Background:The COVID-19 pandemic disrupted work environments worldwide, increasing productivity loss through absenteeism and presenteeism. Identifying key associated factors is essential for informing workplace health strategies during public health crises. Methods/Project: A systematic review and meta-analysis were conducted following PRISMA guidelines, using comprehensive searches of seven electronic databases from inception through January 2024. Studies were systematically selected based on predefined eligibility criteria, and 24 studies examining individual and work-related factors associated with work productivity loss were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools. Correlation coefficients were synthesized using a random-effects meta-analysis of correlations in STATA 17.0, and heterogeneity was evaluated using the I2 statistic and Cochran’s Q test. Findings: Twenty-one factors were analyzed. Job stress, fear of COVID-19, mental health problems, job insecurity, turnover intention, exhaustion, and job demands exhibited moderate positive correlations with productivity loss during the COVID-19 pandemic. Fear of COVID-19 and mental health problems showed relatively large positive correlations with presenteeism. General health status was the factor most strongly associated with absenteeism, exhibiting a moderate negative correlation. Conclusions/Application to Practice: These findings identify key individual and work-related determinants of productivity loss during pandemics. The results support the development of targeted workplace health promotion, mental health support, and preparedness strategies to mitigate productivity loss during future public health emergencies.
AbdollahzadeS.RafieiS.SouriS. (2024). The need for attention to mental health of nursing staff during COVID-19 pandemic as their basic human right. International Journal of Human Rights in Healthcare, 17(2), 145–156. https://doi.org/10.1108/IJHRH-04-2022-0031
2.
AronssonG.GustafssonK. (2005). Sickness presenteeism: Prevalence, attendance-pressure factors, and an outline of a model for research. Journal of Occupational & Environmental Medicine, 47(9), 958–966. https://doi.org/10.1097/01.jom.0000177219.75677.17
3.
AutryC. W.DaughertyP. J. (2003). Warehouse operations employees: linking person-organization fit, job satisfaction, and coping responses. Journal of Business Logistics, 24(1), 171–197. https://doi.org/10.1002/j.2158-1592.2003.tb00036.x
4.
BierlaI.HuverB.RichardS. (2013). New evidence on absenteeism and presenteeism. The International Journal of Human Resource Management, 24(7), 1536–1550. https://doi.org/10.1080/09585192.2012.722120
5.
BironC.Karanika-MurrayM.IversH.SalvoniS.FernetC. (2021). Teleworking while sick: A three-wave study of psychosocial safety climate, psychological demands, and presenteeism. Frontiers in Psychology, 12, Article 734245. https://doi.org/10.3389/fpsyg.2021.734245
6.
BloomN.BunnP.MizenP.SmietankaP.ThwaitesG. (2025). The impact of Covid-19 on productivity. Review of Economics & Statistics, 107(1), 28–41. https://doi.org/10.1162/rest_a_01298
7.
BrooksA.HagenS. E.SathyanarayananS.SchultzA. B.EdingtonD. W. (2010). Presenteeism: Critical issues. Journal of Occupational & Environmental Medicine, 52(11), 1055–1067. https://doi.org/10.1097/JOM.0b013e3181f475cc
8.
BrouwerW.VerbooyK.HoefmanR.van ExelJ. (2023). Production losses due to absenteeism and presenteeism: The influence of compensation mechanisms and multiplier effects. Pharmacoeconomics, 41(9), 1103–1115. https://doi.org/10.1007/s40273-023-01253-y
BrunnerB.IgicI.KellerA. C.WieserS. (2019). Who gains the most from improving working conditions? Health-related absenteeism and presenteeism due to stress at work. The European Journal of Health Economics, 20(8), 1165–1180. https://doi.org/10.1007/s10198-019-01084-9
11.
ChenJ. W.LuL.CooperC. L. (2021). The compensatory protective effects of social support at work in presenteeism during the coronavirus disease pandemic. Frontiers in Psychology, 12, Article 643437. https://doi.org/10.3389/fpsyg.2021.643437
12.
