Long-COVID associated with a greater likelihood of unemployment

By Dr. Chinta SidharthanReviewed by Danielle Ellis, B.Sc.Feb 16 2023

In a recent study published in the journal JAMA Network Open, researchers assessed the unemployment rates among individuals who developed post–coronavirus disease 2019 (COVID-19) condition (PCC) or long COVID after an acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to determine the functional and neurocognitive impairment levels associated with long COVID.

Study: Association of Post–COVID-19 Condition Symptoms and Employment Status. Image Credit: p.ill.i / Shutterstock

Background

Long COVID or PCC patients experience COVID-19-associated symptoms beyond two months, and follow-up studies among PCC patients have reported a wide range of symptoms including fatigue, headaches, cardiovascular problems, breathlessness, inability to exercise, digestive disorders, aches, fever, and neurological problems such as cognitive impairments and brain fog. While studies have reported a decrease in the quality of life among long COVID or PCC patients, the functional impairment associated with this disease remains unclear.

About the study

The present study examined unemployment rates among PCC patients as a proxy for neurocognitive and functional impairment. This survey-based analysis included individuals under the age of 70 and above 18 who had reported a positive antigen or polymerase chain reaction (PCR) test result for COVID-19 at least two months before the beginning of the survey. Patients who reported that their acute COVID-19 symptoms had not resolved were asked to provide a complete list of common symptoms from a checklist of 25 symptoms.

Symptoms of brain fog, difficulties in concentrating or focusing, and memory problems were evaluated further. Self-reported sociodemographic factors, including race and ethnicity, which included Asian, African American, Native American, Pacific Islander, Hispanic, and White races, among others, were used for a weighted analysis.

Statistical analyses were conducted to determine associations between PCC or long COVID and unemployment or the lack of full-time employment among individuals who were not retired. The analysis was adjusted for sex, age, race and ethnicity, area of residence (rural, suburban, or urban), education levels, and region.

Results

The results from the adjusted models indicated a greater likelihood of unemployment or inability to sustain full-time employment associated with PCC or long COVID. In addition, cognitive impairments in PCC patients reduced their ability to work full-time and were associated with a lower quality of life among employed individuals.

The survey included 15,308 COVID-19 patients, and 2,236 reported long COVID symptoms. Of these 2,236 PCC patients, 1,027 reported memory or cognitive impairments. The mean age of PCC patients was 38.8 years, and 9.8% (1,418 out of 15,308) of the COVID-19 patients were unemployed. Of these 1,418 unemployed individuals, 276 had PCC, while 1,142 did not report any PCC symptoms.

A total of 8,229 patients reported having full-time employment, of which 7,212 did not report PCC symptoms, and 1,017 had PCC. The linear regression analysis revealed that PCC symptoms were associated with a decreased likelihood of full-time employment and a higher probability of being unemployed. Furthermore, all cognitive symptoms were associated with a decrease in the likelihood of full-time employment. Among the 15,308 participants who had COVID-19, 63.2% (9679) were women, and 70% (10,720) were White.

Conclusions

To summarize, the study evaluated the association between PCC symptoms, such as memory impairments and cognitive difficulties, including brain fog, and the likelihood of unemployment or full-time employment among COVID-19 patients. The results suggested that COVID-19 patients who reported long COVID cognitive symptoms had a lower likelihood of being able to work full-time and a higher probability of being unemployed.

These findings highlight the need to develop strategies to address the long-term effects of long COVID, especially the neurocognitive and functional impairments that affect the quality of life. The authors believe that while it is difficult to estimate the economic impact of the COVID-19 pandemic conclusively, the study brings to light the persistent and long-term effects of COVID-19 on patients' productivity and quality of life.