Healthcare Consumption and Work Absenteeism of Individuals With and Without Persistent Complaints After COVID-19: The Role of Cognitive-Behavioural Factors, Neuropsychological Functioning and Depressive Symptoms

Abstract

Background: To compare healthcare consumption and work absenteeism of individuals with and without persistent complaints after COVID-19 and determine to what extent cognitive-behavioural factors, neuropsychological functioning and depressive symptoms influence this relationship. Method: Individuals with (n = 129) and without (n = 96) persistent fatigue (Checklist Individual Strength (CIS) fatigue ≥ 35) and difficulty concentrating (CIS concentration ≥ 18) at least 3 months (IQR 16–28 months) after SARS-CoV-2 infection were included. Using the Treatment Inventory of Costs in Patients, healthcare consumption (number of visits) and work absenteeism (≥ 3 weeks absent from paid work) in the past 3 months were assessed. Mediation analyses were performed to investigate whether the putative factors indeed influence the relationship between persistent complaints and work absenteeism or healthcare consumption. Results: Individuals with persistent complaints more often visited a healthcare professional in the past 3 months (3; IQR = 0–11) than participants without persistent complaints (0; IQR = 0–2, p < 0.001). None of the putative factors was associated with healthcare consumption. Work absenteeism (n = 21/85 with paid work) and work disability (n = 27/225) were only reported by participants with persistent complaints, so no mediation analysis could be performed. Within the group with persistent symptoms, worse neuropsychological functioning (attention and executive functioning) and two illness perception subscales were associated with an increased likelihood of work absenteeism. Conclusion: The relationship between reporting persisting symptoms and increased healthcare consumption could not be explained by cognitive-behavioural factors, depressive symptoms or neuropsychological functioning. In participants with persistent complaints, illness perceptions and neuropsychological functioning were associated with work absenteeism.