García M/ Enfermería Investiga Vol. 9 No. 2 2024 (April – June)

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STUDY OF PERSISTENT COVID CASES IN HEALTH WORKERS

REUS-BAIX CAMP) (EDPSSBC). Sant Joan University Hospital. Reus. Spain.

2477-9172 / 2550-6692 All Rights Reserved © 2024 Technical University of Ambato, Nursing Career. This is an open access article

distributed under the terms of the Creative Commons License, which permits unlimited use, distribution, and reproduction in any medium,

provided the original work is properly cited.

Corresponding Author: Esp Mercè Garcia Grau. Email:mariamerce.garcia@salutsantjoan.cat

Received: January 20, 2024

Accepted: March 28, 2024

acute affectation that can continue in a sustained

manner beyond 12 weeks from the onset of the initial

symptoms, being called Persistent COVID (Post

COVID, Long COVID). Objective: Assess the

incidence of Persistent Covid that the workers at the

Sant Joan de Reus Hospital and Reus-Baix Camp

Primary Care (EDPSSJRBC) have presented,

during the period from March 2020 to November

2022, predominant clinical, work impact. Methods:

Descriptive observational study of active workers on

assessment of work capacity against Persistent

Covid in the context of the Health Surveillance of the

Occupational

characterized by: female sex, over 40 years of age,

care work profile, with predominant symptoms of

sleep disorder, memory disorder, difficulty

concentrating, changes in mental status, mood,

arthralgia, fatigue and headache. They presented

abnormal results in the tests: Post COVID-19

Functional Scale, Insomnia Severity Index and

Montreal Cognitive Assessment Test.Conclusions:

Clinical impact of Persistent Covid of the workers in

our study who improved over time and after

Keywords: Post-Acute COVID-19 Syndrome;

COVID-19; Health Personnel; Work Capacity

Evaluation.

INTRODUCTION

COVID-19 disease due to infection with the SARS-

CoV-2 Coronavirus (1,2) presents an acute clinical

weeks from the onset of the first symptom, presents

symptoms that were part of the acute phase of the

SARS-CoV-2 infection and that persists today (3,4).

The symptomatic picture of Persistent COVID may

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COVID. In the Health Surveillance Unit of the

EDPSSJRBC Prevention Service, a medical

procedure was implemented for the detection,

assistance and monitoring of workers with

Persistent COVID symptoms.

The continuity of Persistent COVID symptoms, apart

from the possible impact on workers' daily activities,

may have an implication on the development of their

work activity, with the need for temporary or

Hospital and Primary Care of Reus and Baix Camp,

the healthcare, rehabilitation and follow-up care

provided to the workers in the period from March

2020 to November 2022. Since the study has been

carried out within the framework of the Health

Surveillance Unit, the work impact of the workers

derived from Persistent COVID and the need for

functional adaptation that they may have required in

their work place has also been assessed during the

study period.

period 2020 to 2022. The workers who were

excluded: not belonging to EDPSSJBC; workers in

a situation of incapacity for work and those who did

not complete all phases of the study.

To evaluate the Persistent COVID clinic from the

Health Surveillance Unit of the Occupational Risk

Prevention Service, the Procedure for care action in

workers with Persistent COVID (2021), in force at

EDPSSBC, was applied.

rest or daily activities, persistent cough, chest pain

at rest or daily activity, anosmia or ageusia,

headache, diarrhea, memory loss, changes in

mood, sadness, crying, nervousness, insomnia,

alopecia) to workers who had suffered from COVID-

19. Those who responded affirmatively to Persistent

symptoms of more than 12 weeks were scheduled

to undergo a health examination. This health

examination included a nursing part with the

completion of a new Persistent COVID symptoms

Test for evaluation of dyspnea (Pearson coef 0.92)

(14.15), Test Hamilton anxiety/depression scale

Functional Status Scale (PCFS) ((kappa 0.63))

(18.19), Modified Impact of Fatigue (MFIS)

(Cronbach 0.81) (20.21), Sleep Scale: Insomnia

Severity Index (Cronbach 0.82) (22.23), Pain

Assessment Questionnaire (Bpi) (Cronbach 0.82)

