Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study

L. M. Bek; J. C. Berentschot; M. E. Hellemons; S. C. Remerie; CO-FLOW Collaboration Group; J. van Bommel; J. G.J.V. Aerts; G. M. Ribbers; H. J.G. van den Berg-Emons; M. H. Heijenbrok-Kal

doi:10.1186/s12916-023-03083-3

Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study

L. M. Bek^*
, J. C. Berentschot
, M. E. Hellemons
, S. C. Remerie
, CO-FLOW Collaboration Group
, J. van Bommel
, J. G.J.V. Aerts
, G. M. Ribbers
, H. J.G. van den Berg-Emons
, M. H. Heijenbrok-Kal

^*Corresponding author for this work

Rijndam Rehabilitation Center

Research output: Contribution to journal › Article › Academic › peer-review

14 Citations (Scopus)

131 Downloads (Pure)

Abstract

BACKGROUND:

Currently, evidence about the long-term consequences of COVID-19 on return to work and health-related quality of life (HRQoL) is limited. We evaluated return to work and its associations with baseline characteristics and physical and mental recovery over time in patients up to 1 year after hospitalization for COVID-19. Secondly, we aimed to evaluate the association between return to work and health-related quality of life (HRQoL).

METHODS:

CO-FLOW, a multicenter prospective cohort study, enrolled adult participants hospitalized for COVID-19, aged ≥ 18 years within 6 months after hospital discharge. Return to work and HRQoL were collected at 3, 6, and 12 months after hospital discharge using the iMTA Productivity Cost Questionnaire and the 36-Item Short Form Health Survey, respectively. Data were collected between July 1, 2020, and September 1, 2022. Generalized estimating equations with repeated measurements were used to assess outcomes over time.

RESULTS:

In the CO-FLOW study, 371 participants were employed pre-hospitalization. At 3, 6, and 12 months post-discharge, 50% (170/342), 29% (92/317), and 15% (44/295) of participants had not returned to work, and 21% (71/342), 21% (65/317), and 16% (48/295) only partially, respectively. ICU admission (adjusted odds ratio (95% confidence interval): 0.17 (0.10 to 0.30), p < 0.001), persistent fatigue (0.93 (0.90 to 0.97), p < 0.001), female sex (0.57 (0.36 to 0.90), p = 0.017), and older age (0.96 (0.93 to 0.98), p < 0.001) were independently associated with no return to work. ICU patients required a longer time to return to work than non-ICU patients. Patients who did not return or partially returned to work reported lower scores on all domains of HRQoL than those who fully returned.

CONCLUSIONS:

One year after hospitalization for COVID-19, only 69% of patients fully returned to work, whereas 15% did not return and 16% partially returned to work. No or partial return to work was associated with reduced HRQoL. This study suggests that long-term vocational support might be needed to facilitate return to work. TRIAL REGISTRATION: World Health Organization International Clinical Trials Registry Platform NL8710.

Original language	English
Article number	380
Number of pages	1
Journal	BMC Medicine
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12916-023-03083-3
Publication status	Published - Dec 2023