ChoY.-S.ParkJ. B.LeeK.-J.MinK.-B.BaekC. I. (2016). The association between Korean workers’ presenteeism and psychosocial factors within workplaces. Annals of Occupational & Environmental Medicine, 28(1), Article 41. https://doi.org/10.1186/s40557-016-0124-1
13.
ChouC. Y.MachM. (2021). Unlocking the contradictory outcomes of presenteeism through a temporal model: Effort exertion as a mediator. Frontiers in Psychology, 12, Article 740411. https://doi.org/10.3389/fpsyg.2021.740411
14.
ČikešV.Maskarin RibaricH.ČrnjarK. (2018). The determinants and outcomes of absence behavior: A systematic literature review. Social Sciences, 7(8), Article 120. https://doi.org/10.3390/socsci7080120
CosciF.GuidiJ. (2021). The role of illness behavior in the COVID-19 pandemic. Psychotherapy & Psychosomatics, 90(3), 156–159. https://doi.org/10.1159/000513968
17.
DanquahE.AsiamahN. (2022). Associations between physical work environment, workplace support for health, and presenteeism: A COVID-19 context. International Archives of Occupational & Environmental Health, 95(9), 1807–1816. https://doi.org/10.1007/s00420-022-01877-1
18.
DeadyM.CollinsD. A.GlozierN.GardinerE.ArenaA.GayedA.HarveyS. B. (2025). Naturalistic evaluation of HeadGear: A smartphone app to reduce depressive symptoms in workers. Behavior Therapy, 56(3), 529–542. https://doi.org/10.1016/j.beth.2024.01.001
19.
DeeryS.WalshJ.ZatzickC. D. (2014). A moderated mediation analysis of job demands, presenteeism, and absenteeism. Journal of Occupational & Organizational Psychology, 87(2), 352–369. https://doi.org/10.1111/joop.12051
20.
DennerleinJ. T.BurkeL.SabbathE. L.WilliamsJ. A.PetersS. E.WallaceL.SorensenG. (2020). An integrative total worker health framework for keeping workers safe and healthy during the COVID-19 pandemic. Human Factors, 62(5), 689–696. https://doi.org/10.1177/0018720820932699
21.
Evans-LackoS.KnappM. (2016). Global patterns of workplace productivity for people with depression: Absenteeism and presenteeism costs across eight diverse countries. Social Psychiatry & Psychiatric Epidemiology, 51(11), 1525–1537. https://doi.org/10.1007/s00127-016-1278-4
22.
FieldA. P.GillettR. (2010). How to do a meta-analysis. The British Journal of Mathematical & Statistical Psychology, 63(3), 665–694. https://doi.org/10.1348/000711010X502733
23.
FreelingM.RainbowJ. G.ChamberlainD. (2020). Painting a picture of nurse presenteeism: A multi-country integrative review. International Journal of Nursing Studies, 109, Article 103659. https://doi.org/10.1016/j.ijnurstu.2020.103659
24.
GerichJ. (2022). Home-based telework and presenteeism: New lessons learned from the COVID-19 pandemic. Journal of Occupational & Environmental Medicine, 64(3), 243–249. https://doi.org/10.1097/JOM.0000000000002414
25.
GosselinE.LemyreL.CorneilW. (2013). Presenteeism and absenteeism: Differentiated understanding of related phenomena. Journal of Occupational Health Psychology, 18(1), 75–86. https://doi.org/10.1037/a0030932
26.
HadianM.JabbariA.AbdollahiM.HosseiniE.SheikhbardsiriH. (2022). Explore pre-hospital emergency challenges in the face of the COVID-19 pandemic: A qualitative content analysis in the Iranian context. Frontiers in Public Health, 10, Article 864019. https://doi.org/10.3389/fpubh.2022.864019
27.
