Returning to work: a qualitative study of the experiences of head and neck cancer survivors.

BACKGROUND: UK head and neck cancer incidence and prevalence in working-age people are increasing. Work is important for individuals and society. Head and neck cancer survivors return to work less than other cancer survivors. Treatment affects physical and psychological functioning long-term. Evidence is limited, with no UK qualitative studies. METHODS: A qualitative study was conducted, underpinned by a critical realism approach, involving semi-structured interviews with working head and neck cancer survivors. Interviews were conducted using the Microsoft Teams communication platform and interpreted using reflexive thematic analysis. RESULTS: Thirteen head and neck cancer survivors participated. Three themes were drawn from the data: changed meaning of work and identity, return-to-work experiences, and the impact of healthcare professionals on returning to work. Physical, speech and psychosocial changes affected workplace interactions, including stigmatising responses by work colleagues. CONCLUSION: Participants were challenged by returning to work. Work interactions and context influenced return-to-work success. Head and neck cancer survivors want return-to-work conversations within healthcare consultations, but perceived these as absent.

In brief

Research shows that while inhaling gas and air (Entonox) in labour is safe for mothers and babies, long-term cumulative exposure may carry health risks. Work notice The right to strike The UK government's Strikes (Minimum Service Levels) Bill is, at the time of going to press, at the committee stage in the House of Lords (the first chance for line-by-line examination). Visit bit.ly/ Clementine-register Working mums Maternity leave Careers After Babies research has found that of 848 mothers interviewed, 98% want to return to work after having a child but just 13% can make it work full-time, citing the cost of childcare and lack of flexibility from businesses as the reason. Find out more at hegenbergermedical.com/training Research Healthy eating support Researchers at the University of Hertfordshire are calling for better information on diet and nutrition to be made available to expectant parents.

Long COVID-Challenges in diagnosis and managing return-to-work.

OBJECTIVES: Long COVID may be a public health concern resulting in a hidden toll of the pandemic years later, on workers and their work ability in the workforce. We illustrate the challenges in diagnosing long COVID in a patient, its associated psychological impact on work and how return-to-work can be better managed and supported from an occupational health perspective. METHODS: An Occupational Health trainee working as a government public health officer experienced persistent fatigue, decreased effort tolerance, and difficulties in concentration after contracting COVID-19. There were unintended psychological effects arising from the functional limitations that were not explained with a proper diagnosis. This was further complicated with a lack of access to occupational health services for return-to-work. RESULTS: He developed his own rehabilitation plan to improve his physical tolerance. Progressive efforts to build up his physical fitness complemented with workplace adjustments helped to overcome his functional limitations and allowed him to effectively return-to-work. CONCLUSION: Diagnosing long COVID continues to remain challenging due to a lack of consensus on a definitive diagnostic criterion. This may give rise to unintended mental and psychological impact. Workers with long COVID symptoms can return-to-work, involving a complex individualized approach to the symptoms' impact on work, and workplace adjustments and job modifications available. The psychological toll on the worker must also be addressed. Occupational health professionals are best placed to facilitate these workers in their journey to return-to-work, with multi-disciplinary delivery models providing return to work services.

Experiences of workers with post-COVID-19 symptoms can signpost suitable workplace accommodations

