1 in 8 patients with long COVID also struggles with unemployment

For some people, symptoms of COVID-19 can persist for more than two months after initial infection. However, although COVID has long been widespread, little is still known about this disease. However, recent research has shown that COVID can affect a person’s ability to work, leading to higher unemployment rates and financial hardship. Knowing how to help unemployed patients struggling with long-lasting COVID symptoms is vital.

Published in JAMA network open, the Association of Post-COVID-19 Condition Symptoms and Employment Status study used data from eight waves of a nonprobability internet and population-based survey in 50 US states of respondents ages 18 to 69, conducted from February 2021 to July was conducted in 2022. Of 15,308 survey participants with test-confirmed COVID-19 at least two months prior, 14.6% reported long-term COVID symptoms. This included 45.9% who reported either brain fog or memory impairment.

Of those with long COVID, 12.3% reported being unemployed, compared to 8.7% with no symptoms. Among those with long-standing COVID symptoms, 45.5% worked full-time, compared to 55.2% who reported not having the condition. This shows that long COVID was associated with a lower likelihood of working full-time and a higher likelihood of being unemployed.

“Unfortunately, as a country, we are so eager to get away from COVID that we tend to forget how many people still have lingering symptoms. And even when you acknowledge that people can still be sick, there is a tendency to minimize those symptoms,” said Roy H. Perlis, MD, MSc, lead author of the study and director of the Center for Quantitative Health at Massachusetts General Hospital in Boston . dr Perlis is also Professor of Psychiatry at Harvard Medical School and Associate Editor of JAMA network open.

“Even when you factor in socio-demographic differences, if you have a long history of COVID you are significantly less likely to work full-time and significantly more likely to be unemployed. Those are important numbers to get out of there,” said Dr. perlis. Also, “we looked specifically at the impact of cognitive symptoms — either brain fog or memory impairment — and found that long-term COVID is associated with a greater risk of functional impairment.”

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“We just can’t lose sight of how many people are still affected by COVID out there,” added Dr. Add Pearls.

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Physicians are “very good at characterizing symptoms … but in the end, it’s this overall burden of those symptoms that patients care about, so physicians should ask about functioning,” said Dr. perlis. “It’s not just about asking if a patient has brain fog, but if it’s stopping them from doing things.”

That can help “make that connection between the symptom and the function,” he said. “Physicians learn this, but this paper reminds me of the importance of linking symptoms to functioning.”

“The other thing is that people may not volunteer to report these symptoms because they may not realize these are long COVID symptoms,” said Dr. Perlis, noting, “I’m still amazed in my clinical practice how many people don’t necessarily have a link between this disease and persistent fatigue, brain fog, and impaired balance or dizziness.”

“For those of us in healthcare, we could make that connection very quickly. Not everyone does that,” he said. “So it’s still important to make sure that when we see people with symptoms like this, we ask about previous COVID and whether those symptoms may have persisted.”

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“Sometimes in primary care it’s easy to focus more on things like shortness of breath or fatigue,” said Dr. perlis. But “it’s really important to ask about both cognitive and psychiatric symptoms.”

“We know that for many people with long COVID, depression and anxiety can be at the forefront,” so it’s important to make sure “doctors don’t forget to ask about brain symptoms with long COVID,” he said. “Long COVID can certainly affect the brain, and this paper suggests that some of these brain symptoms have a real impact on function.”

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