Long COVID in Healthcare and Non-Healthcare workers: cross-sectional study in five Spanish hospitals

Abstract Background Healthcare workers (HCWs), including both clinical and non-clinical staff, were on the frontline during the pandemic, and as such, more exposed to COVID-19 in their workplace. However, the prevalence of long COVID and associated occupational risk factors in this group remain poorly understood. Aims To estimate the prevalence of long COVID and assess occupational factors among HCWs across five Spanish hospitals. Methods A cross-sectional study was carried out between 2020-2024 in five Spanish hospitals from Madrid (n = 1), Alicante (n = 1) and Barcelona (n = 3) with a total sample of 8802 HCWs. Data were obtained from hospital registries (n = 3 hospitals) and staff surveys (n = 2 hospitals). Key variables included sex, age, occupational group (HCWs vs non-HCWs), contract type, work-time, shiftwork and clinical service. Prevalence estimates with 95% confidence intervals (CIs) were calculated, and subgroup differences were tested using chi-square of Fisher's exact tests. Results Long COVID prevalence ranged from 3% (CI 2.43-3.59) to 5 % (CI 4.27-5.67) across hospitals. The combined prevalence was 4.2%. Higher prevalence was observed in women (up to 5.9%) and HCWs aged >50 years (up to 15%). Nurse assistant, administrative and maintenance staff consistently showed the highest rates. No significant association were found for contract type, work-time, shiftwork or clinical service. Conclusions Long COVID represents a substantial occupational health issue among Spanish HCWs, particularly affecting women, older workers, and non-clinical staff. These findings highlight the need for targeted workplace health policies and support for affected workers. Key messages • Long COVID disproportionately affects women, older staff, and non-clinical healthcare workers, underscoring inequalities in occupational health risks. • Targeted workplace policies are needed to support HCWs affected by long COVID and to strengthen occupational health resilience in future public health emergencies.