The study, produced in collaboration with the Institut national de la santé publique du Québec (INSPQ), but not peer-reviewed, contacted more than 6,000 Quebec healthcare workers who were infected between July 2020 and May 2021. Their symptoms were compared to a cohort of some 4,300 healthcare workers who had not been infected.
These workers were asked to say if they had one or more of the following 15 symptoms and to quantify their severity (mild, moderate or severe): fatigue, fever, shortness of breath, cough, wheezing, pain, headache, difficulty walking, loss of smell, loss of taste, joint or muscle pain, abdominal pain, diarrhea, sore throat and runny nose.
According to the data collected, 46% of healthcare workers who were infected (2,746 people), but not hospitalized, reported symptoms after 4 weeks, and 40%, after 12 weeks (653). Of those who were hospitalized, 76% reported symptoms after 4 weeks (90), and 68% after 12 weeks (27).
Nearly 10% of workers with symptoms after 4 weeks confirmed that they were still off work; 73% say they returned to work even though they did not recover.
Nearly 20% of non-hospitalized healthcare workers reported at least one serious symptom after 4 weeks. Of those who were hospitalized, 35% reported at least one serious symptom after 12 weeks.
Some of the most common symptoms include fatigue, loss of sense of smell, difficulty breathing, cognitive problems, headaches, muscle aches and arthritis.
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Almost all infected workers reported post-COVID-19 fatigue; 84% believe that this fatigue is moderate; 28% say it is intense.
More than 30% of non-hospitalized workers who had symptoms after one month reported difficulty concentrating, 20% frequent forgetfulness or difficulty organizing, and 10% often lost objects. Persistent symptoms in non-hospitalized workers were two or three times more common than in uninfected workers.
During hospitalization due to COVID-19, female sex and age were associated with a higher risk of developing persistent symptoms.
According to the medical definition established by the World Health Organization (WHO), a person with post-COVID-19 syndrome must have symptoms that persist for at least three months and that cannot be explained by another diagnosis. The syndrome can occur regardless of the initial severity of the infection. Symptoms may appear after an initial recovery (usually after three months) or may never disappear after an initial infection. They may also fluctuate or reappear over time.
This syndrome is associated with about 200 symptoms affecting at least 10 organs, including the brain, heart, lungs and blood vessels.
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Only 4% of the workers analyzed had been vaccinated before their infection. It is therefore still difficult to conclude with certainty the impact of vaccination on the post-COVID-19 syndrome, write the authors, since this cohort has not been sufficiently studied. Among a small group who were vaccinated before infection, the risk of having symptoms after 4 weeks was slightly lower, but the risk of having symptoms after 12 weeks was about the same.
The prevalence, risk factors and prognosis of the post-COVID-19 syndrome are still poorly known, add the study authors, according to which the burden of this new disease not only has an impact on the lives of these workers, but also on the health network.
COVID-19, les impacts sur la prestation de soins de santé de qualité pourraient être profonds si le dysfonctionnement cognitif et d'autres symptômes graves du syndrome post-COVID persistaient de manière professionnellement invalidante à plus long terme","text":"Avec autant de travailleurs de la santé infectés depuis le début de la pandémie de COVID-19, les impacts sur la prestation de soins de santé de qualité pourraient être profonds si le dysfonctionnement cognitif et d'autres symptômes graves du syndrome post-COVID persistaient de manière professionnellement invalidante à plus long terme"}}">With so many healthcare workers infected since the start of the COVID-19 pandemic, the impacts on the delivery of quality healthcare could be profound if cognitive dysfunction and other severe symptoms of post-COVID syndrome persist from professionally disabling way in the longer term
write the authors.
Despite some limitations to this study listed by the authors, they point out that, unlike previous studies, their analysis makes a distinction between hospitalized and non-hospitalized people. They note COVID-19 chez les adultes non hospitalisés","text":"que cette étude montre le fardeau élevé des séquelles de la COVID-19 chez les adultes non hospitalisés"}}">that this study shows the high burden of sequelae of COVID-19 in non-hospitalized adults
.
The authors also warn that it is not possible to determine with this study whether the same prevalence is found in the general population. According to the WHO, 10 to 20% of infected patients show symptoms for more than three months.
Yes, there are some selection biases, but methodologically speaking, this study is of high quality
, estimates Simon Décary, researcher at the Laboratory for Research on Patient-Oriented Rehabilitation at the University of Sherbrooke who studies the post-COVID-19 syndrome. He adds that the sampling is very large and that the analysis is rigorous. In addition, the infections were confirmed by PCR test, which dispels any doubt that the interviewees were really infected with COVID-19.
Dr. Anne Bhéreur, who herself suffers from intense symptoms associated with this syndrome after being infected in December 2020 in the palliative care setting where she worked, says for her part that she is COVID-19]","text":"atterrée de voir qu’on est très loin des estimés les plus conservateurs [sur le syndrome post-COVID-19]"}}">appalled to see that we are very far from the esteemed most conservative [sur le syndrome post-COVID-19]
. While some of these people have mild persistent symptoms, she reminds us that cognitive impacts can have an impact on the quality of a health worker’s work.
The data is strong enough to say that we have a significant problem
believes Dr. Bhéreur.
According to Simon Décary, these data show that action is needed quickly to help these people not only recover, but also to return to their jobs, and to mitigate the risks of other health care workers developing persistent symptoms. I don’t know what decisions the authorities will make, but they have the data to make decisions.
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