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

Carol Strahm, Marco Seneghini, Sabine Güsewell, Thomas Egger, Onicio Leal-Neto, Angela Brucher, Eva Lemmenmeier, Dorette Meier Kleeb, J. Carsten Möller, Philip Rieder, Markus Ruetti, Remus Rutz, Hans-Ruedi Schmid, Reto Stocker, Danielle Vuichard-Gysin, Benedikt Wiggli, Ulrike Besold, Stefan Kuster, Allison McGeer, Lorenz Risch, Andrée Friedl, Matthias Schlegel, Dagmar Schmid, Pietro Vernazza, Christian R. Kahlert & Philipp Kohler

abstract

Background:
The burden of long-term symptoms (ie, long COVID) in patients after mild COVID-19 is debated. Within a cohort of healthcare workers (HCWs), 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 HCWs with positive NPS, seropositive HCWs without positive NPS (presumable asymptomatic/pauci-symptomatic infections), and negative controls. The effect of time since diagnosis and quantitative anti-spike protein antibodies (anti-S) was evaluated. Poisson regression was used to identify risk
factors for symptom occurrence.

Results:
Of 3334 HCWs (median, 41 years; 80% female), 556 (17%) had a positive NPS and 228 (7%) were only seropositive. HCWs with positive NPS more frequently reported ≥1 symptom compared with controls (73% vs 52%, P < .001); seropositive HCWs without positive NPS did not score higher than controls (58% vs 52%, P = .13), although impaired taste/olfaction (16% vs 6%, P < .001) and hair loss (17% vs 10%, P = .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 HCWs without positive NPS are only mildly affected by long COVID. Exhaustion/burnout is common, even in noninfected HCWs. Physical activity might be protective against neurocognitive impairment/fatigue symptoms after COVID-19.

Keywords:
long COVID; serology; asymptomatic; healthcare workers; risk factors
   
keywords long COVID; serology; asymptomatic; healthcare workers; risk factors
   
citation Strahm C, Seneghini M, Güsewell S, Egger T, Leal-Neto O, Brucher A, Lemmenmeier E, Meier Kleeb D, Möller J C, Rieder P, Ruetti M, Rutz R, Schmid H R, Stocker R, Vuichard-Gysin D, Wiggli B, Besold U, Kuster S, McGeer A, Risch L, Friedl A, Schlegel M, Schmid D, Vernazza P, Kahlert C R, Kohler P. Symptoms Compatible With Long Coronavirus Disease (COVID) in Healthcare Workers With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2) Infection—Results of a Prospective Multicenter Cohort. Clinical Infectious Diseases (CID) 2022;1-9.
   
type journal paper/review (English)
date of publishing 28-1-2022
journal title Clinical Infectious Diseases (CID)
ISSN electronic 1537-6591
pages 1-9
PubMed 35090015
DOI https://doi.org/10.1093/cid/ciac054
link http://www.ncbi.nlm.nih.gov/pubmed/35090015
contact Carol Strahm