Return-to-work for People Living with Long COVID: A Scoping Review of Interventions and Recommendations

Abstract

Introduction. Long COVID affects individuals labour market participation in many ways. While some cannot work at all, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary. Objectives. To synthesize evidence on RTW interventions for people living with Long COVID and to identify promising interventions for enhancing work ability and RTW. Methods. We followed Arksey & OMalleys methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies. Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), or not promising (non-statistically significant RTW outcomes or < 20% RTW). Results. Eleven recommendations and eleven intervention studies were identified. Of the intervention studies, 6 were cohort studies, 3 quasi-experimental studies, 1 RCT and 1 case report. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation (1 article), psychoeducation, pacing, and breathing strategies (2 articles), shifting focus from symptom monitoring to optimizing functional outcomes (1 article), and enhanced external CounterPulsation (EECP) inflatable pressure to improve blood flow (1 article). Conclusion. Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Funding for this research was provided by the Glenrose Rehabilitation Hospital Foundation.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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Data Availability

All data use in this systematic review are publicly available.

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