Bibliographical note

Funding Information:
The authors would like to extend their gratitude to all the participants of the ongoing CO-FLOW study for their efforts. In addition, the authors would like to acknowledge the research assistants for data collection in the ongoing CO-FLOW study: G.W.M. Broeren, R.M.B. Imkamp, T.E. Huijboom, E.A. Luijckx, J.H.H. Andela, L. van Veggel, L.E. Bierman, S.L. Roovers, I. Simons, C. Lückerath, and L. Schokker (all affiliated at Erasmus MC, University Medical Center Rotterdam, the Netherlands). CO-FLOW collaboration group**: Michel E. van Genderen1, Jasper van Bommel1, Diederik A.M.P.J. Gommers1, Erwin Ista2,3, Robert van der Stoep4, Rutger Osterthun5,6, Markus P.J.M. Wijffels6, Marieke M. Visser6, Janette J. Tazmi-Staal7, Eva G. Willems7, Roxane Heller8, Shai A. Gajadin9, Wouter J.B. Blox10, Laurien Oswald11, Sieshem Bindraban11, Herbert J. van de Sande12, Ronald N. van Rossem13, Stephanie van Loon-Kooij13, L. Martine Bek5, Julia C. Berentschot14, Merel E. Hellemons14, Joachim G.J.V. Aerts14, Majanka H. Heijenbrok-Kal5,6, H.J.G. van den Berg-Emons5, Gerard M. Ribbers5,6Collaboration group author details:1Department of Adult Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.2Departments of Pediatrics and Pediatric Surgery, Intensive Care Unit, Erasmus MC Sophia Children's Hospital Rotterdam, The Netherlands.3Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center Rotterdam, The Netherlands.4Department of Physical Therapy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.5Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.6Rijndam Rehabilitation, Rotterdam, The Netherlands.7Laurens Intermezzo, Rotterdam, The Netherlands.8Department of Respiratory Medicine, Ikazia Hospital, Rotterdam, The Netherlands.9Department of Respiratory Medicine, IJsselland Hospital, Capelle aan de IJssel, The Netherlands.10Department of Respiratory Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.11Department of Respiratory Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.12Aafje Nursing Home, Rotterdam, The Netherlands.13Department of Respiratory Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands.14Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.

Funding Information:
This study was supported by grants from the COVID-19 Program Care and Prevention of The Netherlands Organization for Health Research and Development (ZonMw, grant number 10430022010026), and Rijndam Rehabilitation and Laurens (both in Rotterdam, The Netherlands). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.

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Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19Final published version, 1.8 MBLicence: CC BY

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Bek, L. M., Berentschot, J. C., Hellemons, M. E., Remerie, S. C., CO-FLOW Collaboration Group, van Bommel, J., Aerts, J. G. J. V., Ribbers, G. M., van den Berg-Emons, H. J. G., & Heijenbrok-Kal, M. H. (2023). Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study. BMC Medicine, 21(1), Article 380. https://doi.org/10.1186/s12916-023-03083-3

@article{e8525ac479984cecb254be4756c78c71,

title = "Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study",

abstract = "BACKGROUND: Currently, evidence about the long-term consequences of COVID-19 on return to work and health-related quality of life (HRQoL) is limited. We evaluated return to work and its associations with baseline characteristics and physical and mental recovery over time in patients up to 1 year after hospitalization for COVID-19. Secondly, we aimed to evaluate the association between return to work and health-related quality of life (HRQoL). METHODS: CO-FLOW, a multicenter prospective cohort study, enrolled adult participants hospitalized for COVID-19, aged ≥ 18 years within 6 months after hospital discharge. Return to work and HRQoL were collected at 3, 6, and 12 months after hospital discharge using the iMTA Productivity Cost Questionnaire and the 36-Item Short Form Health Survey, respectively. Data were collected between July 1, 2020, and September 1, 2022. Generalized estimating equations with repeated measurements were used to assess outcomes over time. RESULTS: In the CO-FLOW study, 371 participants were employed pre-hospitalization. At 3, 6, and 12 months post-discharge, 50\% (170/342), 29\% (92/317), and 15\% (44/295) of participants had not returned to work, and 21\% (71/342), 21\% (65/317), and 16\% (48/295) only partially, respectively. ICU admission (adjusted odds ratio (95\% confidence interval): 0.17 (0.10 to 0.30), p < 0.001), persistent fatigue (0.93 (0.90 to 0.97), p < 0.001), female sex (0.57 (0.36 to 0.90), p = 0.017), and older age (0.96 (0.93 to 0.98), p < 0.001) were independently associated with no return to work. ICU patients required a longer time to return to work than non-ICU patients. Patients who did not return or partially returned to work reported lower scores on all domains of HRQoL than those who fully returned. CONCLUSIONS: One year after hospitalization for COVID-19, only 69\% of patients fully returned to work, whereas 15\% did not return and 16\% partially returned to work. No or partial return to work was associated with reduced HRQoL. This study suggests that long-term vocational support might be needed to facilitate return to work. TRIAL REGISTRATION: World Health Organization International Clinical Trials Registry Platform NL8710.",

