Browse by author
Lookup NU author(s): Professor Clare BambraORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ Background: Long COVID, marked by ongoing multi-systemic symptoms following COVID-19 infection, can impair ability to maintain employment. However, its relationship to workforce retention and working hours remains unclear. Methods: Long COVID was defined as symptoms lasting ≥12 weeks post-infection. We analysed data from a late-2022 follow-up survey involving 45,864 participants of the Real-time Assessment of Community Transmission (REACT) Study in England (median follow-up: 23 months). Hierarchical clustering identified symptom groups. Multivariable regressions examined associations between Long COVID, being in paid work, and changes in working hours. Findings: Of 45,864 participants employed at recruitment, 86% (N = 39,341) remained in paid work at follow-up and 11% (N = 4877) changed work hours. Approximately 4% (N = 1967/45,864) had unresolved Long COVID. Compared with participants with no/short (<4 weeks) symptoms, those with unresolved Long COVID had lower odds of being in paid work at follow-up (adjusted odds ratio [aOR]: 0.62, 95% confidence interval [CI]: 0.55, 0.70), and higher odds of changing work hours (aOR: 4.34, 95% CI: 3.88, 4.85). Three clusters were identified: multisystem severe, fatigue-predominant and anosmia-predominant Long COVID. Compared with the fatigue-predominant cluster, participants with multisystem severe Long COVID had lower odds of paid work (aOR: 0.63, 95% CI: 0.47, 0.84) and higher odds of changing work hours (aOR 2.76, 95% CI 2.21, 3.46). Interpretation: Unresolved Long COVID was associated with worse employment outcomes. Symptom clusters highlighted the importance of considering heterogeneity in Long COVID when assessing workforce impacts and designing public health responses. Fundings: National Institute for Health and Care Research, UK Research and Innovation.
Author(s): Di Gravio C, Guzman V, Wu S, Cooper E, Bambra C, Smith N, Piper A, Whitaker M, Elliott J, Atchison CJ, Cooke G, Chadeau-Hyam M, Elliott P, Ward H
Publication type: Article
Publication status: Published
Journal: The Lancet Regional Health - Europe
Year: 2026
Volume: 68
Print publication date: 01/09/2026
Online publication date: 23/07/2026
Acceptance date: 23/06/2026
Date deposited: 03/08/2026
ISSN (electronic): 2666-7762
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.lanepe.2026.101770
DOI: 10.1016/j.lanepe.2026.101770
Data Access Statement: The data that support the findings of this study are not publicly available. Deidentified data can be made available upon reasonable request and in line with the consent agreed with participants, by submitting a methodologically sound research proposal to react.lc.study@imperial.ac.uk
Altmetrics provided by Altmetric
