key: cord-0716449-tpsoq896
authors: do Prado, C. B.; Emerick, G. S.; Cevolani Pires, L. B.; Salaroli, L. B.
title: Impact of long-term COVID on workers: a systematic review protocol
date: 2022-03-09
journal: nan
DOI: 10.1101/2022.03.07.22272051
sha: 52eb0541051718758b9361cb4414fe0c1e764094
doc_id: 716449
cord_uid: tpsoq896

Introduction: Part of the patients infected by COVID-19 have at least one lasting sequel of the disease and may be framed in the concept of long Covid. These sequelae can compromise the quality of life, increase dependence on other people for personal care, impair the performance of activities of daily living, thus compromising work activities and harming the health of the worker. This protocol aims to critically synthesize the scientific evidence on the effects of Covid-19 among workers and its impact on their health status and professional life. Method: Searches will be performed in MEDLINE via PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS and Epistemonikos. Included studies will be those that report the prevalence of long-term signs and symptoms in workers and/or the impact on their health status and work performance, which may be associated with Covid-19 infection. Data extraction will be conducted by 3 reviewers independently. For data synthesis, a results report will be carried out, based on the main outcome of this study. Discussion: This review will provide evidence to support health surveillance to help decision makers (i.e. healthcare providers, stakeholders and governments) regarding long-term Covid.

[1]. It was a new strain of coronavirus that had not been identified before in humans that 24 soon spread rapidly around the world, leading the WHO to declare a public health 25 emergency of international concern on January 30, 2020 [2] and a pandemic on 11 26 January 2020. March 2020 [3] . 27 This new coronavirus (SARS-CoV-2), responsible for causing the severe acute 28 respiratory syndrome called COVID-19, [4] which has been the focus of attention for

The nomenclature to be used for this complex association of post-COVID symptoms is not yet consolidated and several synonyms have been seen such as "Post-48 COVID Syndrome", "Long covid", " Late sequelae of COVID-19" or "post-acute 49 COVID- 19" [11] . Long-term Covid is conceptually defined as persistent symptoms 50 and/or late complications that people may develop four or more weeks after being infected 51 with the virus that causes COVID- 19 [12] . 52 More than 80% of infected patients have at least one lasting sequelae of COVID -19, 53 which may be framed in the concept of long covid [13] , causing a decrease in quality of 54 life, increased dependence on other people for personal care and impaired performance 55 of the activities of the daily life [14] . 56 In this context, it is noteworthy that the consequences of COVID-19 can 57 compromise work activities and harm the health of the worker, causing social and 58 economic impacts, since they need to be away from work for health treatment, generating 59 a shortage of manpower. for these áreas [15] . The delay in returning to work considerably 60 increases the chances of losing a job, which can lead to physical and mental problems.

When the absence from work lasts more than 6 months, the chance of readaptation to 62 work in the same role drops to 50% [16] .

Work capacity is a dynamic process, in which the worker is able to fulfill the 64 requirements of his tasks, using his physical and mental abilities according to his health 65 conditions [17] . Factors such as lifestyle, social characteristics, work requirements, 66 among others, significantly interfere in this process [16] .

That said, the SARS-CoV-2 pandemic creates new challenges for occupational 68 health mainly related to the return to work for those affected by long-term symptoms.

Complaints of muscle weakness, memory and concentration difficulties can The search strategy will be carried out in order to increase methodological 87 transparency and improve the reproducibility of the findings, following the PRISMA 88 checklist. Additionally, using the acronym PECO (Population / Exposure / Comparison / . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted March 9, 2022. ; https://doi.org/10.1101/2022.03.07.22272051 doi: medRxiv preprint Outcomes) [19] , we elaborated the guiding question of this review, to ensure the 

The search strategy will be carried out through 07 specialized and general and keywords that will be used in MEDLINE is described in table 1; it will be adapted to 113 meet the specific syntax requirements of each database.

Possible changes to the protocol will be described in the publication of the final 115 report, which should be developed according to the preferred reporting items for 116 systematic reviews and meta-analyses [ . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The CEEC strategy is detailed in table 2. 

The primary outcomes will be the prevalence of long covid symptoms in workers and/or the impact on their health status and work performance.

-------and abstracts. If there is a good agreement between the reviewers (at least 80%), each one 147 will proceed with the complete screening of the article. If there is agreement below 80%, 148 the articles will be re-evaluated, and differences will be discussed and resolved by 149 consensus; if a disagreement persists, a fourth reviewer (LBS) will make the final decision 150 using the Rayyan app.

After reading the full text of the other studies, the final studies included will be 152 determined. The corresponding author of any original study will be contacted when the 153 full text is not available. The entire study selection process is presented in a PRISMA . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

The copyright holder for this preprint this version posted March 9, 2022. ; https://doi.org/10.1101/2022.03.07.22272051 doi: medRxiv preprint For data synthesis, a results report will be carried out, based on the main outcome 196 of this study. The grouping of studies for synthesis will be based on long and ambiguous 197 outcome, study design (observational studies), risk of bias assessments (studies with low 198 risk of bias), studies that answer the review question. To analyze the quality of the studies, 199 the MINORS tool will be used.

For the critical analysis of the findings, guidelines published by national and 201 international authorities, such as the World Health Organization, the Ministry of Health 202 and the State Health Departments will be used.

To investigate heterogeneity, the data found will be organized into tables, 204 specifying the methodological, sociodemographic characteristics (for example, sex, age), 205 professional category, type of work during the COVID-19 pandemic (remote / face-to-206 face), severity of symptoms of long covid, clearly referencing all studies included in the 207 review. Prevalence ratio, p-value, confidence intervals, hazard ratio, odds ratio and odds 208 ratio will be described.

Heterogeneity will also be tested by the I² statistic, which can quantify 210 heterogeneity ranging from 0% (no heterogeneity) to 100% (differences between effect 211 sizes can be completely explained by chance alone), and the percentage interpretations 212 are as follows: 0 % -40% indicates potentially unimportant heterogeneity, 30% -60% 213 indicates moderate heterogeneity, 50% -90% indicates substantial heterogeneity, and 214 75% -100% indicates considerable heterogeneity. To explore heterogeneity across 215 studies, subgroup analysis will be performed using a mixed effects model according to 216 the following variables: age, ethnicity, sex, and occupational characteristics. As this is a systematic review protocol, no patient or public will be involved. and conferences related to this field. In addition, any changes to this protocol will be 226 documented with reference to saved searches and analysis methods, which will be 227 recorded in bibliographic databases for data collection and synthesis. In this systematic review protocol, we clearly describe the study designs, 232 participants, interventions, and outcomes that will be considered according to the research 233 question and data sources, search strategy, data extraction, methodological quality of 234 studies, and synthesis approach. of data. Furthermore, with this protocol study, we 235 reinforced the clarity of the search strategy and minimized the risk of bias. These results 236 will provide evidence to inform and personalize shared decision making for healthcare 237 providers, stakeholders, businesses and government.

Therefore, this systematic review will provide relevant evidence on the effects of 239 long-term COVID among workers and its impact on health status and working life. 240 Ultimately, we will point to evidence in order to provide subsidies for the development . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted March 9, 2022. ; https://doi.org/10.1101/2022.03.07.22272051 doi: medRxiv preprint of actions to monitor and care for the health of workers and to guide important strategies 242 and decision-makers of health policies in several countries.

To ensure wider dissemination, we will present the interim findings at local and 244 international conferences and publish them in high-impact open access journals. 

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Searching for and selecting studies

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