The Lancet regional health. Europe · 2026
Long COVID symptom profiles, workforce participation, and working hours among adults in England: a population-based cohort study.
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Di Gravio Chiara, Guzmán Viveka, Wu Shuang, Cooper Emily, Bambra Clare, Smith Nikki, Piper Alex, Whitaker Matthew, Elliott Joshua, Atchison Christina J, Cooke Graham, Chadeau-Hyam Marc, Elliott Paul, Ward Helen
Аннотация
BACKGROUND: Long COVID, marked by ongoing multi-systemic symptoms following COVID-19 infection, can impair ability to maintain employment. However, its relationship to workforce retention and working hours remains unclear.
METHODS: Long COVID was defined as symptoms lasting ≥12 weeks post-infection. We analysed data from a late-2022 follow-up survey involving 45,864 participants of the Real-time Assessment of Community Transmission (REACT) Study in England (median follow-up: 23 months). Hierarchical clustering identified symptom groups. Multivariable regressions examined associations between Long COVID, being in paid work, and changes in working hours.
FINDINGS: Of 45,864 participants employed at recruitment, 86% (N = 39,341) remained in paid work at follow-up and 11% (N = 4877) changed work hours. Approximately 4% (N = 1967/45,864) had unresolved Long COVID. Compared with participants with no/short (<4 weeks) symptoms, those with unresolved Long COVID had lower odds of being in paid work at follow-up (adjusted odds ratio [aOR]: 0.62, 95% confidence interval [CI]: 0.55, 0.70), and higher odds of changing work hours (aOR: 4.34, 95% CI: 3.88, 4.85). Three clusters were identified: multisystem severe, fatigue-predominant and anosmia-predominant Long COVID. Compared with the fatigue-predominant cluster, participants with multisystem severe Long COVID had lower odds of paid work (aOR: 0.63, 95% CI: 0.47, 0.84) and higher odds of changing work hours (aOR 2.76, 95% CI 2.21, 3.46).
INTERPRETATION: Unresolved Long COVID was associated with worse employment outcomes. Symptom clusters highlighted the importance of considering heterogeneity in Long COVID when assessing workforce impacts and designing public health responses.
FUNDINGS: National Institute for Health and Care Research, UK Research and Innovation.
METHODS: Long COVID was defined as symptoms lasting ≥12 weeks post-infection. We analysed data from a late-2022 follow-up survey involving 45,864 participants of the Real-time Assessment of Community Transmission (REACT) Study in England (median follow-up: 23 months). Hierarchical clustering identified symptom groups. Multivariable regressions examined associations between Long COVID, being in paid work, and changes in working hours.
FINDINGS: Of 45,864 participants employed at recruitment, 86% (N = 39,341) remained in paid work at follow-up and 11% (N = 4877) changed work hours. Approximately 4% (N = 1967/45,864) had unresolved Long COVID. Compared with participants with no/short (<4 weeks) symptoms, those with unresolved Long COVID had lower odds of being in paid work at follow-up (adjusted odds ratio [aOR]: 0.62, 95% confidence interval [CI]: 0.55, 0.70), and higher odds of changing work hours (aOR: 4.34, 95% CI: 3.88, 4.85). Three clusters were identified: multisystem severe, fatigue-predominant and anosmia-predominant Long COVID. Compared with the fatigue-predominant cluster, participants with multisystem severe Long COVID had lower odds of paid work (aOR: 0.63, 95% CI: 0.47, 0.84) and higher odds of changing work hours (aOR 2.76, 95% CI 2.21, 3.46).
INTERPRETATION: Unresolved Long COVID was associated with worse employment outcomes. Symptom clusters highlighted the importance of considering heterogeneity in Long COVID when assessing workforce impacts and designing public health responses.
FUNDINGS: National Institute for Health and Care Research, UK Research and Innovation.