76) (24.25) and Montreal Cognitive Assessment

(MOCA) (Cronbach's 0.891) (26.27). In addition, the

specific analytical determination was carried out:

total SARS CoV-2 antibodies (Ab), blood count,

ESR, albumin, total and direct bilirubin, serum

proteins, transferrin, triglycerides, urea, vitamin B12,

vitamin D, antithrombin III, prothrombin time,

activated partial thromboplastin, antinuclear

antibodies, DNA autoantibodies, TSH, T3 and T4,

apoprotein, creatine kinase, fibrinogen, lactic

Anthropometric data were recorded: weight, height

and abdominal circumference. Measurement of

blood pressure, pulse, oxygen saturation, body

temperature was carried out. And a spirometry and

anamnesis of the COVID-19 disease (onset,

symptoms, treatment performed, hospital/ICU

admissions, mechanical ventilation requirements...),

anamnesis of previous history, chronic treatments

and assessment of Persistent COVID symptoms. A

directed physical examination was performed:

neurological examination (cranial nerves,

coordination and balance tests, Romberg test...),

cardiorespiratory, oropharyngeal and abdominal

examination, lumbar fist percussion,

Unit, Cognitive Impairment Unit, Medicine Unit

Internal, Otorhinolaryngology Unit, Cardiology Unit,

Digestology Unit, Rheumatology Unit, Dermatology

Unit...

Subsequent follow-up visits were made to the

workers who required it with an in-person or

telephone appointment to evaluate the results of the

complementary tests requested, treatments

performed, consultations with other medical

study of the EDPSSBC Health Surveillance Unit

were analyzed. The variables considered were: age,

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tests, anthropometric data, analytical and physical

examination results, complementary tests

(electrocardiogram, spirometry, blood pressure),

referrals to medical specialties and possible work

impact.

The treatment and analysis of the data from the

study project is carried out by health personnel from

the EDPSSBC Health Surveillance Unit. Finally, an

assessment of the worker's work aptitude was made

The incidence of the results and 95% confidence

interval (95%CI) were calculated. Differences

between variables were quantified using incidence

rates, odds ratio (OR) and 95% CI. To calculate the

demographic incidence rates, the population of

Hospital workers and the values of the variables

(COVID-19, Persistent COVID) detected

respectively based on gender, age and professional

group have been taken into account. To calculate

the incidence rates of the clinical variables (results

different medical services has been expressed, with

respect to the total number of referrals made

multiplied by 100. Regarding the functional impact

on work, the rate of incidence of occupational

impairment of workers affected by Persistent COVID

with respect to the total number of workers with

Persistent COVID studied. To calculate the 95%CI,

the Excel 365 statistical function was used for a Z

Statistical Software version 20.210 (Med-Calc

Software bv, Ostend, Belgium) was used;

https://www.medcalc.org; 2020).

BIOETHICAL COMMUNICATION

Approval of the EDP Salut Sant Joan de Reus-Baix

Camp Clinical Research Ethics Committee (IISPV

Drug Research Ethics Committee), which considers

consent for this study is accepted. -The scope of the

planned economic compensation does not interfere

with respect for ethical postulates. -This committee

in its meeting dated 06/27/2023, minute number

Favorable Report for the study to be carried out, and

accepts that said study be carried out at: Hospital

Universitari Sant Joan de Reus by GARCIA GRAU,

MERCE of the Health Surveillance Unit as main

researcher. (Code CEIm104/2023 final version:

study period were 398 workers out of a total of 2,120

workers, representing 18.77%. In the resulting data

(Table 1), COVID-19 is observed in women with an

incidence rate of 18.90% (CI95:16.98-20.83%);

greater affectation in the age group under 40 years

(rate of 22.12) (OR 1.50; CI95:1.21-1.87%) and in

care workers (rate of 20.63) (OR 2.71; CI95:1.81-

4.02%), versus non-care

.

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affirmatively to the Persistent COVID

symptomatology screening surveys. Of those who

responded to the screening surveys, 70 workers

(44.30%) showed symptoms compatible with the

definition of Persistent COVID (Table 2).

The incidence of Persistent COVID in the study

population (Table 2) predominates in women at a

response to screening; in the population over 40

years of age (rate 49.40%) (population with a

greater response to screening and with the

presence of previous pathologies that may influence

the symptoms of Persistent COVID); and in the

healthcare population (rate 44.37%), front-line

personnel, with a higher response rate to screening.

PERSISTENT COVID in the Health Surveillance

Unit (20 workers did not attend a medical

appointment and were excluded from the study). In

reference to the symptoms of Persistent COVID

(table 3): workers reported sleep disorders 32%

followed by memory loss or difficulty concentrating

30%, mood changes, sadness, crying or

nervousness 28%, pain joint pain at rest 28%,

feeling fatigue or tiredness in daily activities 24%

and headache 22%. If we analyze the pathological

test 77.42% (although the majority indicate minimal

respectively, followed by the pain test (45.16%;

CI95: 27.64-62.68%) and quality of life, sleep and

emotions. (45.16%; CI95:27.64-62.68%).

Of the tests carried out in the health examinations

carried out (Table 3), the majority of workers present

followed by a body mass index of Obesity in 45.16%

and alterations ECG 22.58% (left bundle branch

block, first degree atrioventricular block, left anterior