HansenC. D.AndersenJ. H. (2008). Going ill to work – What personal circumstances, attitudes and work-related factors are associated with sickness presenteeism?Social Science & Medicine, 67(6), 956–964. https://doi.org/10.1016/j.socscimed.2008.05.022
28.
HartleyD. J.DavilaM. A.MarquartJ. W.MullingsJ. L. (2013). Fear is a disease: The impact of fear and exposure to infectious disease on correctional officer job stress and satisfaction. American Journal of Criminal Justice, 38(2), 323–340. https://doi.org/10.1007/s12103-012-9175-1
29.
HigginsJ. P.ThompsonS. G.DeeksJ. J.AltmanD. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557
30.
HowardK. J.HowardJ. T.SmythA. F. (2012). The problem of absenteeism and presenteeism in the workplace. In GatchelR. J.SchultzI. Z. (Eds.), Handbook of occupational health and wellness (pp. 151–179). Springer US. https://doi.org/10.1007/978-1-4614-4839-6_8
31.
HubensK.KrolM.CoastJ.DrummondM. F.BrouwerW. B. F.Uyl-de GrootC. A.Hakkaart-van RoijenL. (2021). Measurement instruments of productivity loss of paid and unpaid work: A systematic review and assessment of suitability for health economic evaluations from a societal perspective. Value in Health, 24(11), 1686–1699. https://doi.org/10.1016/j.jval.2021.05.002
32.
IdrisI.IdrisM. A.Syed-YahyaS. N. N.ZadowA. (2023). Longitudinal effects of quantitative job demands (QJD) on presenteeism and absenteeism: The role of QuanJI and QualJI as moderators. International Journal of Stress Management, 30(2), 195–208. https://doi.org/10.1037/str0000292
33.
IshimaruT.MineY.FujinoY. (2020). Two definitions of presenteeism: Sickness presenteeism and impaired work function. Occupational Medicine, 70(2), 95–100. https://doi.org/10.1093/occmed/kqaa009
34.
JiaH.ShangP.GaoS.CaoP.YuJ.YuX. (2022). Work stress, health status and presenteeism in relation to task performance among Chinese medical staff during COVID-19 pandemic. Frontiers in Public Health, 10, Article 836113. https://doi.org/10.3389/fpubh.2022.836113
35.
JohnsG. (2010). Presenteeism in the workplace: A review and research agenda. Journal of Organizational Behavior, 31(4), 519–542. https://doi.org/10.1002/job.630
36.
JohnstonD. A.HarveyS. B.GlozierN.CalvoR. A.ChristensenH.DeadyM. (2019). The relationship between depression symptoms, absenteeism and presenteeism. Journal of Affective Disorders, 256, 536–540. https://doi.org/10.1016/j.jad.2019.06.041
37.
KaratepeO. M.SaydamM. B.OkumusF. (2021). COVID-19, mental health problems, and their detrimental effects on hotel employees’ propensity to be late for work, absenteeism, and life satisfaction. Current Issues in Tourism, 24(7), 934–951. https://doi.org/10.1080/13683500.2021.1884665
38.
KayaalpA.ViskupicF.WiltseD. L.SublettL. W. (2023). Older workers’ work attitudes and behaviors during COVID-19 pandemic: A mediational model. Journal of Workplace Behavioral Health, 38(3), 254–273. https://doi.org/10.1080/15555240.2023.2212910
39.
KimY. S.ShinD. J.KimB. K. (2023). Effect of COVID-19-induced changes on job insecurity, presenteeism, and turnover intention in the workplace—An investigation of generalized anxiety disorder among hotel employees using the GAD-7 scale. Sustainability, 15(6), Article 5377. https://doi.org/10.3390/su15065377
40.
KoopmanC.PelletierK. R.MurrayJ. F.ShardaC. E.BergerM. L.TurpinR. S.HacklemanP.GibsonP.HolmesD. M.BendelT. (2002). Stanford presenteeism scale: health status and employee productivity. Journal of Occupational and Environmental Medicine, 44(1), 14–20. https://doi.org/10.1097/00043764-200201000-00004
41.