author = "Bek, \{L. M.\} and Berentschot, \{J. C.\} and Hellemons, \{M. E.\} and Remerie, \{S. C.\} and \{CO-FLOW Collaboration Group\} and \{van Bommel\}, J. and Aerts, \{J. G.J.V.\} and Ribbers, \{G. M.\} and \{van den Berg-Emons\}, \{H. J.G.\} and Heijenbrok-Kal, \{M. H.\}",

note = "Funding Information: The authors would like to extend their gratitude to all the participants of the ongoing CO-FLOW study for their efforts. In addition, the authors would like to acknowledge the research assistants for data collection in the ongoing CO-FLOW study: G.W.M. Broeren, R.M.B. Imkamp, T.E. Huijboom, E.A. Luijckx, J.H.H. Andela, L. van Veggel, L.E. Bierman, S.L. Roovers, I. Simons, C. L{\"u}ckerath, and L. Schokker (all affiliated at Erasmus MC, University Medical Center Rotterdam, the Netherlands). CO-FLOW collaboration group**: Michel E. van Genderen1, Jasper van Bommel1, Diederik A.M.P.J. Gommers1, Erwin Ista2,3, Robert van der Stoep4, Rutger Osterthun5,6, Markus P.J.M. Wijffels6, Marieke M. Visser6, Janette J. Tazmi-Staal7, Eva G. Willems7, Roxane Heller8, Shai A. Gajadin9, Wouter J.B. Blox10, Laurien Oswald11, Sieshem Bindraban11, Herbert J. van de Sande12, Ronald N. van Rossem13, Stephanie van Loon-Kooij13, L. Martine Bek5, Julia C. Berentschot14, Merel E. Hellemons14, Joachim G.J.V. Aerts14, Majanka H. Heijenbrok-Kal5,6, H.J.G. van den Berg-Emons5, Gerard M. Ribbers5,6Collaboration group author details:1Department of Adult Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.2Departments of Pediatrics and Pediatric Surgery, Intensive Care Unit, Erasmus MC Sophia Children's Hospital Rotterdam, The Netherlands.3Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center Rotterdam, The Netherlands.4Department of Physical Therapy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.5Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.6Rijndam Rehabilitation, Rotterdam, The Netherlands.7Laurens Intermezzo, Rotterdam, The Netherlands.8Department of Respiratory Medicine, Ikazia Hospital, Rotterdam, The Netherlands.9Department of Respiratory Medicine, IJsselland Hospital, Capelle aan de IJssel, The Netherlands.10Department of Respiratory Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.11Department of Respiratory Medicine, Franciscus Gasthuis \& Vlietland, Rotterdam, The Netherlands.12Aafje Nursing Home, Rotterdam, The Netherlands.13Department of Respiratory Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands.14Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Funding Information: This study was supported by grants from the COVID-19 Program Care and Prevention of The Netherlands Organization for Health Research and Development (ZonMw, grant number 10430022010026), and Rijndam Rehabilitation and Laurens (both in Rotterdam, The Netherlands). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2023, BioMed Central Ltd., part of Springer Nature.",

year = "2023",

month = dec,

doi = "10.1186/s12916-023-03083-3",

language = "English",

volume = "21",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central Ltd.",

number = "1",

}

Bek, LM , Berentschot, JC , Hellemons, ME, Remerie, SC, CO-FLOW Collaboration Group, van Bommel, J , Aerts, JGJV , Ribbers, GM , van den Berg-Emons, HJG & Heijenbrok-Kal, MH 2023, 'Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study', BMC Medicine, vol. 21, no. 1, 380. https://doi.org/10.1186/s12916-023-03083-3

TY - JOUR

T1 - Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19

T2 - the CO-FLOW study

AU - Bek, L. M.

