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1.
Aerosp Med Hum Perform ; 92(12): 962-969, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1608328

ABSTRACT

BACKGROUND: Knowledge of the clinical course and consequences of COVID-19 initially evolved in the context of severe presentations and among those with comorbidities. However, understanding the outcomes of milder infections in healthy individuals is important for safe return-to-duty in extreme environments or to occupations requiring significant fitness. We reviewed the literature to characterize the nature and timing of persistent and emergent clinical sequelae in milder COVID-19 cases to facilitate development of post-COVID-19 screening and surveillance protocols.METHODS: We searched databases including EMBASE, MEDLINE, Cochrane COVID-19 study register, gray literature, clinical trial registries, and relevant health and disease prevention sources for publications from 2019 to February 18th, 2021, documenting COVID-19 sequelae. Articles were included if the COVID-19 severity was mild and there were no, or only minor, pre-existing comorbidities. Persistent and emergent sequelae were then stratified based on time since diagnosis.RESULTS: Among those with mild COVID-19, sequelae were shown to emerge or persist for months following presumed recovery. Among those with no comorbidities, cardiac, hematological, and respiratory sequelae emerged after 1-2 mo, and primarily cardiac abnormalities persisted at ≥ 3 mo. Among those with minor comorbidities, persistent respiratory abnormalities, fatigue, dyspnea, and headache were common, and mental health symptoms emerged by 1-2 mo postinfection.DISCUSSION: After presumed recovery from mild COVID-19, a range of symptoms can persist and later emerge. Whether these are new or previously unrecognized is unclear. Under-recognized COVID-19 sequelae may increase the risk of subtle or sudden incapacitation and have implications for return-to-work (RTW) screening and surveillance for safety-critical roles.Tucci V, Saary J. Persistent and emergent clinical sequelae of mild COVID-19. Aerosp Med Hum Perform. 2021; 92(12):962-969.


Subject(s)
COVID-19 , Disease Progression , Dyspnea , Humans , Return to Work , SARS-CoV-2
2.
Crit Care ; 25(1): 382, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1506095

ABSTRACT

BACKGROUND: There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months. METHODS: In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM. RESULTS: Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51-70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06-13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, - 0.19 [- 0.28 to - 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty. CONCLUSIONS: At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020.


Subject(s)
COVID-19/epidemiology , Critical Illness/epidemiology , Disabled Persons , Recovery of Function/physiology , Return to Work/trends , Aged , Aged, 80 and over , Australia/epidemiology , COVID-19/diagnosis , COVID-19/therapy , Cohort Studies , Critical Illness/therapy , Female , Follow-Up Studies , Health Status , Humans , Male , Middle Aged , Mortality/trends , Prospective Studies , Time Factors , Treatment Outcome
3.
Occup Med (Lond) ; 71(3): 162-163, 2021 06 16.
Article in English | MEDLINE | ID: covidwho-1493900
4.
J Occup Environ Med ; 63(11): 970-974, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1480010

ABSTRACT

OBJECTIVE: To investigate whether HCWs return to work (RTW) after COVID-19 was associated with time to a negative viral detection test. METHODS: To evaluate the association of RTW with an undetectable RT-PCR adjusting for different factors. RESULTS: Three hundred seventy-five HCWs who required medical leave for COVID-19 at a hospital in Madrid. Multivariable analyses confirmed the association of delayed RTW with interval to negative PCR (ORadj 1.12, 95% CI 1.08, 1.17) as well as age, sex, and nursing staff and clinical support services compared to physicians. A predictive model based on those variables is proposed, which had an area under the receiver operating curve of 0.82. CONCLUSIONS: Delayed RTW was associated with longer interval to a negative RT-PCR after symptom onset, adjusting for occupational category, age, and sex.


Subject(s)
COVID-19 , SARS-CoV-2 , Health Personnel , Humans , Polymerase Chain Reaction , Return to Work
5.
Crit Care Med ; 49(11): e1157-e1162, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1467424

