LC Check (Long Covid in NHS staff): demographic and social risk factors and the relationship with sickness absence
Aims To investigate the risk factors for staff developing ‘Long Covid’ and predictors of taking sick leave as a result of Long Covid.
What the research will involve:
We will use existing NHS CHECK data from the four waves of data collection (baseline, 6, 12, and 32 months) to analyse the characteristics and risk factors of HWCs who experience ‘Long Covid’, as defined by experiencing symptoms post-acute infection for 12 or more weeks. We will also explore the characteristics and risk factors of healthcare worker (HCWs) taking sickness absence as a result of Long Covid, using the NHS Human Resources definition of four consecutive weeks off work, constituting a long-term absence.
What has the study found so far?
We carried out a narrative review of definitions of Long COVID (LC), prevalence, symptoms, risk factors, and associated impacts in research on healthcare workers (HCWs). We found that LC is prevalent among HCWs t, with the most frequent symptoms associated with LC in the general population are also reported among HCWs. Risk factors for LC are also similar to those in the general population, e.g. female sex, older age, and having a pre-existing respiratory illness, but the mechanism(s) responsible for LC remain unknown. A variety of terms, timeframes and symptoms are used to define LC, creating challenges 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. (https://academic.oup.com/bmb/article/151/1/16/7740889?login=false)
An analysis of data from 5,248 HCWs found that 33.6% (n=1730) reported prolonged COVID-19 symptoms consistent with LC, defined in this study in line with NICE guidelines as Post COVID Syndrome . However, only 7.4% (n=385) of participants reported a formal diagnosis of PCS. The most common PCS symptoms were fatigue, difficult concentrating, insomnia, and anxiety or depression. Baseline risk factors for reporting PCS included screening for common mental disorders, direct contact with COVID-19 patients, pre-existing respiratory illnesses, female sex, and older age. (https://oem.bmj.com/content/81/9/471.abstract)
Our second analysis found that, in the 4,721 participants who reported sickness absence, at 12 months post-baseline, 89.5% of participants attributed sickness absence to a COVID-19 infection, while 84.6% reported the same at 32 months. Median self-reported days off work at both timepoints were higher among HCWs who self-reported LC symptoms (12mo=14 days (IQR=10-30), 32mo=7 days (IQR=4-14)) compared with HCWs who did not (12mo=9.5 days (IQR=3.5-14), 32mo=5 days (IQR=2-7)). A similar finding was observed for HCWs who reported a formal diagnosis of LC compared with those who did not. There was a noticeable reduction in COVID-19-related sickness absence between our 12 and 32 month follow-up surveys across all groups. Among HCWs who self-reported LC symptoms, predictors for reporting long-term sickness absence at both timepoints included having a pre-existing respiratory illness and being aged 41-50 years. This paper includes a companion piece written by members of our patient and public involvement and engagement (PPIE) group about their experiences.
Dr Brendan Dempsey presented initial results of the study at the Society of Occupational Medicine conference in Newcastle (June 2023).
Dr Dempsey presented results of the full analyses to the European Psychiatry Association (EPA) conference, which was held in Switzerland (September 2024).
Study Team and further Information: Dr Danielle Lamb, Dr Sharon Stevelink, Prof Ira Madan
Further information: d.lamb@ucl.ac.uk
Funders: Colt Foundation