Post COVID-19 Condition, Work Ability and Occupational Changes: Results from a Population-based Cohort

Background Evidence from population-based studies on the impact of post COVID-19 condition (PCC) on ability to work is limited but critical due to its high prevalence among individuals of working-age. Objective To evaluate the association between PCC, work ability, and occupational changes. Design Population-based, longitudinal cohort. Setting General population, Canton of Zurich, Switzerland. Participants 672 adults of working-age with SARS-CoV-2 infection. Measurements Current work ability, work ability related to physical and mental demands, and estimated future work ability in 2 years (assessed using Work Ability Index), as well as PCC-related occupational changes at one year after infection. Results There was very strong evidence that current work ability scores were 0.62 (95% confidence interval (CI) 0.30 to 0.95) points lower among those with PCC compared to those without. Similarly, there was very strong evidence for lower odds of reporting higher work ability with respect to physical (odds ratio (OR) 0.30, 95% CI 0.20 to 0.46) and mental (OR 0.40, 0.27 to 0.62) demands among those with PCC compared to those without. Higher age and history of psychiatric diagnosis were associated with a more substantial reduction in current work ability. 5.8% of those with PCC reported direct effects of PCC on their occupational situation, with 1.6% of those with PCC completely dropping out of the workforce and 43% of those with PCC-related occupational changes reporting financial difficulties as a result. Limitations Selection, use of self-reported outcome measures, and limited generalizability to individuals with most severe COVID-19 or following vaccination. Conclusions These findings highlight the need for providing support and interdisciplinary interventions to individuals affected by PCC to help them maintain or regain their work ability and productivity. Primary Funding Source Federal Office of Public Health, Department of Health of the Canton of Zurich, University of Zurich Foundation, Switzerland. Study Registration ISRCTN14990068. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study is part of the Corona Immunitas research network, coordinated by the Swiss School of Public Health (SSPH+), and funded by fundraising of SSPH+ including funds of the Swiss Federal Office of Public Health and private funders (ethical guidelines for funding stated by SSPH+ were respected), by funds of the Cantons of Switzerland (Vaud, Zurich, and Basel) and by institutional funds of the Universities. Additional funding specific to this study was received from the Department of Health of the Canton of Zurich, the Swiss Federal Office of Public Health, and the University of Zurich (UZH) Foundation. PK received funding from the Swiss National Science Foundation, grant no 100019M_201113. TB received funding from the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 801076, through the SSPH+ Global PhD Fellowship Program in Public Health Sciences (GlobalP3HS) of the SSPH+. DM received funding by the University of Zurich Postdoc Grant, grant no. FK-22-053. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the responsible ethics committee of the Canton of Zurich, Switzerland (BASEC-Nr. 2020-01739). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the corresponding author after the peer-reviewed publication of the article.