LaiJ.MaS.WangY.CaiZ.HuJ.WeiN.WuJ.DuH.ChenT.LiR.TanH.KangL.YaoL.HuangM.WangH.WangG.LiuZ.HuS. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), Article e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
42.
LauzierM.LalandeK.DionP. M.ChomienneM. H.GrenierJ.RodriguesJ. (2024). Presenteeism and job satisfaction among hospital environmental service workers during the COVID-19 pandemic: A moderated mediation model. International Journal of Healthcare Management, 17(4), 807–816. https://doi.org/10.1080/20479700.2023.2246239
LuL.LinH. Y.CooperC. L. (2013). Unhealthy and present: motives and consequences of the act of presenteeism among Taiwanese employees. Journal of Occupational Health Psychology, 18(4), 406–416. https://doi.org/10.1037/a0034331
45.
LuiJ. N. M.AndresE. B.JohnstonJ. M. (2018). Presenteeism exposures and outcomes amongst hospital doctors and nurses: A systematic review. BMC Health Services Research, 18(1), 1–15. https://doi.org/10.1186/s12913-018-3789-z
46.
LuiJ. N. M.JohnstonJ. M. (2019). Working while sick: Validation of the multidimensional presenteeism exposures and productivity survey for nurses (MPEPS-N). BMC Health Services Research, 19(1), Article 542. https://doi.org/10.1186/s12913-019-4373-x
47.
LytteltonT.ZangE. (2022). Occupations and sickness-related absences during the COVID-19 pandemic. Journal of Health & Social Behavior, 63(1), 19–36. https://doi.org/10.1177/00221465211053615
48.
MaestasN. A.MullenK. J.RennaneS. (2021). Absenteeism and presenteeism among American workers. Journal of Disability Policy Studies, 32(1), 13–23. https://doi.org/10.1177/1044207320933211
49.
MansourS.Faisal AzeemM.DollardM.PotterR. (2022). How psychosocial safety climate helped alleviate work intensification effects on presenteeism during the COVID-19 crisis? A moderated mediation model. International Journal of Environmental Research & Public Health, 19(20), Article 13673. https://doi.org/10.3390/ijerph192013673
50.
MaurícioA. C.LaranjeiraC. (2023). Presenteeism, job satisfaction, and psychological distress among Portuguese workers in a private social solidarity institution during the COVID-19 pandemic: A cross-sectional study. Administrative Sciences, 13(10), Article 220. https://doi.org/10.3390/admsci13100220
51.
Moe-ByrneT.ShepherdJ.Merecz-KotD.SinokkiM.NaumanenP.Hakkaart-van RoijenL.Uyl-de GrootC. A.BrouwerW. B. F. (2022). Effectiveness of tailored digital health interventions for mental health at the workplace: A systematic review of randomised controlled trials. PLOS Digital Health, 1(10), Article e0000123. https://doi.org/10.1371/journal.pdig.0000123
52.
MoolaS.MunnZ.TufanaruC.AromatarisE.SearsK.SfetcuR.CurrieM.LisyK.QureshiR.MattisP.MuP. (2020). Chapter 7. Systematic reviews of etiology and risk. In AromatarisE.LockwoodC.PorrittK.PillaB.JordanZ. (Eds.), JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-24-06
53.
Mosteiro-DíazM. P.Baldonedo-MosteiroM.BorgesE.BaptistaP.QueirósC.Sánchez-ZaballosM.FelliV.AbreuM.SilvaF.Franco-CorreiaS. (2020). Presenteeism in nurses: Comparative study of Spanish, Portuguese and Brazilian nurses. International Nursing Review, 67(4), 466–475. https://doi.org/10.1111/inr.12615
54.
MunnZ.BarkerT. H.MoolaS.TufanaruC.SternC.McArthurA.StephensonM.AromatarisE. (2020). Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Evidence Synthesis, 18(10), 2127–2133. https://doi.org/10.11124/JBISRIR-D-19-00099
55.
