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Risk factors for long coronavirus disease 2019 (long COVID) among healthcare personnel, Brazil, 2020-2022
Alexandre R Marra1,2, Vanderson Souza Sampaio3, Mina Cintho Ozahata3
1Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
Insights
Multiple SARS-CoV-2 infections increase the risk of long COVID in healthcare workers. Maintaining immunity through COVID-19 vaccination significantly reduces the likelihood of developing long COVID.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Long coronavirus disease 2019 (COVID-19) presents a significant health challenge.
- Understanding risk factors for long COVID in healthcare personnel (HCP) is crucial for targeted prevention strategies.
Purpose of the Study:
- To identify risk factors associated with the development of long COVID among HCP.
- To evaluate the impact of SARS-CoV-2 variants and vaccination status on long COVID development.
Main Methods:
- A case-control study was conducted among HCP with confirmed symptomatic COVID-19 in Brazil.
- Cases were defined as individuals meeting the CDC criteria for long COVID.
- Multiple logistic regression analysis assessed associations between exposures and long COVID outcomes over 180 days.
Main Results:
- Out of 7,051 HCP, 1,933 (27.4%) developed long COVID.
- Risk factors included female sex, increasing age, and multiple SARS-CoV-2 infections.
- Infection with SARS-CoV-2 delta or omicron variants and receiving four vaccine doses were protective against long COVID.
Conclusions:
- Long COVID is prevalent among HCP, with over a quarter experiencing persistent symptoms.
- Multiple SARS-CoV-2 infections are a significant risk factor for long COVID.
- COVID-19 vaccination and prior infection with specific variants confer protection against developing long COVID.
Objective:
To determine risk factors for the development of long coronavirus disease 2019 (COVID-19) in healthcare personnel (HCP).
Methods:
We conducted a case-control study among HCP who had confirmed symptomatic COVID-19 working in a Brazilian healthcare system between March 1, 2020, and July 15, 2022. Cases were defined as those having long COVID according to the Centers for Disease Control and Prevention definition. Controls were defined as HCP who had documented COVID-19 but did not develop long COVID. Multiple logistic regression was used to assess the association between exposure variables and long COVID during 180 days of follow-up.
Results:
Of 7,051 HCP diagnosed with COVID-19, 1,933 (27.4%) who developed long COVID were compared to 5,118 (72.6%) who did not. The majority of those with long COVID (51.8%) had 3 or more symptoms. Factors associated with the development of long COVID were female sex (OR, 1.21; 95% CI, 1.05-1.39), age (OR, 1.01; 95% CI, 1.00-1.02), and 2 or more SARS-CoV-2 infections (OR, 1.27; 95% CI, 1.07-1.50). Those infected with the SARS-CoV-2 δ (delta) variant (OR, 0.30; 95% CI, 0.17-0.50) or the SARS-CoV-2 o (omicron) variant (OR, 0.49; 95% CI, 0.30-0.78), and those receiving 4 COVID-19 vaccine doses prior to infection (OR, 0.05; 95% CI, 0.01-0.19) were significantly less likely to develop long COVID.
Conclusions:
Long COVID can be prevalent among HCP. Acquiring >1 SARS-CoV-2 infection was a major risk factor for long COVID, while maintenance of immunity via vaccination was highly protective.
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