The post COVID-19 syndrome (PCS) is an emerging phenomenon worldwide with enormous socioeconomic impact. While many patients describe neuropsychiatric deficits, the symptoms are yet to be assessed and defined systematically. In this prospective cohort study, we report on the results of a neuropsychiatric consultation implemented in May 2021. A cohort of 105 consecutive patients with merely mild acute course of disease was identified by its high symptom load 6 months post infection using a standardized neurocognitive and psychiatric-psychosomatic assessment. In this cohort, we found a strong correlation between higher scores in questionnaires for fatigue (MFI-20), somatization (PHQ15) and depression (PHQ9) and worse functional outcome as measured by the post COVID functional scale (PCFS). In contrast, neurocognitive scales correlated with age, but not with PCFS. Standard laboratory and cardiopulmonary biomarkers did not differ between the group of patients with predominant neuropsychiatric symptoms and a control group of neuropsychiatrically unaffected PCS patients. Our study delineates a phenotype of PCS dominated by symptoms of fatigue, somatisation and depression. The strong association of psychiatric and psychosomatic symptoms with the PCFS warrants a systematic evaluation of psychosocial side effects of the pandemic itself and psychiatric comorbidities on the long-term outcome of patients with SARS-CoV-2 infection.

Background: Post COVID-19 Condition (PCC, also known as long COVID and post-acute sequelae of COVID-19) is a major public health concern with severe and pervasive impacts on physical and mental health. PCC is highly heterogeneous and may manifest as different clusters of symptoms of varying intensity and duration. The etiology of PCC remains uncertain, though several underlying pathophysiological mechanisms, such as cellular damage, inflammatory cytokines, and a hypercoagulable state, are thought to contribute to PCC inception and trajectory. Examination of potential serological markers of PCC, accounting for clinical covariates, may yield emergent pathophysiological insights. Objectives: Primary objectives of this thesis are to 1) Identify key clinical and potential serological predictors of PCC; 2) Acquire clinical and serological data in a large-scale prospective observational study; 3) Assess relationships between PCC and serological markers, accounting for clinical covariates; 4) Systematically review evidence to date on primary observational studies comparing serological response between people with and without persistent symptoms post COVID-19 recovery; 5) Discuss persisting gaps in knowledge and data quality, and propose strategies for resolve. Methods: This thesis is framed around three core efforts: 1) The design of survey questions and study materials, recruitment of participants, and data collection in a large-scale prospective cohort study launched in 2020; 2) The assessment of relationships between pre-defined serological predictors and PCC, accounting for clinical covariates; and 3) A robust rapid review of PCC onset and phenotype as functions of serological markers. Expert opinion was sought to define serological predictors. Clinical predictors were defined a priori based on systematic reviews meeting AMSTAR 2 guidelines. Conclusions: To address objectives, we described efforts to collect clinical and serological data from a large-scale prospective cohort study; identify PCC-cases and infected-controls; assess associations between pre-defined serological predictors (IgG titres targeting SARS-CoV-2 spike (S), nucleocapsid (N), and receiver binding domain (RBD) antigens, and efficient neutralization) and PCC; and synthesized findings from an extensive rapid review on PCC as a function of serological markers. Our multivariate analysis using Stop the Spread Ottawa data is, to our knowledge, the first Canadian study to report the direction and magnitude of association between selected serological predictors (anti-IgG response to S, N, and RBD SARS-CoV-2 antigens, and neutralizing efficiency) and PCC status and impact on quality of life. Finally, we described five potential strategies which may improve the accessibility, quality, and amalgamation of data pertaining to PCC: 1) Fostering comparability between studies to enable synthesis of multiple datasets; 2) Advancing the characterization and consensus on PCC phenotypes; 3) Employing innovative modelling strategies that could potentially yield novel insights; 4) Promoting robust collaboration and knowledge sharing among research teams; and 5) Engaging people with lived experience at all stages of research.

I ett ständigt föränderligt samhälle krävs det att organisationer arbetar för att upplevas attraktiva då det kan leda till konkurrenskraft på marknaden. Covid-19 ställer nya krav på arbetsgivaren som i vissa fall fått införa distansarbete för anställda.  Studien syftar till att beskriva anställdas upplevelser av distansarbete under covid-19 och hur fortsatt distansarbete efter covid-19 är en faktor som de anställda upplever påverkar organisationens attraktivitet. Två forskningsfrågor utvecklas:  1. Vad har anställda för upplevelser av distansarbete under covid-19?2. På vilket sätt är distansarbete efter covid-19 en faktor som anställda upplever påverkar  organisationens attraktivitet?  Tolkningsperspektivet präglar studiens syfte och tillvägagångssätt. Studien genomförs fallspecifikt i en global organisation och en induktiv ansats genomsyrar studien då syftet är utforskande. Studien är av kvalitativ karaktär där semistrukturerade intervjuer använts för insamling av empiri. Vidare används en tematisk analys som metodansats. I Forskningsfråga 1 utvecklas temana: Work life balance, Information, kommunikation och interaktion samt Effekten av distansarbetet. Forskningsfråga 2 består av temana: Flexibilitet efter covid-19 och Flexibilitetens indikationer. Förankring med tidigare forskning skapar en större förståelse för empirin. Slutsatsen är att upplevelserna av distansarbete under covid-19 i det specifika fallet varierar och är individuella. Det framkommer att flexibelt distansarbete efter covid-19 ökar organisationens attraktivitet eftersom det signalera på andra attraktiva faktorer däremot krävs vissa förutsättningar från organisationens sida. / In a constantly changing society, there is a demand for organizations to be seen as attractive as they may develop competitiveness on the market. Due to covid-19 newly formed demands are being established for the employer to follow such as working remotely.  The purpose of the study is to describe the employee's experiences of remote work during covid-19 and how organizations will be perceived as attractive by the employees when offering remote work post covid-19. Two research questions have been conducted:  What are the employee's experiences with remote work? In what way do remote work post covid-19 influence the attractiveness of the organization? Interpretivism is conducted as the paradigm of the study to further carve the purpose and approach. The study is developed through a single case study in a global organization with an inductive approach that permeates the investigation of the purpose. The study is qualitative where semi-structured interviews are used as a collection of empirics. Furthermore, a thematic analysis is used. In the first research question the following themes are developed: Work-life balance, Information, Communication and Interaction and The Effect of Remote work. The themes developed through the second research question follow: Flexibility after covid-19 and the Indications of Flexibility. The previous research creates a greater understanding of empirics. The conclusion reveals that the perception of remote work during covid-19 in the specific case varies and is individualistic. Flexibility in remote work post covid-19 emerges as increasing the attractiveness of the organization. This serves as an indication of other attractive elements however some conditions are required.