Purpose: The prevalence and multi-system nature of post-COVID-19 symptoms warrants clearer understanding of their work ability implications within the working age population. An exploratory survey was undertaken to provide empirical evidence of the work-relevant experiences of workers recovering from COVID-19. Design/methodology/approach: A bespoke online survey based on a biopsychosocial framework ran between December 2020 and February 2021. It collected quantitative ratings of work ability and return-to-work status, qualitative responses about return-to-work experiences, obstacles and recommendations, along with views on employer benefits for making accommodations. A sample of 145 UK workers recovering from COVID-19 was recruited via social media, professional networks and industry contacts. Qualitative data was subject to thematic analysis. Participants were mainly from health/social care (50%) and educational settings (14%). Findings: Just over 90% indicated that they had experienced at least some post-COVID-19 symptoms, notably fatigue and cognitive effects. For 55%, symptoms lasted longer than six months. Only 15% had managed a full return-to-work. Of the 88 who provided workability ratings, just 13 and 18% respectively rated their physical and mental workability as good or very good. Difficulties in resuming work were attributed to symptom unpredictability, their interaction with job demands, managing symptoms and demands in parallel, unhelpful attitudes and expectations. Manager and peer support was reported as variable. Originality/value: Workplace health management characterised by flexible long-term collaborative return-to-work planning, supported by more COVID-centric absence policies and organisational cultures, appear pivotal for sustaining the return-to-work of the large segments of the global workforce affected by post-COVID-19 symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Profile of healthcare workers who contracted COVID-19 after vaccination against SARS-CoV-2

Introduction: Being at high-risk for COVID-19, healthcare workers (HCW) were prioritized in the beginning of vaccination campaigns in Tunisia. The emergence of several variants raises the issue of resistance and postvaccination infection. Aim(s): To study epidemiological and clinical characteristics of COVID-19 infection in HCW who previously had COVID19 vaccine. Method(s): Retrospective descriptive study focusing on Rabta hospital's HCW who presented themselves for a reinstatement visit after post-vaccination COVID-19 infection, from 15 March to 31 December 2021. Result(s): There were 122 HCW with a mean age of 42.8 years, a sex ratio of 0.5, and an average professional seniority of 13.8 years. 32% worked full-time in COVID-19 wards and13.1% had a history of COVID-19 before vaccination. Half had received two doses of vaccine. They were vaccinated mainly with mRNA (66.4%), viral vector (19.9%) or attenuated virus (12.3%). Symptoms appeared, on average, 35 days after the last dose of vaccine and the disease was confirmed by RT-PCR after 3 days of the symptom's onset. The main symptoms described were asthenia (66.4%), cough (66.4%), headache (62.3%), anosmia (64.8%), ageusia (55.7%), fever (52.2%), diarrhea (40.2%) ans dyspnea (21.3%). They were mainly put on symptomatic treatment and home rest for 11 days. However, 15% had an extension of their sick-leave and 2.5% presented a severe form requiring hospitalization. On return to work, 59.8% reported the persistence of symptoms including cough (18.9%), asthenia (11.5%), dyspnea (9.8%), anosmia and ageusia (7.4%). Conclusion(s): Vaccinated HCW presented mainly a mild form of COVID-19. Vaccination is an important and promising means to end this pandemic.

Respiratory symptomatology of Covid-19 in healthcare workers

Introduction: Health personnel are particularly exposed to the risk of contamination by SARS-CoV2. Various symptoms, particularly respiratory, have been described in this population. Objective(s): Determine the socio-professional, clinical and paraclinical characteristics of healthcare workers with Covid-19. Method(s): Descriptive cross-sectional study with health staff at Rabta hospital, suffering from Covid-19. The information was collected using a questionnaire administered by the doctor during the return to work consultation. Result(s): Our population included 418 health workers and was predominantly female (75.4%) with an average age of 41.5 +/- 10.5 years. They belonged to medical services in 40.1% of cases and held the position of nurse in 33.7% of cases. Contamination was intra-hospital in 45.7% of cases. A history of allergic asthma was noted in 7.4% of health workers. Respiratory symptoms were present in 63.9% of cases, mainly consisting of cough (45.9%) and dyspnea (28.9%). It was a moderate form in 24.2% of cases. A chest computed tomography was performed in 10.3% of cases, objectifying interstitial lung disease in 49% of cases. Hospitalization was necessary for 5.7% of staff with an average duration of 7.9 days. It was significantly related to the presence of respiratory signs (p<=10-3). On returning to work, 14.6% of affected personnel reported the persistence of exertional dyspnea. Conclusion(s): The respiratory signs of Covid-19, dominated by cough and dyspnea, were widely represented in our population and statistically associated with the need for hospitalization.

Data-Driven COVID-19 Vaccine Development for Janssen

The COVID-19 pandemic has spurred extensive vaccine research worldwide. One crucial part of vaccine development is the phase III clinical trial that assesses the vaccine for safety and efficacy in the prevention of COVID-19. In this work, we enumerate the first successful implementation of using machine learning models to accelerate phase III vaccine trials, working with the single-dose Johnson & Johnson vaccine to predictively select trial sites with naturally high incidence rates ("hotspots"). We develop DELPHI, a novel, accurate, policy-driven machine learning model that serves as the basis of our predictions. During the second half of 2020, the DELPHI-driven site selection identified hotspots with more than 90% accuracy, shortened trial duration by six to eight weeks (approximately 33%), and reduced enrollment by 15,000 (approximately 25%). In turn, this accelerated time to market enabled Janssen's vaccine to receive its emergency use authorization and realize its public health impact earlier than expected. Several geographies identified by DELPHI have since been the first areas to report variants of concern (e.g., Omicron in South Africa), and thus DELPHI's choice of these areas also produced early data on how the vaccine responds to new threats. Johnson & Johnson has also implemented a similar approach across its business including supporting trial site selection for other vaccine programs, modeling surgical procedure demand for its Medical Device unit, and providing guidance on return-to-work programs for its 130,000 employees. Continued application of this methodology can help shorten clinical development and change the economics of drug development by reducing the level of risk and cost associated with investing in novel therapies. This will allow Johnson & Johnson and others to enable more effective delivery of medicines to patients.

Recuperacion laboral, clinica y funcional a 3 meses del alta en pacientes hospitalizados por neumonia por SARSCoV2. Relacion con la terapia recibida

Introduction: The SARS-CoV 2 pandemic has brought a high burden of disease. Its long-term repercussions are still under investigation. The objective of this report was to evaluate the occupational, clinical, and functional respiratory recovery at 3 months of patients hospitalized for COVID-19, related to the ventilatory therapy received. Material(s) and Method(s): Prospective cohort of 116 patients from the Hospital Naval Almirante Nef de Vina del Mar, Chile, with clinical and functional respiratory follow-up at 3 months. Result(s): Median follow-up 100 days. 75 men, Median age 60 years, 50% obese, 34.5% smokers and 13.8% with respiratory comorbidity. 16% had undergo rehabilitation. Dyspnea in 73.7% and fatigue in 50%. Only 54.8% returned to work. 65% who used oxygen therapy (O2) returned to work compared to 44% who used HFNC and 33.3% IMV. Return to normal life achieved was greater in the O2 group compared with HFNC group and IMV group (71.4% versus 17.5% and 11.1%). Pulmonary function tests were normal in 39 patients (33.6%). Normal DLCO and normal distance walked in 6 minutes were higher in the group that return to work. The HNFC group had an OR of 5.9 of DLCO alterations, while VMI group had an OR of 3.6 in relation to the group that received O2. Discussion(s): This cohort repeats risk factors and persistence of symptoms described in literature. DLCO alteration was the most frequently founding and to a greater extent than other reports. Conclusion(s): At 3 months of follow-up, work absenteeism, persistence of symptoms and respiratory functional alteration were frequently evidenced, especially in those who received ventilatory support.

Examining Risk Factors Related to Cardiac Rehabilitation Cessation among Heart Transplant Recipients

Background Cardiac rehabilitation (CR) has shown clinical benefit in heart transplant (HT) recipients. However, variable adherence with CR has been reported. We aimed to describe adherence and factors associated with CR cessation. Methods We performed a retrospective chart review of HT recipients who attended at least one CR session at a tertiary medical center (2013-2021). Complete adherence was defined as participation in all 36 CR sessions. We extracted participant age, sex, race, BMI, diabetes, creatinine clearance, post-operative complications (reoperation, major bleeding, infection, or need for dialysis), hospital length of stay, and METs on baseline exercise tolerance test prior to CR. We computed the proportion of HT recipients who did not complete CR, and then compared their characteristics to those of HT recipients with complete adherence using Kruskal Wallis tests and Fisher's Exact tests for continuous and categorical variables, respectively. Primary reasons for cessation were extracted from the electronic health record. Results There were 55 HT recipients (median age 55.9 years, 67.3% male) who attended CR;25 (45.5%) had complete adherence. Thirty did not complete CR (14 patients attended 1-12 sessions, 12 patients attended 13-24 sessions, and 4 patients attended 25-35 sessions) and participated in a median of 13 sessions (IQR 9-21). Within this group, 46.7% reported medical reasons for cessation, 20.0% for personal reasons, 13.3% for COVID-19 pandemic, 6.7% for insurance expense, 3.3% for relocation, and 3.3% for return to work or school. Patients who did not complete CR experienced more post-operative complications after HT (63.3% vs 32.0%, p = 0.03) but there were no other differences in characteristics between groups. Conclusion Nearly half of HT recipients in our sample had complete adherence to CR. Among those who did not complete CR, medical reasons were most commonly cited. Postoperative complications predicted CR cessation, but there were no other differences between groups, albeit with a relatively small sample size.Copyright © 2023 American College of Cardiology Foundation

Long-term impact of covid-19: a systematic review of the literature and meta-analysis

The long-term impact of COVID-19 is still unknown. This study aimed to explore post COVID-19 effects on patients chest computed tomography (CT), lung function, respiratory symptoms, fatigue, functional capacity, health-related quality of life (HRQoL), and the ability to return to work beyond 3 months post infection. Method(s): A systematic search was performed on PubMed, Web of Science, and Ovid MEDLINE on 22 May 2021, to identify studies that reported persistent effects of COVID-19 beyond 3 months. Data on the proportion of patients who had the outcome were collected and analyzed using a one-group meta-analysis. Result(s): Data were extracted from 24 articles that presented information on a total of 5323 adults, post-infection, between 3 to 6 months after symptom onset or hospital discharge. The pooled prevalence of CT abnormalities was 59% (95% CI 44-73, I2 = 96%), abnormal lung function was 39% (95% CI 24-55, I2 = 94%), fatigue was 38% (95% CI 27-49, I2 = 98%), dyspnea was 32% (95% CI 24-40, I2 = 98%), chest paint/tightness was 16% (95% CI 12-21, I2 = 94%), and cough was 13%, (95% CI 9-17, I2 = 94%). Decreased functional capacity and HRQoL were found in 36% (95% CI 22-49, I2 = 97%) and 52% (95% CI 33-71, I2 = 94%), respectively. On average, 8 out of 10 of the patients had returned to work or reported no work impairment. Conclusion(s): Post-COVID-19 patients may experience persistent respiratory symptoms, fatigue, decreased functional capacity and decreased quality of life up to 6 months after infection. Further studies are needed to establish the extent to which post-COVID-19 effects continue beyond 6 months, how they interact with each other, and to clarify their causes and effective management.

Facilitating Factors and Barriers in the Return to Work of Working Women Survivors of Breast Cancer: A Qualitative Study.

Several studies have identified the main barriers and facilitators that breast cancer survivors experience in the return to work (RTW). The authors conducted a qualitative study using focus group discussions with a group of female non-metastatic breast cancer survivors (n = 6), a group of health professionals from different medical specialties (n = 8), and a third group of company managers mainly composed of human resources managers (n = 7). The study was carried out between March and December 2021 in Zaragoza (Spain). Transcripts were analyzed using inductive content analysis to identify work-related barriers and facilitators and coded by the research team. Barriers identified included physical and cognitive symptoms, psychosocial problems, lack of knowledge and coordination (health professional, patients, and managers), legal vacuum, physical change, time constraints, work characteristics (lower skilled jobs), unsupportive supervisors and coworkers, family problems and self-demand. Facilitators included family and work support, physical activity and rehabilitation, personalized attention, interdisciplinary collaboration, legal advice for workers, knowledge about breast cancer in companies, positive aspects of work, elaboration of protocols for RTW in women with breast cancer. RTW in working women with breast cancer requires a personalized and holistic view that includes the perspectives of patients, healthcare professionals and company managers.

