44 In both studies, an uncertainty regarding persistent symptoms was emphasized, and HCWs described using their medical knowledge to make sense of their symptoms, with some fearing that LC symptoms were a sign of more serious pathologies, such as pulmonary embolism or myocarditis.30,44 HCWs sought advice and reassurance from colleagues with similar symptoms or who were working with people with LC.30,44 These connections were a key source of information given the lack of official government guidance or care pathways at the time.30,44 They felt let down by their national healthcare system because of the lack of support when trying to access care.30,44 Many also feared or experienced disapproval when trying to take time off work from their colleagues who did not believe in their symptoms.30,44 When reflecting on what services should be available for people suffering with LC, HCWs in both studies advocated for a ‘one-stop-shop’, multi-disciplinary team approach, which would help to fix the fragmented service they experienced and would offer personalized support for symptoms.30,44

 

Oh dear.

And also a coauthor of "Anomalies in the review process and interpretation of the evidence in the NICE guideline for chronic fatigue syndrome and myalgic encephalomyelitis" by White et al. (link)