Evidence map›Paper›PMID 41820731›Full record

ArticleJournal of occupational rehabilitation2026

Long COVID and the Challenge of Long-Term Employment: An Ecological, Sequential Explanatory Mixed-Methods Approach.

Han Su, Briana Keller, Valerie Danesh, Joanne McPeake, Leanne M Boehm, Tammy L Eaton, Matthew F Mart, Mayur B Patel, E Wesley Ely

Abstract read
In one paragraph

Article in Journal of occupational rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Han SuSchool of Nursing, Vanderbilt University, 461 21 St Ave. S, Nashville, TN, 37240, USA. han.su@vanderbilt.edu.
Briana KellerSchool of Nursing, Vanderbilt University, 461 21 St Ave. S, Nashville, TN, 37240, USA.
Valerie DaneshCenter for Applied Health Research, Baylor Scott and White Health, Dallas, TX, USA.
Joanne McPeakeThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Leanne M BoehmSchool of Nursing, Vanderbilt University, 461 21 St Ave. S, Nashville, TN, 37240, USA.
Tammy L EatonVA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Matthew F MartCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Center for Health Services Research, Institute for Population and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
Mayur B PatelCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Center for Health Services Research, Institute for Population and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
E Wesley ElyCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Center for Health Services Research, Institute for Population and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.

Funding

RRD VA IK2 RX004799
6 · The paper itself

Abstract

purposeTo identify and contextualize the determinants of long-term employment, health, and financial outcomes among individuals affected by Long COVID.

methodsSequential explanatory mixed-methods study design guided by the social-ecological model. Adults with Long COVID who were employed before infection and returned to work during the three-year follow-up were recruited through in-person and virtual outpatient venues: ResearchMatch, a Long COVID clinic, and a peer support group affiliated with a medical center. Participants completed validated surveys assessing factors influencing sustained employment. Stratified semi-structured interviews were then conducted to explore how these factors shaped sustained employment. Quantitative data were analyzed using descriptive and inferential statistical methods, while qualitative data were analyzed through content analysis.

resultsAmong 79 participants who returned to work, 58% (n = 46) remained employed after a mean follow-up of 1,077 days. Those still employed reported reduced capacity and persistent uncertainty. Those no longer employed experienced worse physical health (p < 0.002), greater comorbidity burden (p = 0.01), more environmental barriers (p = 0.02), and increased financial hardship (p = 0.03). Qualitative analyses identified nonlinear return-to-work trajectories shaped by fluctuating and often invisible symptoms, alongside multilevel themes influencing employment sustainability, including misalignment between functional capacity and job demands, challenges obtaining workplace accommodations, stigma, limited policies, and labor market barriers.

conclusionsEmployment sustainability among individuals with Long COVID is shaped by complex, multilevel barriers, with job loss further worsening health and financial hardship. Investment in comprehensive Long COVID care, including multidisciplinary clinical services, vocational rehabilitation, clinician education, public awareness initiatives, employer training, and policy reform, is critical to support long-term recovery and employment sustainability.

Indexed as

DisabilitiesJob accommodationReturn to workVocational rehabilitation

Identifiers

PMID41820731
PMCPMC13366508

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.