When Should Healthcare Workers With Coronavirus Disease 2019 (COVID-19) Return to Work? An Analysis of Follow-up Antigen Test Results After a Positive COVID Test.

A high percentage of healthcare workers (HCWs) who had met the Centers for Disease Control and Prevention criteria for returning to work 5 days after symptom onset remained positive for their return-to-work COVID-19 antigen test, suggesting continued infectiousness. Boosted HCWs were more likely to be antigen positive on their return-to-work test compared to unvaccinated HCWs, which merits further research.

Uncovering the Experience: Return to Work of Nurses After Parental Leave.

INTRODUCTION: To understand the experiences of emergency nurses who have returned to work after parental leave, specifically relating to the return to work transition, work-life balance, work engagement, and opportunities to continue human milk expression. METHODS: Nurses (N = 19) were recruited from 5 emergency departments within 1 hospital system in the United States Midwest. Nurses (n = 11) were eligible to participate in a one-on-one interview if they had returned from parental leave within 6 months of the interview date. Nurses (n = 8) were eligible to participate in a focus group if they had returned from parental leave within 2 years of the interview date. Interviews were structured and data collection concluded when researchers believed data saturation was reached. Interviews were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke's qualitative thematic analysis 6-phase framework. RESULTS: Three major themes from the data were identified: (1) work engagement, (2) lactation, and (3) childcare. Work engagement was broken down into the subthemes: lack of communication, perceived engagement expectations, and actual engagement. Lactation was broken down into the subthemes: the act of pumping, lactation breaks, and lactation rooms. The coronavirus disease 2019 pandemic impact on return-to-work is described under each major theme. DISCUSSION: Our findings provide insight into the unique challenges and experiences of nurses navigating parental leave and return-to-work in the emergency department. Strategies such as provision of managerial check-ins, return to work reorientation, lactation break coverage, enhanced supplementary lactation support, and leadership-provided accommodation may lighten the burden of these challenges and improve the returning nurse's job satisfaction.

An early return-to-work program for COVID-19 close contacts in healthcare during the Omicron wave in Japan

During the coronavirus disease 2019 (COVID-19) pandemic, maintaining adequate staffing in healthcare facilities is important to provide a safe work environment for healthcare workers (HCWs). Japan's early return-to-work (RTW) program may be a rational strategy at a time when there is an increased demand for the services of HCWs. We assessed whether the early RTW program for HCWs who have been in close contact with a COVID-19 case in our hospital was justified. Close contacts were identified according to the guidance document of the World Health Organization. HCWs who met all of the following conditions were eligible to apply to an early RTW program: (1) difficult to replace with another HCW, (2) received the third dose of a COVID-19 mRNA vaccine, (3) a negative COVID-19 antigen test before each work shift, and (4) consent from relevant HCWs and their managers to participate in the program. Between January and March 2022, 256 HCWs were identified as close contacts (median age, 35 years;192 female). Thirty-seven (14%) secondary attack cases of COVID-19 were detected. Among 141 HCWs (55%) who applied to the early RTW program, nurses and physicians comprised about three-quarters of participants, with a higher participation rate by physicians (78%) than nurses (59%). Eighteen HCWs tested positive for COVID-19 by the sixth day after starting the early RTW program. No COVID-19 infection clusters were reported during the observation period. These findings suggest that the early RTW program for COVID-19 close contacts was a reasonable strategy for HCWs during the Omicron wave. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

Analysis of the Return to Work Program for Disabled Workers during the Pandemic COVID-19 Using the Quality of Life and Work Ability Index: Cross-Sectional Study.

