Sex and occupational differences in long COVID prevalence among healthcare workers: a multicentre registry-based study in three Spanish hospitals

Aims To estimate the prevalence of clinically diagnosed long COVID and examine associated occupational and demographic factors among healthcare workers (HCWs) in Spain using registry data of three hospitals. Methods A multicentre study was conducted between 2020 and 2023 in three Spanish hospitals (Madrid, n=1; Barcelona, n=2). Long COVID prevalence and 95% confidence intervals (CIs) were estimated overall and by sex, age group, and occupational category. Associations between long COVID and occupational category were assessed using Poisson regression models with robust variance, stratified by sex and adjusted for age and hospital. Results Registry data included 8,439 HCWs. Long COVID prevalence ranged from 3.0% to 5.0% and increased with age, with an adjusted prevalence ratio (PR) increase of 3-9% per year. Occupational differences were more pronounced among men. In University Hospital Ramon y Cajal, male nurses (PR 2.56; 95% CI 1.13–5.81) and other HCWs (PR 3.67; 95% CI 1.12–12.08) had higher prevalence compared with physicians. In Hospital Parc Tauli, male nurse assistants (PR 20.33; 95% CI 3.64–113.42) and support staff (PR 8.30; 95% CI 1.46–47.19) showed markedly elevated prevalence, although confidence intervals were wide. Among women, occupational associations were weaker and less consistent. Overall sex differences were modest, but sex modified the association between occupational role and long COVID prevalence. Conclusions Long COVID affected 3-5% of Spanish HCWs. Occupational role, particularly among men, was associated with long COVID prevalence, highlighting the need for occupational health surveillance and follow-up strategies that account for sex-specific patterns and differences in job roles.