ABSTRACT

OBJECTIVES: Joblessness is common in survivors from critical care. Our aim was to describe rates of return to work versus unemployment following coronavirus disease 2019 acute respiratory distress syndrome requiring intensive care admission. DESIGN: Single-center, prospective case series. SETTING: Critical Care Follow-Up Clinic, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy. PATIENTS: One hundred and one consecutive laboratory-confirmed coronavirus disease 2019 patients were discharged from our hospital following an ICU stay between March 1, 2020, and June 30, 2020. Twenty-five died in the ICU. Seventy-six were discharged alive from hospital. Two patients refused participation, while three were unreachable. The remaining 71 were alive at 6 months and interviewed. INTERVENTIONS: Baseline and outcome healthcare data were extracted from the electronic patient records. Employment data were collected using a previously published structured interview instrument that included current and previous employment status, hours worked per week, and timing of return to work. Health-related quality of life status was assessed using the Italian EQ-5D-5L questionnaire. MEASUREMENTS AND MAIN RESULTS: Of the 71 interviewed patients, 45 (63%) were employed prior to coronavirus disease 2019, of which 40 (89%) of them worked full-time. Thirty-three (73%) of the previously employed survivors had returned to work by 6 months, 10 (22%) were unemployed, and 2 (5%) were newly retired. Among those who returned to work, 20 (85%) of them reported reduced effectiveness at work. Those who did not return to work were either still on sick leave or lost their job as a consequence of coronavirus disease 2019. Reported quality of life of survivors not returning to work was worse than of those returning to work. CONCLUSIONS: The majority of coronavirus disease 2019 survivors following ICU in our cohort had returned to work by 6 months of follow-up. However, most of them reported reduced work effectiveness. Prolonged sick leave and unemployment were common findings in those not returning.


Subject(s)
COVID-19/epidemiology , Critical Care/statistics & numerical data , Respiratory Distress Syndrome/epidemiology , Return to Work/statistics & numerical data , Unemployment/statistics & numerical data , Age Factors , Aged , Comorbidity , Female , Frailty/epidemiology , Humans , Length of Stay , Male , Middle Aged , Patient Discharge/statistics & numerical data , Quality of Life , Retirement/statistics & numerical data , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Socioeconomic Factors
7.
Int Marit Health ; 72(3): 223-227, 2021.
Article in English | MEDLINE | ID: covidwho-1450927

ABSTRACT

Since the global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of a coronavirus disease 2019 (COVID-19) infection started, millions of people globally have become infected. It must not be forgotten that thousands of those affected are commercial or recreational divers. A severe COVID-19 seriously affects the respiratory system and the pulmonary parenchyma but it may also involve the cardiovascular and the blood coagulation system. For this reason, many divers and hyperbaric medicine specialists are becoming increasingly concerned about a diver's ability to safely return to diving after a SARS-CoV-2 infection. The article presents current guidelines for diving fitness health assessment after a COVID-19 both for active and prospective divers, with particular emphasis on the types of diagnostic procedures and tests to be performed in cases of asymptomatic infection with SARS-CoV-2 as well as in patients who have recovered from a symptomatic COVID-19.


Subject(s)
COVID-19/complications , Diving/standards , Return to Work , Guidelines as Topic , Humans , SARS-CoV-2
8.
Front Public Health ; 9: 722604, 2021.
Article in English | MEDLINE | ID: covidwho-1450847

ABSTRACT

Objective: The objective of this study was to investigate how knowledge and practice of coronavirus disease 2019 (COVID-19) prevention measures affected concerns about returning to work among supermarket staff. Attitudes about the ability of traditional Chinese medicine (TCM) to prevent COVID-19 were also assessed. Methods: A cross-sectional study was conducted in Huanggang, Hubei Province, China from April 23 to 25, 2020. Participants were invited to fill out an electronic questionnaire on their cell phones. Results: The results showed that from 2,309 valid questionnaires, 61.5% of participants were concerned about resuming work. Major concerns included asymptomatic infection (85.01%) and employees gathering in the workplace (78.96%). Multivariate logistic regression indicated that the female gender, having school-aged children and pregnancy were risk factors for being concerned about resuming work, while good knowledge and practice of preventive measures were protective factors. Knowledge and practice of preventive measures were positively correlated. Among preventive measures, the highest percentage of participants knew about wearing masks and washing hands. Meanwhile, 65.8% of participants expressed confidence in the ability of TCM to prevent COVID-19, where 74 and 51.3% thought there was a need and a strong need, respectively, for preventive TCM-based products. Among them, 71.5% preferred oral granules. Regarding TCM as a COVID-19 preventative, most were interested in information about safety and efficacy. Conclusion: These findings suggested that promoting knowledge and practices regarding COVID-19 prevention can help alleviate concerns about returning to work. Meanwhile, TCM can feasibly be accepted to diversify COVID-19 prevention methods. Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2000031955.


