EC Pulmonology and Respiratory Medicine

Background: Long-term symptoms can greatly affect the lives and employment of people who have had COVID-19. Although studies exist on COVID-19’s long-term symptoms, an investigation of these symptoms specifically among recovered teachers has been overlooked. There is a lack of empirical evidence on the impact of personal resources in mitigating symptom severity and aiding teachers' successful reintegration into schools.

Objective: To evaluate the association of personal resources with teachers' well-being and severity of long-term symptoms following COVID-19 recovery.

Methods: A cross-sectional design, using an online survey questionnaire, from January-February 2022. Participants were COVID-19 survivor teachers from Israel (N = 117). Of them, 57.3% contracted COVID-19 in the six months prior to the study, while 42.7% contracted COVID-19 six-twelve months prior to the study. Statistical analyses included chi-square, factor analysis, Pearson correlations, and a linear regression analysis.

Results: A positive correlation was found between mental well-being and personal resources (i.e., optimism, social support, willingness to seek mental help, and attitude towards physical activity). Blood pressure (high/low), numbness, hot flashes, and dry eyes were negatively associated with optimism, social support, and willingness to seek mental help. The regression models to predict mental well-being yielded significant results [F(4,112) = 19.55, p < .001], explaining 19.55% of the variance. The symptoms: numbness, dry eyes, low/high blood pressure were associated with time since recovery [chi²(1) = 3.28, p < .05].

Conclusion: Comprehensive follow-up care for teachers with long COVID should be prioritized to support their return to schools. Certain measures could improve their physical and mental health and overall well-being.

 Keywords: Recovered Teachers; Personal Resources; Social Support; Well-Being; Long COVID; Post-COVID Symptoms

