Functional impact of long Covid on work performance and return to work: a cross-sectional study

Authors

DOI:

https://doi.org/10.11606/s15188787.2026060007097

Keywords:

Post-Acute COVID-19 Syndrome, Functional Status, Work Performance, Return to Work

Abstract

 OBJECTIVE: To evaluate the association between long Covid and socioeconomic, clinical, healthcare, and functional factors with reduced work performance and difficulty returning to work. METHODS: A cross-sectional study of individuals in São Paulo aged ≥ 18 years with long Covid (77.8%), with data collected between April 2023 and June 2024. A systematic random sample of severe and mild Covid-19 cases from March 2020 to January 2022. The severity of Covid-19 was classified according to the U.S. Centers for Disease Control and Prevention (CDC) guidelines. Prevalences were assessed, and a Poisson test was performed to examine the association between reduced work performance and difficulty returning to work and sociodemographic, clinical, healthcare-related, and functional factors considered significant (p ≤ 0.05). Among the participants, 43.9% experienced reduced work performance, and 22.2% had difficulty returning to work. Long Covid is defined as having two or more symptoms that develop and persist for more than four weeks after Covid-19, cannot be explained by an alternative diagnosis, and are assessed using a Likert scale for the intensity of self-reported symptoms (0–10). Participants’ functional status was assessed using scales for basic activities (Katz), instrumental activities (Lawton), functional limitations (WHO-DAS), and sarcopenia (SARC-F). RESULTS: Poorer work performance was associated with advanced age (PR = 2.20;  95%CI 1.27–3.80), as well as being the primary provider (PR = 1.55; 95%CI 1.05–2.29), and having moderate (OR = 2.99; 95%CI 1.60–5.58) or severe (OR = 4.88; 95%CI 2.59–9.19) functional impairment. For difficulty returning to work, the main association observed was severe functional impairment (OR = 4.33; 95%CI 1.58–11.80). CONCLUSION: It is noteworthy that advanced age and, particularly, severe functional impairment were significantly associated with poorer performance and difficulty returning to work in the studied population with long Covid.

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Published

2026-08-07

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Vol. 60 (2026)

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Original Articles

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Copyright (c) 2026 Fabio Cavalcanti Freitas, Vivian Cintra Sousa, Daniella de Melo, Diêgo Araújo de Moraes Ramos, Gabriela Sayuri Ochiai, Daniel Kolisch, Julia Costa Guimarães, Larissa Gomes da Silva, Erika Christina Gouveia e Silva, José Eduardo Pompeu, Ana Carolina Basso Schmitt

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How to Cite

Freitas, F. C., Sousa, V. C., Melo, D. de, Ramos, D. A. de M., Ochiai, G. S., Kolisch, D., Guimarães, J. C., Silva, L. G. da, Silva, E. C. G. e, Pompeu, J. E., & Schmitt, A. C. B. (2026). Functional impact of long Covid on work performance and return to work: a cross-sectional study. Revista De Saúde Pública, 60, 35. https://doi.org/10.11606/s15188787.2026060007097