JMIR Publications

ABSTRACT

Background:

Emerging evidence suggests that globally, between 30-50% of those who are infected with Coronavirus Disease 2019 (COVID-19) experience Long COVID (LC) symptoms. These symptoms create challenges with return-to-work (RTW) in a high proportion of individuals with LC. In order to tailor rehabilitation programs to LC sequelae and help improve RTW outcomes, more research on LC rehabilitation program outcomes is needed.

Objective:

This study described characteristics and outcomes of workers who participated in a LC occupational rehabilitation program.

Methods:

A historical cohort study was conducted. Descriptive variables included demographic and occupational factors as well as patient-reported outcome measures (i.e., the Fatigue Severity Scale (FSS), Post-COVID Functional Scale (PCFS), Short Form Health Survey (SF-36), Pain Disability Index (PDI), Pain Visual Analogue Scale (VAS), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Questionnaire (GAD-7), and post-traumatic stress disorder checklist (PCL-5)). The main outcome variable was return-to-work status. Descriptive statistics were calculated. Logistic regression examined predictors of return-to-work.

Results:

The sample consisted of 81 workers. Most workers were female (n=52) and from health-related occupations (n=43). Only 43 individuals returned to work at program discharge, with 93% of these returning to modified duties. Although there were statistically significant improvements on the pain VAS (11.1 + 25.6 (t(31) = 2.5, P=.02)), the PDI (9.4 + 12.5 (t(32) = 4.3, P<.001)), the FSS (3.9 + 8.7 (t(38) = 2.8, P=.009)), the SF-36’s PCS (4.8 + 8.7 (t(38) = -3.5, P=.001)), the PHQ-9 (3.7 + 4.0 (t(31) = 5.2, P<.001)), and the GAD-7 (1.8 + 4.4 (t(22) = 1.8, P=.03)), there were no significant improvements in the PCFS, overall mental component score of the SF-36, or on the PCL-5. Availability of modified duties (OR 3.38, 95% CI: 1.26-9.10) and shorter time between accident and intake (OR 0.99, 95% CI: 0.99-1.00) predicted return-to-work even when controlling for age and gender.

Conclusions:

Findings suggest that modified duties and earlier, timely rehabilitation are essential for successful return-to-work in people with LC. Additional research is needed, including larger observational cohorts as well as randomized controlled trials, to evaluate effectiveness of LC rehabilitation.