1. Fleischer Michael., et al. “Post-COVID-19 syndrome is rarely associated with damage of the nervous system: findings from a prospective observational cohort study in 171 patients”. Neurology and Therapy4 (2022): 1637-1657.
2. Yong Shin Jie. "Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments”. Infectious Diseases10 (2021): 737-754.
3. Davis Hannah E., et al. “Characterizing long COVID in an international cohort: 7 months of symptoms and their impact”. EClinicalMedicine 38 (2021): 101019.
4. Lippi Giuseppe., et al. "COVID-19 and its long-term sequelae: what do we know in 2023”. Polish Archives of Internal Medicine 4 (2023): 16402.
5. Vanichkachorn Greg., et al. “Post–COVID-19 syndrome (long haul syndrome): description of a multidisciplinary clinic at Mayo clinic and characteristics of the initial patient cohort”. Mayo Clinic Proceedings 7 (2021): 1782-1791.
6. Zarei Mohammad., et al. “Long‐term side effects and lingering symptoms post COVID‐19 recovery”. Reviews in Medical Virology3 (2022): e2289.
7. Han Q., et al. “Long-term sequelae of COVID-19: a systematic review and meta-analysis of one-year follow-up studies on post-COVID symptoms”. Pathogens2 (2022): 269.
8. Levkovich Inbar and Ela Kalimi. "Long COVID-19 Symptoms among Recovered Teachers in Israel: A Mixed-Methods Study”. COVID4 (2023): 480-493.
9. Smith Pierre., et al. “Post COVID-19 condition and its physical, mental and social implications: protocol of a 2-year longitudinal cohort study in the Belgian adult population”. Archives of Public Health1 (2022): 151.
10. Fallah Bahareh., et al. “Investigating the association between stress coping strategies and social support in COVID-19 survivors”. Iranian Journal of Psychiatry and Behavioral Sciences4 (2021): e112635.
11. Aiyegbusi Olalekan Lee., et al. “Symptoms, complications and management of long COVID: a review”. Journal of the Royal Society of Medicine9 (2021): 428-442.
12. Koc Ho Cheng., et al. “Long COVID and its Management”. International Journal of Biological Sciences12 (2022): 4768.
13. Ferber Sari Goldstein., et al. “Perceived social support in the social distancing era: the association between circles of potential support and COVID-19 reactive psychopathology”. Anxiety, Stress, and Coping1 (2022): 58-71.
14. Lannin Daniel G., et al. "Anticipating self-stigma: The roles of values and perceptions of therapy clients”. Stigma and Health (2023).
15. Yu Yu., et al. “Double stigma and help-seeking barriers among Blacks with a behavioral health disorder”. Psychiatric Rehabilitation Journal 2 (2022): 183-191.
16. Entilli Lorenza., et al. “Social support and help-seeking among suicide bereaved: a study with Italian survivors”. OMEGA-Journal of Death and Dying2 (2023): 534-553.
17. Huang Liang and Ting Zhang. "Perceived social support, psychological capital, and subjective well-being among college students in the context of online learning during the COVID-19 pandemic”. The Asia-Pacific Education Researcher 5 (2022): 563-574.
18. Nam Suk Kyung., et al. “Psychological factors in college students' attitudes toward seeking professional psychological help: A meta-analysis”. Professional Psychology: Research and Practice1 (2013): 37-45.
19. Hutchison Sarah M., et al. “School staff and teachers during the second year of COVID-19: Higher anxiety symptoms, higher psychological distress, and poorer mental health compared to the general population”. Journal of Affective Disorders Reports 8 (2022): 100335.
20. Puig-Perez Sara., et al. “Optimism as a protective factor against the psychological impact of COVID-19 pandemic through its effects on perceived stress and infection stress anticipation”. Current Psychology (2022): 1-15.
21. Martin SD., et al. “Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students”. Journal of Professional Nursing 38 (2022): 45-53.
22. Levkovich Inbar., et al. "Challenges to Israeli Teachers during the Fifth Wave of the COVID-19 Pandemic: How Did They Cope When the Schools Reopened?”. The Teacher Educator (2023): 1-12.
23. Awwad-Tabry Sawsan., et al. “Arab Teachers’ Well-Being upon School Reopening during COVID-19: Applying the Job Demands–Resources Model”. Education Sciences4 (2023): 418.
24. Zimet Gregory D., et al. “The multidimensional scale of perceived social support”. Journal of Personality Assessment 1 (1988): 30-41.
25. Fischer Edward H and John I Turner. "Orientations to seeking professional help: development and research utility of an attitude scale”. Journal of Consulting and Clinical Psychology1 (1970): 79-90.
26. Scheier Michael F and Charles S Carver. "Optimism, coping, and health: assessment and implications of generalized outcome expectancies”. Health Psychology3 (1985): 219-247.
27. Motl Robert W., et al. “Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls”. Preventive Medicine5 (2000): 584-594.
28. Nelson Timothy D., et al. "Negative attitudes toward physical activity: Measurement and role in predicting physical activity levels among preadolescents”. Journal of Pediatric Psychology1 (2010): 89-98.
29. Lamers Sanne MA., et al. “Evaluating the psychometric properties of the mental health continuum‐short form (MHC‐SF)”. Journal of Clinical Psychology1 (2011): 99-110.
30. Tran Viet-Thi., et al. “Development and validation of the long coronavirus disease (COVID) symptom and impact tools: a set of patient-reported instruments constructed from patients’ lived experience”. Clinical Infectious Diseases 2 (2022): 278-287.
31. Hobfoll SE. “Conservation of resources: A new attempt at conceptualizing stress”. American Psychologist3 (1989): 513-524.
32. Hobfoll SE., et al. “Conservation of resources in the organizational context: The reality of resources and their consequences”. Annual Review of Organizational Psychology and Organizational Behavior 5 (2018): 103-128.
33. Levkovich Inbar and Shiri Shinan-Altman. "Impact of the COVID-19 pandemic on stress and emotional reactions in Israel: a mixed-methods study”. International Health4 (2021): 358-366.
34. Levkovich Inbar., et al. “Depression and health-related quality of life among elderly patients during the COVID-19 pandemic in Israel: A cross-sectional study”. Journal of Primary Care and Community Health 12 (2021): 2150132721995448.
35. Wahyuhadi Joni., et al. “Association of stigma with mental health and quality of life among Indonesian COVID-19 survivors”. Plos one2 (2022): e0264218.
36. Garrigues Eve., et al. “Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19”. Journal of Infection6 (2020): e4-e6.
37. Lopez-Leon Sandra., et al. “Long-COVID in children and adolescents: A systematic review and meta-analyses”. Scientific Reports1 (2022): 9950.
38. Vaes Anouk W., et al. “Recovery from COVID-19: a sprint or marathon? 6-month follow-up data from online long COVID-19 support group members”. ERJ Open Research2 (2021): 00141-2021.
39. Rogers Jonathan P., et al. “Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic”. The Lancet Psychiatry7 (2020): 611-627.
40. Nandasena HMRKG., et al. “Quality of life of COVID 19 patients after discharge: Systematic review”. PloS one 2 (2022): e0263941.
41. Rass Verena., et al. “Factors associated with impaired quality of life three months after being diagnosed with COVID-19”. Quality of Life Research5 (2021): 1401-1414.
42. Huang Lixue., et al. “Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study”. The Lancet Respiratory Medicine9 (2022): 863-876.
43. Fadila Maulidiya., et al. "Factors Related to Quality of Life among Elderly During COVID-19 Pandemic”. International Journal of Nursing and Health Services (IJNHS)1 (2022): 45-55.
44. Poudel Ak Narayan., et al. “Impact of Covid-19 on health-related quality of life of patients: A structured review”. PloS one10 (2021): e0259164.
45. Coelho Carlos M., et al. “On the nature of fear and anxiety triggered by COVID-19”. Frontiers in Psychology 11 (2020): 581314.
46. Shinan-Altman Shiri and Inbar Levkovich. "Are personal resources and perceived stress associated with psychological outcomes among Israeli teachers during the third COVID-19 lockdown?”. International Journal of Environmental Research and Public Health9 (2022): 5634.
47. Sun Luna., et al. “Prevalence and risk factors for acute posttraumatic stress disorder during the COVID-19 outbreak”. Journal of Affective Disorders 283 (2021): 123-129.
48. Kesuma Evi Gustia., et al. “Social support Improved the quality of life among Covid-19 Survivors in Sumbawa”. International Journal of Nursing and Health Services (IJNHS) 4 (2022): 319-327.
49. Levkovich Inbar and Shiri Shinan-Altman. "Factors associated with work-family enrichment among working Israeli parents during COVID-19 lockdowns”. Archives of Environmental and Occupational Health2 (2023): 61-70.
50. Shinan-Altman Shiri., et al. "Healthcare utilization among breast cancer patients during the COVID-19 outbreak”. Palliative and Supportive Care4 (2020): 385-391.
51. Yang Xiao., et al. “Social support and clinical improvement in COVID-19 positive patients in China”. Nursing Outlook6 (2020): 830-837.