AU - Berentschot, J. C.

AU - Hellemons, M. E.

AU - Remerie, S. C.

AU - CO-FLOW Collaboration Group

AU - van Bommel, J.

AU - Aerts, J. G.J.V.

AU - Ribbers, G. M.

AU - van den Berg-Emons, H. J.G.

AU - Heijenbrok-Kal, M. H.

N1 - Funding Information: The authors would like to extend their gratitude to all the participants of the ongoing CO-FLOW study for their efforts. In addition, the authors would like to acknowledge the research assistants for data collection in the ongoing CO-FLOW study: G.W.M. Broeren, R.M.B. Imkamp, T.E. Huijboom, E.A. Luijckx, J.H.H. Andela, L. van Veggel, L.E. Bierman, S.L. Roovers, I. Simons, C. Lückerath, and L. Schokker (all affiliated at Erasmus MC, University Medical Center Rotterdam, the Netherlands). CO-FLOW collaboration group**: Michel E. van Genderen1, Jasper van Bommel1, Diederik A.M.P.J. Gommers1, Erwin Ista2,3, Robert van der Stoep4, Rutger Osterthun5,6, Markus P.J.M. Wijffels6, Marieke M. Visser6, Janette J. Tazmi-Staal7, Eva G. Willems7, Roxane Heller8, Shai A. Gajadin9, Wouter J.B. Blox10, Laurien Oswald11, Sieshem Bindraban11, Herbert J. van de Sande12, Ronald N. van Rossem13, Stephanie van Loon-Kooij13, L. Martine Bek5, Julia C. Berentschot14, Merel E. Hellemons14, Joachim G.J.V. Aerts14, Majanka H. Heijenbrok-Kal5,6, H.J.G. van den Berg-Emons5, Gerard M. Ribbers5,6Collaboration group author details:1Department of Adult Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.2Departments of Pediatrics and Pediatric Surgery, Intensive Care Unit, Erasmus MC Sophia Children's Hospital Rotterdam, The Netherlands.3Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center Rotterdam, The Netherlands.4Department of Physical Therapy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.5Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands.6Rijndam Rehabilitation, Rotterdam, The Netherlands.7Laurens Intermezzo, Rotterdam, The Netherlands.8Department of Respiratory Medicine, Ikazia Hospital, Rotterdam, The Netherlands.9Department of Respiratory Medicine, IJsselland Hospital, Capelle aan de IJssel, The Netherlands.10Department of Respiratory Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.11Department of Respiratory Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.12Aafje Nursing Home, Rotterdam, The Netherlands.13Department of Respiratory Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands.14Department of Respiratory Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands. Funding Information: This study was supported by grants from the COVID-19 Program Care and Prevention of The Netherlands Organization for Health Research and Development (ZonMw, grant number 10430022010026), and Rijndam Rehabilitation and Laurens (both in Rotterdam, The Netherlands). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: © 2023, BioMed Central Ltd., part of Springer Nature.

