Clinical Scorecard: Impact of Workforce Departure and Productivity Decline in Adults with and without Post-COVID-19 Condition: Insights from the PRIME Post-COVID Cohort Study

At a Glance

Key Highlights

• The analysis included 3342 adults: 790 with PCC, 437 who had recovered from PCC, and 2115 who never reported PCC.

• Over 2 years, workforce exit occurred in 17% of participants with PCC, 10% of those who recovered, and 9% who never reported PCC.

• After adjustment, PCC remained associated with greater odds of workforce exit compared with never having PCC (adjusted odds ratio, 1.38; 95% CI, 1.02-1.86).

• Among employed participants, mean absenteeism was 14% with PCC, 8% after recovery, and 5% among those who never reported PCC.

• Mean presenteeism was 43% with PCC, 23% after recovery, and 13% among those who never reported PCC.

• Among participants who left the workforce, work incapacity was highest with PCC (46%). Financial strain was also highest among nonemployed participants with PCC (54%).

Study-Based Implications

PCC Classification

• PCC status was based on participants’ responses to whether they felt recovered from COVID-19.

• Participants who did not feel recovered in 2024 were classified as having PCC.

• Participants who previously reported not feeling recovered for more than 3 months but subsequently felt recovered were classified as recovered.

• Participants who never reported not feeling recovered were classified as Never PCC.

Management

• The findings support long-term assistance, workplace accommodations, and targeted interventions for people with PCC.

• Medical, occupational, and social support may be particularly important for individuals experiencing work loss or financial strain.

• The study did not evaluate the effectiveness of a specific return-to-work intervention.

Monitoring & Follow-Up

• Follow-up assessments should consider employment status, absenteeism, presenteeism, work incapacity, functional health, and financial strain.

• Postexertional malaise and orthostatic intolerance were associated with workforce exit among participants with PCC.

• Work capacity assessments should account for the persistent and potentially fluctuating effects of PCC.

Risks

• PCC, older age, longer symptom duration, physical or mental health conditions, and poorer functional health were associated with workforce exit.

• Overestimation of functional capacity may complicate access to appropriate disability benefits and workplace support.

• Workforce exit and reduced productivity may contribute to substantial personal, social, and economic burdens.

Participant & Work Data

• All participants were employed at the 2022 assessment and were reevaluated in 2024.

• The mean participant age was 53 years, and 60% were women.

• Approximately 87% had a confirmed polymerase chain reaction test, whereas 13% self-reported a positive test.

• In 2024, 24% had PCC, 13% had recovered, and 63% had never reported PCC.

• The study included no prescribing or treatment-effectiveness data.

Clinical Best Practices

• Integrate medical, occupational, workplace, and social support for people whose PCC affects employment.

• Consider postexertional malaise, orthostatic intolerance, functional health, and comorbid conditions when evaluating work capacity.

• Develop individualized workplace accommodations and reintegration plans that reflect persistent or fluctuating limitations.

• Monitor financial strain, particularly among people with PCC who leave the workforce.

• Interpret the findings with consideration of possible selection bias, PCC misclassification, and underrepresentation of severe PCC and adults with lower digital literacy.

Related Resources & Content

1. Original study: Workforce exit and work productivity loss in adults with and without post-COVID-19 condition

2. World Health Organization. Post COVID-19 condition (long COVID). WHO; 2026.

3. Ottiger M, et al. Work ability and return to work of patients with post-COVID-19: a systematic review and meta-analysis. BMC Public Health. 2024;24:1811.

4. Gottlieb M, et al. Work impairment and financial outcomes among adults with vs without long COVID. JAMA Netw Open. 2025;8:e2526310.

5. Pagen DME, et al. High proportions of postexertional malaise and orthostatic intolerance in people living with post–COVID-19 condition: the PRIME post-COVID study. Front Med (Lausanne). 2023;10:1292446.

6. Pagen DME, et al. Design and recruitment of the PRIME post-COVID cohort study. Front Public Health. 2022;10:1032955.

7. Van Herck M, et al. Impact of post–COVID-19 condition on health status and activities of daily living: the PRIME post-COVID study. Thorax. 2024;79:457-464.