Functional impact of long COVID among healthcare workers with comorbidities in Quebec, Canada: a cross-sectional study

Introduction: Long COVID is a frequent post-infectious chronic condition that impacts quality of life and work performance. Whether individuals with comorbidities experience a greater functional impact of long COVID is unknown. We evaluated the functional impact of long COVID among healthcare workers (HCWs) with chronic cardiovascular diseases, chronic respiratory diseases, obesity or a history of depression, and compared it with that of HCWs without comorbidities. Methods: We conducted a cross-sectional study in Quebec, Canada. We compared self-reported long COVID cases to COVID-19-infected controls without long COVID on work ability, work functioning, health-related absenteeism, dyspnoea-associated impairment and psychological distress among HCWs (a) with at least one of the four comorbidities, (b) with each of the four comorbidities and (c) without comorbidities. We used inverse probability of exposure and robust Poisson regressions to estimate adjusted prevalence differences (aPD) and prevalence ratios. Comorbidity data were obtained from the Quebec integrated chronic disease surveillance system. Results: A total of 3754 and 8439 HCWs with and without comorbidities, respectively, were included. Among HCWs with at least one of the four comorbidities, long COVID was associated with higher prevalence of low work ability (aPD=15%, 95% CI: 12% to 18%), low work functioning (aPD=27%, 95% CI: 22% to 31%), health-related long-term absenteeism (aPD=8%, 95% CI: 5% to 11%), dyspnoea-associated impairment (aPD=23%, 95% CI: 19% to 26%) and psychological distress (aPD=24%, 95% CI: 20% to 28%). aPDs were greater among HCWs with comorbidities than among those without for low work ability (p=0.013 for interaction), for low work functioning (p=0.034) and for dyspnoea-associated impairment (p