Respiratory symptom patterns in healthcare workers in Germany: a prospective study during the SARS-CoV-2 pandemic

Healthcare professionals (HCPs) faced unique exposure risks during the SARS-CoV-2 pandemic. This study investigated the prevalence and patterns of respiratory symptoms among HCPs, examining potential demographic, occupational, and vaccination-related risk factors during the early pandemic period.

In this prospective observational study, 1,300 HCPs at a German academic medical center completed surveys about respiratory symptoms between March 2020 and April 2024. Participants reported five specific respiratory symptoms (cough, fever, dyspnea, sore throat, and impairment of taste/smell) and rated their intensity. These symptoms were grouped into one variable acute respiratory tract symptoms (ARS). Demographic and occupational data were collected at baseline. Symptom frequencies were compared with national surveillance data, and logistic regression analysis was used to identify potential risk factors.

Episodes of ARS demonstrated seasonality patterns similar to German national surveillance data. Female HCPs reported significantly more frequent and more severe rhinitis and sore throat symptoms, as well as more severe taste and smell impairment than male HCPs (p < 0.05). Participants with ARS were younger than those without. Despite an extremely low rate of laboratory-confirmed SARS-CoV-2 infections within the cohort during the study period (<1%), SARS-CoV-2 vaccination was associated with reduced risk for respiratory symptoms (OR 0.64, 95% CI 0.46-0.90).

Our findings provide insights into respiratory symptom patterns during critical periods of a global pandemic and identify associations that merit further investigation. The protective association of SARS-CoV-2 vaccination with reduced respiratory symptom frequency, combined with seasonal patterns mirroring national trends, may inform occupational health strategies during future respiratory disease outbreaks.