Long COVID Symptom Persistence and Functional Impairment in Healthcare Workers: A 12-Month Prospective Cohort Study

This study investigates prevalence, symptom trajectory, and functional impairment of Long COVID in a healthcare worker cohort at 3, 6, and 12 months post-infection within the context of occupational medicine and infectious disease epidemiology, an area of growing scientific importance given its implications for Long COVID clinical management protocols, occupational return-to-work guidelines, and healthcare workforce capacity planning. Using prospective cohort study with validated questionnaires (PHQ-9, MRC Dyspnea Scale, Fatigue Severity Scale, SF-36) and clinical assessments at 3, 6, and 12 months, we examine post-viral immune dysregulation, autonomic dysfunction, and tissue injury producing persistent multi-system symptom burden in 1,284 healthcare workers with confirmed prior COVID-19 enrolled at 3-month post-infection assessment drawn from five academic medical centers in the New York metropolitan area. Results indicate that 44.2% of enrolled healthcare workers met Long COVID criteria at 3 months, declining to 28.4% at 12 months; fatigue was the most persistent symptom at 12 months (31.4%), and moderate-to-severe acute illness independently tripled odds of persistent Long COVID (p < 0.001), with 44.2% Long COVID prevalence at 3 months, 28.4% at 12 months as the primary quantitative benchmark. Concordance between primary and confirmatory measurement approaches exceeded 93%, validating the analytical framework. These findings contribute empirically to occupational medicine and infectious disease epidemiology and carry actionable implications for the design of programs and policies targeting Long COVID clinical management protocols, occupational return-to-work guidelines, and healthcare workforce capacity planning.