Physical Impact of SARS-CoV-2 Infection in a Population of Italian Healthcare Workers

Abstract

SARS-CoV-2 infection often causes symptoms and illness that can last for months after the acute phase, i.e., so-called “Long COVID” or Post-acute COVID-19. Due to the high prevalence of SARS-CoV-2 infection among Healthcare Workers (HCWs), post-COVID-19 symptoms can be common and threaten workers’ occupational health and healthcare systems’ functioning. The aim of this cross-sectional, observational study was to present data related to post-COVID-19 outcomes in a population of HCWs infected by COVID-19 from October 2020 to April 2021, and to identify possible factors associated with the persistence of illness, such as gender, age, previous medical conditions, and features of acute illness. A total of 318 HCWs who had become infected by COVID-19 were examined and interviewed approximately two months after their recovery from the infection. The clinical examinations were performed by Occupational Physicians in accordance with a specific protocol at the Occupational Medicine Unit of a tertiary hospital in Italy. The mean age of the participants was 45 years old, and 66.7% of the workers were women while 33.3% were men; the sample mainly consisted of nurses (44.7%). During the medical examination, more than half of the workers mentioned that they had experienced multiple residual bouts of illness after the acute phase of infection. Men and women were similarly affected. The most reported symptom was fatigue (32.1%), followed by musculoskeletal pain (13.6%) and dyspnea (13.2%). In the multivariate analysis, dyspnea (p < 0.001) and fatigue (p < 0.001) during the acute stage of illness and the presence of any limitation in working activities, in the context of fitness for a work evaluation performed while the occupational medicine surveillance program was being conducted (p = 0.025), were independently associated with any post-COVID-19 symptoms, which were considered final outcomes. The main post-COVID-19 symptoms—dyspnea, fatigue, and musculoskeletal pain—showed significant associations with dyspnea, fatigue, and musculoskeletal pain experienced during the acute stage of infection, with the presence of limitations in working activities, and pre-existing pneumological diseases. A normal weight according to body mass index was a protective factor. The identification of vulnerable workers as those with limitations in working activities, pneumological diseases, a high BMI, and of an older age and the implementation of preventive measures are key factors for preserving Occupational Health. Fitness-to-work evaluations performed by Occupational Physicians can be considered a complex index of overall health and functionality that can identify workers who may suffer from relevant post-COVID-19 symptoms.

Factors Contributing to Delayed Return to Work among French Healthcare Professionals Afflicted by COVID-19 at a Hospital in the Rhône-Alpes Region, 2021

“…Our results are consistent with those of the literature, which showed that fatigue is the most frequent symptom after SARS-CoV-2 infections [18]. Lulli et al identified that over half of healthcare workers infected with COVID-19 mentioned at least one symptom persisting, and fatigue was the most reported disorder [19]. According to a systematic review, fatigue affects more than 50% of patients [20].…”

Work, telework, and mental health during COVID-19

“…These symptoms included fatigue, difficulties with concentration, respiratory problems, and a poor quality of life. More than half of the population analyzed in an Italian study of healthcare professionals (56.3%) displayed persistent symptoms, the most common of which was fatigue (32.1%), followed by musculoskeletal pain (13.6%) and dyspnea (13.2%); these symptoms restricted the employees' working conditions 46 . According to a study of the general population in several nations, more than 54.6% of people reported long periods of being unable to work; 34.5% of people reported losing their jobs due to illness; 63.9% reported having trouble coping with daily tasks; and 17.6% reported having financial difficulties as a result of the disease.…”

Trabajo, teletrabajo y salud mental en el contexto COVID-19

“…La evaluación de numerosos trabajadores en el ámbito del servicio social en Alemania identificó que casi el 73% experimentó síntomas persistentes durante más de tres meses, destacándose la fatiga, problemas de concentración y dificultades para respirar, además de una baja calidad de vida en aquellos trabajadores con síntomas persistentes 45 . Una investigación con trabajadores de la salud en Italia reflejó que más de la mitad de la población analizada (56,3%) manifestaron síntomas persistentes, entre los que se destacan la fatiga con el 32,1%, seguido de dolores musculoesqueléticos con el 13,6% y la disnea con el 13,2%; síntomas que limitaron las condiciones laborales de esta población de trabajadores 46 . Por su parte, un estudio con población general de varios países destacó que más del 54,6% de las personas experimentaron largos períodos sin poder trabajar, el 34,5% habían perdido su trabajo debido a una enfermedad, el 63,9% informaron dificultades para hacer frente a las actividades cotidianas, y el 17,6% había experimentado dificultades financieras como resultado de la enfermedad.…”