Long COVID and Its Associations with Burnout, Anxiety and Depression Among U.S. Healthcare Workers in the United States

Thanh Huyen T Vu^1*Miao Hua²Cerina Lee³Judith T Moskowitz⁴Amisha Wallia⁵Lisa R Hirschhorn⁴John T Wilkins¹Charlesnika T Evans¹

• ¹Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
• ²Chicago Department of Public Health, Chicago, Illinois, United States
• ³Department of Mental Health. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
• ⁴Department of Medical Social Sciences, Feinberg School of Medicine Northwestern University, Chicago, Illinois, United States
• ⁵Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States

Background: Data on Long COVID and its associations with burnout, anxiety and depression among healthcare workers (HCW) in the United States (U.S.) is limited.Methods: This study utilized cross-sectional data from the final survey conducted in July 2023, which was part of a longitudinal cohort study assessing COVID-19-related burnout and wellbeing among healthcare workers (HCWs) in a large tertiary academic healthcare system in the Chicago area. The survey included questions on self-reported Long COVID status, as well as the Oldenburg Burnout Inventory (OLBI) to measure burnout and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CAT) to assess anxiety and depression. A total of 1,979 HCWs participated in the survey, yielding a response rate of 56.1%.The analysis included 1,678 respondents with complete data, of whom 1,171 (70%) self-reported having had COVID-19. Of these, 90 (7.7%) reported Long COVID, with 53% indicating that their most bothersome symptoms persisted for more than 6 months, while 50% reported no longer experiencing those symptoms at the time of the survey. Multivariable linear regression analyses revealed that Long COVID was significantly associated with higher OLBI scores (β =2.20, p=0.004), PROMIS anxiety scores (β =2.64, p=0.001) and PROMIS depression scores (β =1.98, p=0.011) compared to those who had COVID-19 but not Long COVID. Similar patterns of associations were observed when comparing the Long COVID group to those who never had COVID-19. No significant differences were found between those who never had COVID-19 and those who had COVID-19 without developing Long COVID.Conclusions: Long COVID was associated with higher levels of burnout, depression, and anxiety among healthcare workers compared to those who had COVID-19 alone or were never infected, despite its lower prevalence during the endemic phase. These findings underscore the need for continued prevention efforts and targeted support strategies in healthcare settings.