NowakJ.EmmermacherA.WendscheJ.DöblerA. S.WeggeJ. (2022). Presenteeism and absenteeism in the manufacturing sector: A multilevel approach identifying underlying factors and relations to health. Current Psychology, 42, 1–19. https://doi.org/10.1007/s12144-022-03013-1
56.
OzbozkurtO. B.BaharE.YesilkusF. (2024). Fear of COVID-19 as a mediator within the impact of presenteeism on social loafing. Work, 77(2), 431–443. https://doi.org/10.3233/WOR-230025
PapakonstantinouD.TomosC. (2022). Workplace productivity loss as a result of absenteeism and presenteeism in chronic and episodic migraine: A scoping review. International Journal of Workplace Health Management, 15(1), 38–53. https://doi.org/10.1108/IJWHM-05-2021-0123
59.
Parent-LamarcheA.LaforceS. (2022). A moderated mediation analysis of new work-related stressors, psychological distress, and absenteeism in health care during a pandemic: Is recognition the cure for preventing falling in battle?Journal of Occupational & Environmental Medicine, 64(10), 839–847. https://doi.org/10.1097/JOM.0000000000002619
60.
ParkJ. H. (2017). Study on correlation between change in employment environment and job instability of a hotel corporation: Mainly with deluxe hotels in the Daejeon area. International Journal of Tourism and Hospitality Research, 31(6), 141–154. https://doi.org/10.21298/IJTHR.2017.06.31.6.141
61.
PartlettC.RileyR. D. (2017). Random effects meta-analysis: Coverage performance of 95% confidence and prediction intervals following REML estimation. Statistics in Medicine, 36(2), 301–317. https://doi.org/10.1002/sim.7140
62.
PetersonR. A.BrownS. P. (2005). On the use of beta coefficients in meta-analysis. Journal of Applied Psychology, 90(1), 175–181. https://doi.org/10.1037/0021-9010.90.1.175
63.
RivkinW.DiestelS.GerpottF. H.UngerD. (2022). Should I stay or should I go? The role of daily presenteeism as an adaptive response to perform at work despite somatic complaints for employee effectiveness. Journal of Occupational Health Psychology, 27(4), 411–425. https://doi.org/10.1037/ocp0000322
64.
RuhleS. A.SüßS. (2020). Presenteeism and absenteeism at work—An analysis of archetypes of sickness attendance cultures. Journal of Business & Psychology, 35(2), 241–255. https://doi.org/10.1007/s10869-019-09615-0
65.
SarwarA.AbdullahM. I.ImranM. K.FatimaT. (2023). When fear about health hurts performance: COVID-19 and its impact on employee’s work. Review of Managerial Science, 17(2), 513–537. https://doi.org/10.1007/s11846-022-00536-6
66.
SchugC.GeiserF.HiebelN.BeschonerP.Jerg-BretzkeL.AlbusC.WeidnerK.MorawaE.ErimY. (2022). Sick leave and intention to quit the job among nursing staff in German hospitals during the COVID-19 pandemic. International Journal of Environmental Research & Public Health, 19(4), Article 1947. https://doi.org/10.3390/ijerph19041947
67.
ShimuraA.YokoiK.IshibashiY.AkatsukaY.InoueT. (2021). Remote work decreases psychological and physical stress responses, but full-remote work increases presenteeism. Frontiers in Psychology, 12, Article 730969. https://doi.org/10.3389/fpsyg.2021.730969
68.
ShossM. K.MinH.HoranK.SchlotzhauerA. E.NigamJ. A. S.SwansonN. G. (2023). Risking one’s life to save one’s livelihood: Precarious work, presenteeism, and worry about disease exposure during the COVID-19 pandemic. Journal of Occupational Health Psychology, 28(6), 363–379. https://doi.org/10.1037/ocp0000366
69.