Subject(s)
COVID-19 , Medicine, Chinese Traditional , Attitude , Child , China/epidemiology , Cross-Sectional Studies , Female , Humans , Return to Work , SARS-CoV-2 , Supermarkets , Surveys and Questionnaires
12.
Infect Control Hosp Epidemiol ; 42(9): 1166-1167, 2021 09.
Article in English | MEDLINE | ID: covidwho-1428653
13.
Ann Biol Clin (Paris) ; 79(4): 325-330, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1412311

ABSTRACT

Health care workers (HCWs) are at major risk to be infected by SARS-CoV-2 and transmit the virus to the patients. Furthermore, travels are a major factor in the diffusion of the virus. We report our experience regarding the screening of asymptomatic HCWs returning from holidays, following the issue of a national guideline on 08/20/2020. The organization of the occupational health department and the clinical laboratory was adapted in order to start the screening on August, 24, 2020. All HCWs tested for SARS-CoV-2 the week before and 4 weeks after the implementation of the screening were included. The mean number of tests was analyzed per working day and working week. Overall, 502 (31.4%) HCWs were tested for SARS-CoV-2 during the study period. The mean number of HCWs tested per working day was 27.1. HCWs accounted for 36.9% (n = 167) and 11.2% (n = 84) of the tests performed in the 1st and the 4th week following the implementation of the guidelines. The number of tests performed each week in HCWs increased by at least 20-fold after the implementation of the guidelines. No asymptomatic HCW was tested positive. Screening of asymptomatic HCWs was poorly effective in the context of low circulation of the virus. We suggest giving priority to infection prevention and control measures and screening of symptomatic subjects and asymptomatic contacts.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Health Personnel , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/standards , Cross Infection/prevention & control , France/epidemiology , Guideline Adherence/organization & administration , Guideline Adherence/standards , Guideline Adherence/statistics & numerical data , Health Personnel/statistics & numerical data , Hospitals, General , Humans , Implementation Science , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Mass Screening/methods , Mass Screening/organization & administration , Mass Screening/standards , Occupational Health Services/organization & administration , Occupational Health Services/standards , Occupational Health Services/statistics & numerical data , Return to Work/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
14.
Salud Publica Mex ; 63(1, ene-feb): 148-149, 2020 Dec 22.
Article in Spanish | MEDLINE | ID: covidwho-1404203

ABSTRACT

[no disponible].


Subject(s)
COVID-19 , Pandemics , Return to Work , Humans , Return to Work/ethics
15.
Salud Publica Mex ; 63(1, ene-feb): 147-148, 2020 Dec 22.
Article in Spanish | MEDLINE | ID: covidwho-1404202

ABSTRACT

[no disponible].


Subject(s)
COVID-19 , Pandemics , Return to Work , Humans
19.
Salud Publica Mex ; 63(1, ene-feb): 136-146, 2020 Dec 22.
Article in Spanish | MEDLINE | ID: covidwho-1310304

ABSTRACT

Objetivo. Establecer criterios médicos de retorno al trabajo en personal con riesgo de complicaciones por Covid-19. Material y métodos. Se realizó una revisión sistemática para identificar las condiciones y las características clínicas que influyen en el riesgo de desarrollar Covid-19 grave. Resultados. Se ha demostrado incremento del riesgo en obesidad, edad >60 años, diabetes mellitus, hipertensión arterial, enfermedad pulmonar obstructiva crónica, enfermedad cardiovascular, enfermedad renal crónica y cáncer. Solamente en diabetes se ha estudiado si el control previo influye. Se proponen condiciones específicas y el nivel de riesgo epidemiológico para el retorno al trabajo. Conclusiones. El retorno laboral de estos grupos debe priorizarse buscando favorecer el control de la enfermedad, identificando el estado de salud que incrementa el riesgo y protegiendo el derecho al trabajo. Se presentan recomendaciones para guiar la reincorporación al trabajo.


Subject(s)
COVID-19/transmission , Return to Work , Age Factors , Asthma/complications , Breast Feeding , COVID-19/prevention & control , Cardiovascular Diseases/complications , Comorbidity , Diabetes Mellitus , Female , HIV Infections/complications , Humans , Hypertension/complications , Middle Aged , Neoplasms/complications , Obesity/complications , Pregnancy , Pulmonary Disease, Chronic Obstructive/complications , Renal Insufficiency, Chronic/complications , Risk Factors
20.
J Occup Environ Med ; 63(3): 199-220, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1307591

ABSTRACT

OBJECTIVE: Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures. METHODS: A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk. RESULTS: The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars. CONCLUSIONS: A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Physicians/standards , Return to Work , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/methods , Guidelines as Topic , Humans , Occupational Health , Review Literature as Topic , Risk Assessment , Risk Factors , SARS-CoV-2 , Workplace/standards
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