Workforce exit and work productivity loss in adults with and without post-COVID-19 condition:The PRIME post-COVID cohort study

Background: Post-COVID-19 condition (PCC) is highly prevalent, yet evidence on its long-term impact on work participation remains limited. This study assessed workforce exit and work productivity loss among adults with PCC compared to those recovered or without PCC. Methods: In this prospective cohort study (PRIME post-COVID) in the Netherlands, we used online questionnaire data from adults with a positive COVID-19 test between June 2020 and September 2022. Participants were categorized as PCC (not feeling recovered >= 3 months post-infection), Recovered, or Never PCC. All were employed in 2022, and workforce exit, work productivity loss, work incapacity, and financial strain were evaluated in 2024. Findings: The 2-year workforce exit rate was 17% in PCC (N = 790), 10% in Recovered (N = 437), and 9% in Never PCC (N = 2,115). Rates were higher among those with PCC, older age, and health conditions. Absenteeism and presenteeism were up to three times higher in PCC and two times higher in Recovered, compared to Never PCC. Among non-employed participants, work incapacity was highest in PCC (46%) versus Recovered (17%) and Never PCC (12%). Financial strain was highest in non-employed PCC (54%) and lowest in employed Never PCC (19%). Conclusion: PCC substantially impacts workforce participation and productivity. Support, interventions, and awareness are urgently needed. (c) 2026 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )