Objective:

To compare 2-year workforce exit among adults with post–COVID-19 condition (PCC), those who recovered from PCC, and those who never reported PCC and to compare absenteeism, presenteeism, work incapacity, and financial strain across these groups.

Approach:

• Study Design: The PRIME post-COVID study is an observational cohort study with retrospective and prospective elements involving adults tested for SARS-CoV-2 in the Netherlands and surveyed in 2022 and 2024.
• Participants: The analysis included 3342 adults who were employed in 2022, had a confirmed or self-reported positive SARS-CoV-2 test, completed the required questionnaires, and had no missing analysis data.

Key Findings:

• Workforce exit by 2024 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).
• Absenteeism and presenteeism were up to 3 times higher with PCC and 2 times higher after recovery compared with never having PCC.
• Among participants who left the workforce, work incapacity was highest with PCC (46%). Financial strain was highest among nonemployed participants with PCC (54%).

Interpretation:

PCC was associated with sustained adverse effects on workforce participation, productivity, work capacity, and financial well-being, including after accounting for other factors associated with workforce exit.

Limitations:

• Productivity measurements covered only the preceding 7 days and may not capture the fluctuating course of PCC.
• Severe PCC, adults with lower digital literacy, and nonparticipants may have been underrepresented; selection bias and PCC misclassification remain possible.

Conclusion:

PCC was associated with greater workforce exit and productivity loss, supporting the need for long-term assistance, workplace accommodations, and targeted interventions.