Healthcare workers (HCWs) with long-COVID symptoms reported that their physicians shrugged off their concerns and that they struggled to get the care they needed, a new systematic review suggests.
For the rapid review, published yesterday in PLOS One, researchers from the University of Aberdeen and Robert Gordon University in Scotland reviewed 30 studies published from December 2019 to December 2022 to evaluate the effects of long COVID on HCW health, working life, personal circumstances, and use of healthcare resources. Two of the studies provided qualitative evidence, and 28 survey studies offered quantitative evidence.
Experience made some more empathetic with patients
The researchers identified five themes, which were uncertainty about symptoms, problems accessing services, the importance of listening and support, patient versus professional identity, and identification of ways to improve communication and services for long-COVID patients.
"Most participants described a deterioration in their ability to carry out everyday tasks, including clinicians concerned about the safety of their practice, and raised concerns over whether they would ever recover or return to work," the study authors wrote.
HCWs who did return to work said they worried about not being able to function at the required level or make sufficient contributions to their workplace. Many turned to social media for information and support, with some saying they were now better able to empathize with long-COVID patients and those with inconclusive test results.
"A number of us in the group have said how ashamed we are of some of the attitudes we've had towards people, and lack of empathy… This concept of being irritated by patients when they're not really pleased when something comes back normal… Hopefully, it will make me a better and more empathetic doctor at the end," a physician said in one study.
I need someone to be my doctor.
Some study participants reported difficulty accessing and navigating care, as well as delayed, absent, or inappropriate responses and a lack of support from their general practitioners (GPs) in acknowledging and investigating their symptoms. In one study, participant doctors said their professional expertise wasn't recognized or respected, and some resorted to contacting personal or professional contacts to get appointments or referrals to specialists.
In one study, HCWs expressed frustration that their doctors did not perceive and treat them as patients. They also said they struggled to understand the expectation that, as HCWs, they were on their own in formulating their treatment.
"[My GP] does rely heavily on me being a doctor and making my own management plan… There’s a place for ICE [ideas, concerns and expectations] but I need someone to be my doctor," a physician wrote. "If I don't come up with something, it's 'wait and see' or a blood test."
Many turned to social media for validation
Participants reported turning to social media groups for support, validation, and information. They also advocated for taking a multidisciplinary approach to identifying and treating long-COVID symptoms, as well as the need for more tailored healthcare services.
"My expectation of such a clinic would be to rule out treatable causes or complications, based on our symptoms… We now know that COVID is a multi-system disease so the fact that you don't display signs of respiratory infection doesn't mean that you don't have a problem," one health professional said.
The percentages of HCWs with confirmed infection reporting long-COVID symptoms ranged from 23.1% at 6 months post-infection to 73.0% at a median of 117 days. The most common symptom was fatigue (4% 8 months post-infection to 75% at 1 month), while those reporting headache ranged from 0.5% 60 days post-infection to 42.0% at 1 month. Loss of taste and/or smell ranged from 0.5% at up to 60 days after infection to 51.1% at more than 3 months.
We now know that COVID is a multi-system disease so the fact that you don't display signs of respiratory infection doesn't mean that you don't have a problem.
Other common symptoms were shortness of breath, impaired concentration, respiratory problems, depression, and anxiety. Many HCWs reported that their symptoms led to missed work, disruptions in home and social life, and an inability to participate in leisure activities.
"Our findings are in line with those in the literature showing that there are barriers to healthcare professionals accessing healthcare and highlighting the challenges of receiving care due to their professional role," the researchers wrote. "A more representative approach in Long COVID research is needed to reflect the diverse nature of healthcare staff and their occupations."