BACKGROUND: Occupational accidents are rising, but there is little evidence on the outcomes of patients who received case management during Return to work (RTW) programs. This study examined the case management-based on RTW program features that improve the work ability index (WAI) and quality of life (QoL). METHODS: This cross-sectional research involved 230 disabled workers due to an occupational injury in Indonesia, 154 participated in RTW, and 75 did not participate in RTW (non-RTW) during the COVID-19 pandemic. Sociodemographic and occupational factors were used to examine the RTW results. We used the Finnish Institute of Occupational Health's WAI questionnaires to measure the work ability index and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) for quality of life. RESULTS: The study found a statistically significant difference in working duration and preferred treatment for RTW between the groups (p-value = 0.039). Furthermore, the quality of life in the domain of environmental health and work ability index score also demonstrated a significant difference between the groups (p-value = 0.023 and 0.000, respectively). CONCLUSIONS: During the COVID-19 pandemic, this study found that the RTW program improved the quality of life and work abilities of disabled workers.

Impact of pre-pandemic sick leave diagnoses on the length of COVID-19-related sick leave: a nationwide registry-based study.

BACKGROUND: The COVID-19 pandemic has caused difficulties and changes in many aspects of people's health and lives. Although infection affected work capacity, during the first wave policies for sick leave due to COVID-19 were unclear. The aim of this study was to investigate the impact of sick leave diagnoses in the year before the COVID-19 diagnosis  on sick leave duration due to COVID-19 in a nationwide non-hospitalised population. METHODS: Data from three Swedish registries were analysed for sick leave commencing between 1 March and 31 August 2020, with a follow-up period of 4 months. Sick leave due to COVID-19 was considered the number of days that sickness benefits were used and included at least one registered COVID-19 diagnosis. Sick leave in the year before COVID-19 diagnosis were categorised into five diagnostic groups and one reference group (participants without prior sick leave). RESULTS: The study comprised 8935 individuals who received sickness benefits due to COVID-19 in Sweden during the first pandemic wave (mean age 46.7 years, 67% females, and 24% had diagnoses for sick leave in the year before COVID-19 diagnosis). The duration of sick leave due to COVID-19 was significantly higher in the groups with prior sick leave owing to musculoskeletal system diseases (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.01-1.15); respiratory system diseases (OR: 1.22, 95% CI: 1.14-1.31); all other isolated diagnoses (OR: 1.08, 95% CI: 1.03-1.14); and multiple diagnoses (OR: 1.32, 95% CI: 1.21-1.43). CONCLUSIONS: The results of this nationwide registry-based study indicate that individuals with premorbid conditions are more prone to longer sick leave durations due to COVID-19. Prediction of sick leave duration during the first wave of the COVID-19 pandemic is complex and several factors played a role.

Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, rehabilitation facilities have become less accessible for patients with a stroke. Lack of early, intensive rehabilitation misses the opportunity for recovery during the critical time window of endogenous plasticity and improvement post-stroke. OBJECTIVES: The purpose of this commentary was to highlighting the benefits of telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic. METHODS: Relevant publications regarding the management of individuals with a stroke, telerehabilitation and teleworking in the setting of COVID-19 were reviewed. RESULTS: Previous studies showed that telerehabilitation can effectively provide an alternate method of promoting recovery for patients with a stroke. With the physical distancing precautions in place for mitigating viral spread, teleworking can also provide a method for long term recovery and improvements in quality of life after a stroke. CONCLUSIONS: Overall, this commentary addresses the benefits of physically distant, safe and effective alternatives to support individuals who live with a stroke during COVID-19 pandemic.

