Physical, Psychological, and Cognitive Profile of Post-COVID Conditions in Healthcare Workers, Quebec, Canada

Sara Carazo, Danuta M Skowronski, Robert Laforce Jr, Denis Talbot, Emilia L Falcone, Denis Laliberté, Geoffroy Denis, Pierre Deshaies, Sandrine Hegg-Deloye, Gaston De Serres, Sara Carazo, Danuta M Skowronski, Robert Laforce Jr, Denis Talbot, Emilia L Falcone, Denis Laliberté, Geoffroy Denis, Pierre Deshaies, Sandrine Hegg-Deloye, Gaston De Serres

Abstract

Background: The prevalence of post-COVID conditions (PCC) and associated physical, psychological, and cognitive symptoms was assessed among Quebec healthcare workers (HCWs) with coronavirus disease 2019 (COVID-19).

Methods: This case-control study compared 6061 symptomatic HCWs with polymerase chain reaction-confirmed COVID-19 between July 2020 and May 2021 with a random sample of 4390 symptomatic HCWs who were test-negative controls. The prevalence of physical symptoms lasting ≥4 weeks (PCC4w) or ≥12 weeks (PCC12w) was estimated among hospitalized and nonhospitalized cases. In multivariate models, sociodemographic and clinical characteristics, as well as vaccine history, were evaluated as potential risk factors. Prevalence ratios compared 4 aspects of self-reported cognitive dysfunction among PCC cases to controls, adjusting for psychological distress and fatigue.

Results: PCC4w and PCC12w prevalences of 46% (2746/5943) and 40% (653/1746), respectively, were observed among nonhospitalized cases and 76% (90/118) and 68% (27/37), respectively, among hospitalized cases. Hospitalization, female sex, and age were associated with higher PCC risk. A substantial proportion of nonhospitalized PCC4w cases often or very often reported cognitive dysfunction, including concentration (33%) or organizing (23%) difficulties, forgetfulness (20%), and loss of necessary items (10%). All 4 aspects of cognitive dysfunction were associated with PCC4w symptoms, psychological distress, and fatigue.

Conclusions: PCC may be a frequent sequela of ambulatory COVID-19 in working-age adults, with important effects on cognition. With so many HCWs infected, the implications for quality healthcare delivery could be profound if cognitive dysfunction and other severe PCC symptoms persist in a professionally disabling way. Further evaluation of PCC prevalence and prognosis is warranted.

Keywords: SARS-CoV-2; cognitive dysfunction; healthcare workers; post-COVID conditions.

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Flowchart of study population. Abbreviations: COVID-19, coronavirus disease 2019; HCW, healthcare worker; PCR, polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Figure 2.
Figure 2.
Distribution of the number of symptoms (A) and number of severe symptoms (B) reported by nonhospitalized healthcare workers, by time from coronavirus disease 2019 illness onset to survey. Abbreviation: HCW, healthcare worker.
Figure 3.
Figure 3.
Prevalence and severity of the main symptoms still present ≥4 weeks after illness onset reported by nonhospitalized (A) and hospitalized (B) healthcare workers with coronavirus disease 2019. Cognitive dysfunction defined as self-reporting often or very often presenting difficulty to concentrate or maintain attention, difficulty to organize oneself, forgetting things, or losing necessary items among those who did not present with these dysfunctions before being infected with severe acute respiratory syndrome coronavirus 2. Abbreviations: COVID-19, coronavirus disease 2019; HCW, healthcare worker.
Figure 4.
Figure 4.
Prevalence of self-reported cognitive dysfunctions and psychological distress among non–coronavirus disease 2019 (COVID-19) controls, COVID-19 cases without post-COVID conditions (PCC), and nonhospitalized and hospitalized cases with PCC, among Quebec healthcare workers. Abbreviations: COVID-19, coronavirus disease 2019; HCW, healthcare worker; hosp, hospitalized; K6, Kessler Psychological Distress Scale; non-hosp, nonhospitalized; PCC, post-COVID conditions; PCC4w, ≥4-week post-COVID conditions; PCC12w, ≥12-week post-COVID conditions.

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Source: PubMed

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