Symptoms Compatible With Long Coronavirus Disease (COVID) in Healthcare Workers With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection—Results of a Prospective Multicenter Cohort

Abstract

Background The burden of long-term symptoms (i.e. long-COVID) in patients after mild COVID-19 is debated. Within a cohort of healthcare workers (HCW), frequency and risk factors for symptoms compatible with long-COVID are assessed. Methods Participants answered baseline (August/September 2020) and weekly questionnaires on SARS-CoV-2 nasopharyngeal swab (NPS) results and acute disease symptoms. In January 2021, SARS-CoV-2 serology was performed; in March, symptoms compatible with long-COVID (including psychometric scores) were asked and compared between HCW with positive NPS, seropositive HCW without positive NPS (presumable a-/pauci-symptomatic infections), and negative controls. Also, the effect of time since diagnosis and quantitative anti-S was evaluated. Poisson regression was used to identify risk factors for symptom occurrence. Results Of 3’334 HCW (median 41 years; 80% female), 556 (17%) had a positive NPS and 228 (7%) were only seropositive. HCW with positive NPS more frequently reported ≥1 symptom compared to controls (73%vs.52%, p<0.001); seropositive HCW without positive NPS did not score higher than controls (58%vs.52%, p=0.13), although impaired taste/olfaction (16%vs.6%, p<0.001) and hair loss (17%vs.10%, p=0.004) were more common. Exhaustion/burnout was reported by 24% of negative controls. Many symptoms remained elevated in those diagnosed >6 months ago; anti-S titers correlated with high symptom scores. Acute viral symptoms in weekly questionnaires best predicted long-COVID symptoms. Physical activity at baseline was negatively associated with neurocognitive impairment and fatigue scores. Conclusions Seropositive HCW without positive NPS are only mildly affected by long-COVID. Exhaustion/burnout is common, even in non-infected HCW. Physical activity might be protective against neurocognitive impairment/fatigue symptoms after COVID-19.

Prevalence and risk factors for long COVID after mild disease: a longitudinal study with a symptomatic control group

“…Indeed, we observed that non-confirmed COVID-19 cases reported similar residual symptoms after acute illness, albeit at a much lower frequency. Few studies have included a control group composed of symptomatic patients that tested negative for SARS-CoV-2 [14,31]. In a cohort of healthcare workers, olfactory disorders and hair loss were related to long COVID while positive and negative cases both had similar frequencies of 12/26 exhaustion/burnout and fatigue [14].…”

“…Few studies have included a control group composed of symptomatic patients that tested negative for SARS-CoV-2 [14,31]. In a cohort of healthcare workers, olfactory disorders and hair loss were related to long COVID while positive and negative cases both had similar frequencies of 12/26 exhaustion/burnout and fatigue [14]. In a population-based digital retrospective cohort including outpatients and well-matched controls, 62 symptoms were associated with long COVID [31].…”

“…Sex hormone differences in immune response [24] and autoimmunity triggered by SARS-CoV-2 have been suggested to be involved in the disease 13/26 pathogenesis of long COVID [23]. Other studies have found that individuals with more symptoms during the acute phase were at a higher risk for developing long COVID [9,14].…”

Update of the Potential Treatments for Psychiatric and Neuropsychiatric Symptoms in the Context of the Post-COVID-19 Condition: Still a Lot of Suffering and Many More Things to Learn

“…With this review, the importance of the multidisciplinary approach to properly treat post-COVID-19 syndrome in general and psychiatric and neuropsychiatric post-COVID-19 symptoms specifically is highlighted [26,36,43]. Some included articles also showed the addiction risk management challenge [36,37].…”

“…Some authors conclude in a large prospective study on healthcare workers that physical activity might protect against neurocognitive impairment/fatigue symptoms after COVID-19, suggesting that physical activity could be a good preventive strategy to introduce and encourage [43].…”