Symptoms compatible with long-COVID in healthcare workers with and without SARS-CoV-2 infection – results of a prospective multicenter cohort

  1. Carol Strahm
  2. Marco Seneghini
  3. Sabine Güsewell
  4. Thomas Egger
  5. Onicio Leal
  6. Angela Brucher
  7. Eva Lemmenmeier
  8. Dorette Meier Kleeb
  9. J. Carsten Möller
  10. Philip Rieder
  11. Markus Ruetti
  12. Remus Rutz
  13. Hans-Ruedi Schmid
  14. Reto Stocker
  15. Danielle Vuichard-Gysin
  16. Benedikt Wiggli
  17. Ulrike Besold
  18. Stefan P. Kuster
  19. Allison McGeer
  20. Lorenz Risch
  21. Andrée Friedl
  22. Matthias Schlegel
  23. Dagmar Schmid
  24. Pietro Vernazza
  25. Christian R. Kahlert
  26. Philipp Kohler
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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.

summary

In this prospective healthcare worker cohort, participants with SARS-CoV-2-positive nasopharyngeal swab were most likely to report long-COVID symptoms, whereas seropositive participants without positive swab were only mildly affected. Physical activity at baseline was negatively associated with neurocognitive impairment and fatigue.

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