Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.
Occupational Medicine Unit, Careggi University Hospital, 50134 Florence, Italy.
Int J Environ Res Public Health. 2023 Mar 3;20(5):4506. doi: 10.3390/ijerph20054506.
SARS-CoV-2 infection often causes symptoms and illness that can last for months after the acute phase, i.e., so-called "Long COVID" or Post-acute COVID-19. Due to the high prevalence of SARS-CoV-2 infection among Healthcare Workers (HCWs), post-COVID-19 symptoms can be common and threaten workers' occupational health and healthcare systems' functioning. The aim of this cross-sectional, observational study was to present data related to post-COVID-19 outcomes in a population of HCWs infected by COVID-19 from October 2020 to April 2021, and to identify possible factors associated with the persistence of illness, such as gender, age, previous medical conditions, and features of acute illness. A total of 318 HCWs who had become infected by COVID-19 were examined and interviewed approximately two months after their recovery from the infection. The clinical examinations were performed by Occupational Physicians in accordance with a specific protocol at the Occupational Medicine Unit of a tertiary hospital in Italy. The mean age of the participants was 45 years old, and 66.7% of the workers were women while 33.3% were men; the sample mainly consisted of nurses (44.7%). During the medical examination, more than half of the workers mentioned that they had experienced multiple residual bouts of illness after the acute phase of infection. Men and women were similarly affected. The most reported symptom was fatigue (32.1%), followed by musculoskeletal pain (13.6%) and dyspnea (13.2%). In the multivariate analysis, dyspnea ( < 0.001) and fatigue ( < 0.001) during the acute stage of illness and the presence of any limitation in working activities, in the context of fitness for a work evaluation performed while the occupational medicine surveillance program was being conducted ( = 0.025), were independently associated with any post-COVID-19 symptoms, which were considered final outcomes. The main post-COVID-19 symptoms-dyspnea, fatigue, and musculoskeletal pain-showed significant associations with dyspnea, fatigue, and musculoskeletal pain experienced during the acute stage of infection, with the presence of limitations in working activities, and pre-existing pneumological diseases. A normal weight according to body mass index was a protective factor. The identification of vulnerable workers as those with limitations in working activities, pneumological diseases, a high BMI, and of an older age and the implementation of preventive measures are key factors for preserving Occupational Health. Fitness-to-work evaluations performed by Occupational Physicians can be considered a complex index of overall health and functionality that can identify workers who may suffer from relevant post-COVID-19 symptoms.
SARS-CoV-2 感染通常会导致急性感染期过后数月的症状和疾病，即所谓的“长新冠”或急性 COVID-19 后。由于 SARS-CoV-2 感染在医疗保健工作者（HCWs）中普遍存在，因此 COVID-19 后症状可能很常见，并威胁到工人的职业健康和医疗系统的运作。本横断面观察性研究旨在介绍 2020 年 10 月至 2021 年 4 月期间 COVID-19 感染的 HCWs 中与 COVID-19 后结果相关的数据，并确定与疾病持续存在相关的可能因素，如性别、年龄、既往疾病和急性疾病特征。共检查并采访了 318 名感染 COVID-19 的 HCWs，大约在他们从感染中康复后两个月进行。临床检查由意大利一家三级医院的职业医生按照特定方案进行。参与者的平均年龄为 45 岁，66.7%的工作人员为女性，33.3%为男性；样本主要由护士（44.7%）组成。在体检过程中，超过一半的工作人员表示，他们在急性感染期后经历了多次反复的疾病发作。男性和女性受到的影响相似。报告最多的症状是疲劳（32.1%），其次是肌肉骨骼疼痛（13.6%）和呼吸困难（13.2%）。在多变量分析中，呼吸困难（<0.001）和疲劳（<0.001）在急性疾病阶段以及在进行职业医学监测计划期间进行的工作能力评估时存在任何工作活动限制（=0.025），与任何 COVID-19 后症状独立相关，这些症状被认为是最终结果。主要的 COVID-19 后症状——呼吸困难、疲劳和肌肉骨骼疼痛——与急性感染期的呼吸困难、疲劳和肌肉骨骼疼痛以及工作活动限制和预先存在的肺部疾病显著相关。根据体重指数，正常体重是一个保护因素。确定工作活动受限、肺部疾病、高体重指数和年龄较大的脆弱工人，并采取预防措施，是保护职业健康的关键因素。职业医生进行的工作能力评估可被视为整体健康和功能的复杂指标，可识别可能患有相关 COVID-19 后症状的工人。