SARS-CoV-2 Infection Incidence Following Exposure Assessments for Healthcare Workers

Background. Although healthcare worker (HCW) absenteeism due to COVID-19 exposure represents a significant challenge, there are currently no evidence-based criteria for assessing infection risk based on COVID-19 exposure type.We aimed to identify the incidence of acquiring infection following varying exposures to COVID-19 to guide safe return-to-work policies for staff in healthcare settings. Methods. We analyzed prospectively collected data at an academic centre with approximately 17 000 active staff between January 1 - April 30, 2022 during a large BA.1 Omicron surge. More than 99% of staff received >2 vaccine doses. All staff selfreporting household, community, and workplace exposure to confirmed cases of COVID-19 submitted attestation to the Occupational Health department detailing the nature of the exposure, the duration, and setting. Staff were required to report all positive test results by rapid antigen or PCR testing. Results. A total of 3209 staff submitted exposure reports (2493 household, 539 community, and 177 workplace). Of these, 1008 (31.4%) tested positive 2 days prior to or 14 days after the exposure (36% household;19% community, 7% workplace). In the community exposure group, 19% tested positive due to a discrete exposure of < 4 hours and 21% tested positive with an exposure >4 hours. For household exposures and workplace exposures, these values were 25%/27% and 6%/10%, respectively (Figure 1). The median time to testing positive was 2 days for household exposures and 3 days for community and workplace exposures (Figure 2, Panels A-C). By day 4 post-exposure, more than 80% of positive results were reported (Figure 2, Panel D). Risk of testing positive differed based on baseline symptom status at the time of reporting (Table 1). The risk of infection amongst healthcare workers reporting exposures, according to their symptom status at the time of reporting their exposures. Conclusion. Our data suggests that the highest risk of acquiring SARS-CoV-2 was via household contacts, regardless of exposure duration, with workplace exposures carrying less risk. Using a cut-off of 4 hours for exposure duration to delineate risk may be of limited value. These data could help workplaces predict infection risk following exposure and guide return-to-work policies that balance the need to staff workplaces, including hospitals, with reducing risk of on-site transmission during periods of increased community transmission (Figure 3). (Figure Presented).

The High Incidence of Long-COVID-19 in Kidney Transplant Recipients: A Longitudinal Cohort Study

Purpose: This study aimed to investigate the clinical consequences at 3 months after symptom onset among kidney transplant recipients surviving COVID-19. Method(s): This is an ongoing single-center observational prospective study including adult kidney transplant recipients who were diagnosed and survived after COVID-19 between 03/20/2020 and 05/31/2021. Patients who lost their graft were excluded. The patients are scheduled to receive a telephone contact at 3 months after symptom onset from the clinical research team. The call consisted of a structured questionnaire of symptoms with binary answers (yes or no). The questionnaire included the following symptoms: headache, dizziness, anosmia/ageusia, weakness, myalgia, inappetence, diarrhea, and dyspnea, which could be presented before and/or after the COVID-19 diagnosis. Those patients with at least one symptom presented only after the disease, were defined as having Long-COVID-19. Subsequently, the clinical research team included a question about the work status. Adjusted multivariable logistic regression models were used to identify the risk factors associated with Long-COVID-19. Result(s): There were 1,731 patients with COVID-19, with 455 deaths and 36 graft losses. Of the remaining 1,240 patients, 454 (36%) didn't answer our calls, yielding a final cohort of 786 patients. Of them, 217 (28%) developed Long-COVID-19. The incidence of each symptom at 3 months was: dyspnea (7%), myalgia (12%), weakness (11%), headache (10%), dizziness (7%), diarrhea (4%), inappetence (4%) and anosmia/ageusia (3%). About 1% of our patients needed domiciliary O2. Of those who we obtained the working status (n=239), 95 (40%) were employed before COVID-19 and 79 of them (83%) had returned to their original work at 3 months. After COVID-19 diagnosis, 44% of the patients were hospitalized (31% in ICU), 35% used supplemental O2, and 5% required mechanical ventilation. Fever (53%), shiver (39%), nausea (3%), anosmia/ageusia (59%), hospitalization (67%), and adverse cardiovascular events (3%), such as thrombosis or myocardial infarction, were risk factors associated with subsequent development of Long-COVID-19, using adjusted multivariable logistic regression. Conclusion(s): The incidence of Long-COVID-19 at 3 months was 28% and was associated with reduced quality of life and return to work. Several COVID-19 associated symptoms and disease severity markers were associated with Long- COVID-19.