Brain Fog and Quality of Life at Work in Non-Hospitalized Patients after COVID-19

Abstract

<i>Background:</i> There is still a need for studies on the quality of life (QoL) at work among COVID-19 survivors. Therefore, we aimed to evaluate the association between the brain fog symptoms and the QoL at work in non-hospitalized patients with previous SARS-CoV-2 infection. <i>Methods:</i> Three hundred non-hospitalized patients (79.33% women; median age, 36 years; interquartile range, 30-48 years) were included in the final analysis. An anonymous neuropsychological questionnaire containing eight different questions on the presence of brain fog symptoms in four time intervals, i.e., pre-COVID-19 and 0-4, 4-12, and >12 weeks after infection, was retrospectively introduced to patients and staff of the University Hospital in Krakow. Additionally, a four-point Likert scale was used to evaluate QoL at work in four time periods. Included were participants aged ≥ 18 years in whom the diagnosis of COVID-19 was confirmed by the RT-PCR from nasopharyngeal swab and the first symptoms occurred no earlier than 3 months before the completion of the questionnaire. <i>Results:</i> Before SARS-CoV-2 infection, 28.00% (<i>n</i> = 84) of patients reported poor QoL at work. Within 4, 4-12, and >12 weeks after infection, a decrease in QoL was observed in 75.67% (<i>n</i> = 227), 65.00% (<i>n</i> = 195), and 53.66% (<i>n</i> = 161) of patients, respectively (<i>p</i> < 0.001). With increasing deterioration of the QoL at work, the number of brain fog symptoms increased, and patients with severe QoL impairment exhibited a median of five symptoms for <4, 4-12, and >12 weeks post-COVID-19. In the multivariable logistic regression model, predictors of the deterioration of the QoL at work depended on the time from COVID-19 onset; in the acute phase of the disease (<4 weeks), it was predicted by impairment in remembering information from the past (OR 1.88, 95%CI: 1.18-3.00, <i>p</i> = 0.008) and multitasking (OR 1.96, 95%CI: 1.48-2.58, <i>p</i> < 0.001). Furthermore, an impairment in the QoL at work 4-12 weeks and >12 weeks after COVID-19 was independently associated with age (OR 0.46, 95%CI: 0.25-0.85, <i>p</i> = 0.014 and OR 1.03, 95%CI: 1.01-1.05, <i>p</i> = 0.025, respectively), problems with multitasking (OR 2.05, 95%CI: 1.40-3.01, <i>p</i> < 0.001 and OR 1.75, 95%CI: 1.15-2.66, <i>p</i> = 0.009, respectively), answering questions in an understandable/unambiguous manner (OR 1.99, 95%CI: 1.27-3.14, <i>p</i> = 0.003 and OR 2.00, 95%CI: 1.47-2.36, <i>p</i> = 0.001, respectively), and, only for the >12 week interval, problems with remembering information from the past (OR 2.21, 95%CI: 1.24-3.92, <i>p</i> = 0.007). <i>Conclusions:</i> Certain brain fog symptoms, such as impaired memory or multitasking, are predictors of a poorer QoL at work not only during the acute phase of COVID-19 but also within more than 12 weeks after the onset of infection.