PY - 2023/12

Y1 - 2023/12

N2 - BACKGROUND: Currently, evidence about the long-term consequences of COVID-19 on return to work and health-related quality of life (HRQoL) is limited. We evaluated return to work and its associations with baseline characteristics and physical and mental recovery over time in patients up to 1 year after hospitalization for COVID-19. Secondly, we aimed to evaluate the association between return to work and health-related quality of life (HRQoL). METHODS: CO-FLOW, a multicenter prospective cohort study, enrolled adult participants hospitalized for COVID-19, aged ≥ 18 years within 6 months after hospital discharge. Return to work and HRQoL were collected at 3, 6, and 12 months after hospital discharge using the iMTA Productivity Cost Questionnaire and the 36-Item Short Form Health Survey, respectively. Data were collected between July 1, 2020, and September 1, 2022. Generalized estimating equations with repeated measurements were used to assess outcomes over time. RESULTS: In the CO-FLOW study, 371 participants were employed pre-hospitalization. At 3, 6, and 12 months post-discharge, 50% (170/342), 29% (92/317), and 15% (44/295) of participants had not returned to work, and 21% (71/342), 21% (65/317), and 16% (48/295) only partially, respectively. ICU admission (adjusted odds ratio (95% confidence interval): 0.17 (0.10 to 0.30), p < 0.001), persistent fatigue (0.93 (0.90 to 0.97), p < 0.001), female sex (0.57 (0.36 to 0.90), p = 0.017), and older age (0.96 (0.93 to 0.98), p < 0.001) were independently associated with no return to work. ICU patients required a longer time to return to work than non-ICU patients. Patients who did not return or partially returned to work reported lower scores on all domains of HRQoL than those who fully returned. CONCLUSIONS: One year after hospitalization for COVID-19, only 69% of patients fully returned to work, whereas 15% did not return and 16% partially returned to work. No or partial return to work was associated with reduced HRQoL. This study suggests that long-term vocational support might be needed to facilitate return to work. TRIAL REGISTRATION: World Health Organization International Clinical Trials Registry Platform NL8710.

AB - BACKGROUND: Currently, evidence about the long-term consequences of COVID-19 on return to work and health-related quality of life (HRQoL) is limited. We evaluated return to work and its associations with baseline characteristics and physical and mental recovery over time in patients up to 1 year after hospitalization for COVID-19. Secondly, we aimed to evaluate the association between return to work and health-related quality of life (HRQoL). METHODS: CO-FLOW, a multicenter prospective cohort study, enrolled adult participants hospitalized for COVID-19, aged ≥ 18 years within 6 months after hospital discharge. Return to work and HRQoL were collected at 3, 6, and 12 months after hospital discharge using the iMTA Productivity Cost Questionnaire and the 36-Item Short Form Health Survey, respectively. Data were collected between July 1, 2020, and September 1, 2022. Generalized estimating equations with repeated measurements were used to assess outcomes over time. RESULTS: In the CO-FLOW study, 371 participants were employed pre-hospitalization. At 3, 6, and 12 months post-discharge, 50% (170/342), 29% (92/317), and 15% (44/295) of participants had not returned to work, and 21% (71/342), 21% (65/317), and 16% (48/295) only partially, respectively. ICU admission (adjusted odds ratio (95% confidence interval): 0.17 (0.10 to 0.30), p < 0.001), persistent fatigue (0.93 (0.90 to 0.97), p < 0.001), female sex (0.57 (0.36 to 0.90), p = 0.017), and older age (0.96 (0.93 to 0.98), p < 0.001) were independently associated with no return to work. ICU patients required a longer time to return to work than non-ICU patients. Patients who did not return or partially returned to work reported lower scores on all domains of HRQoL than those who fully returned. CONCLUSIONS: One year after hospitalization for COVID-19, only 69% of patients fully returned to work, whereas 15% did not return and 16% partially returned to work. No or partial return to work was associated with reduced HRQoL. This study suggests that long-term vocational support might be needed to facilitate return to work. TRIAL REGISTRATION: World Health Organization International Clinical Trials Registry Platform NL8710.

UR - https://www.scopus.com/pages/publications/85173020178

U2 - 10.1186/s12916-023-03083-3

DO - 10.1186/s12916-023-03083-3

M3 - Article

C2 - 37784149

AN - SCOPUS:85173020178

SN - 1741-7015

VL - 21

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 380

ER -

Return to work and health-related quality of life up to 1 year in patients hospitalized for COVID-19: the CO-FLOW study

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