SinclairR. R.AllenT.BarberL.BergmanM.BrittT.ButlerA.FordM.HammerL.KathL.ProbstT.YuanZ. (2020). Occupational health science in the time of COVID-19: Now more than ever. Occupational Health Science, 4(1), 1–22. https://doi.org/10.1007/s41542-020-00064-3
70.
StepanekM.JahanshahiK.MillardF. (2019). Individual, workplace, and combined effects modeling of employee productivity loss. Journal of Occupational & Environmental Medicine, 61(6), 469–478. https://doi.org/10.1097/JOM.0000000000001573
71.
StevensonJ.MillerC. L.MartinK.MohammadiL.LawnS. (2022). Investigating the reciprocal temporal relationships between tobacco consumption and psychological disorders for youth: An international review. BMJ Open, 12(6), Article e055499. https://doi.org/10.1136/bmjopen-2021-055499
72.
TaylorS. G.ButtsM. M.ColeM. S.PoundsT. (2021). Are you sick? Understanding the effects of coworker presenteeism on workplace mistreatment. Journal of Applied Psychology, 106(9), 1299–1313. https://doi.org/10.1037/apl0000966
73.
TurpinR. S.OzminkowskiR. J.ShardaC. E.CollinsJ. J.BergerM. L.BillottiG. M.BaaseC. M.OlsonM. J.NicholsonS. (2004). Reliability and validity of the Stanford Presenteeism Scale. Journal of Occupational & Environmental Medicine, 46(11), 1123–1133. https://doi.org/10.1097/01.jom.0000144999.35675.a0
74.
VinbergS.LandstadB. J.TjulinÅ.NordenmarkM. (2021). Sickness presenteeism among the Swedish self-employed during the COVID-19 pandemic. Frontiers in Psychology, 12, Article 723036. https://doi.org/10.3389/fpsyg.2021.723036
75.
VizhehM.QorbaniM.ArzaghiS. M.MuhidinS.JavanmardZ.EsmaeiliM. (2020). The mental health of healthcare workers in the COVID-19 pandemic: A systematic review. Journal of Diabetes & Metabolic Disorders, 19(2), 1967–1978. https://doi.org/10.1007/s40200-020-00643-9
76.
WadaK.ArakidaM.WatanabeR.NegishiM.SatoJ.TsutsumiA. (2013). The economic impact of loss of performance due to absenteeism and presenteeism caused by depressive symptoms and comorbid health conditions among Japanese workers. Industrial Health, 51(5), 482–489. https://doi.org/10.2486/indhealth.2013-0016
77.
WahlundT.Mataix-ColsD.Olofsdotter LauriK. O.de SchipperE.LjótssonB.AspvallK.AnderssonE. (2021). Brief online cognitive behavioural intervention for dysfunctional worry related to the COVID-19 pandemic: A randomised controlled trial. Psychotherapy & Psychosomatics, 90(3), 191–199. https://doi.org/10.1159/000512843
YaghoubiM.SalimiM.Meskarpour-AmiriM. (2022). Systematic review of productivity loss among healthcare workers due to Covid-19. The International Journal of Health Planning & Management, 37(1), 94–111. https://doi.org/10.1002/hpm.3351
80.
YoshidaT.KoyamaT.IshimaruT.MinouraA.MutohM.TabuchiT. (2023). Fear of COVID-19 among Japanese workers and exacerbation of chronic pain: A nationwide cross-sectional study. Journal of Occupational & Environmental Medicine, 65(3), e134–e140. https://doi.org/10.1097/JOM.0000000000002772
81.
ZhanM.QinY.XueX.ZhuS. (2020). Death from Covid-19 of 23 health care workers in China. The New England Journal of Medicine, 382(23), 2267–2268. https://doi.org/10.1056/NEJMc2005696
82.
ZhangW.BansbackN.AnisA. H. (2011). Measuring and valuing productivity loss due to poor health: A critical review. Social Science & Medicine, 72(2), 185–192. https://doi.org/10.1016/j.socscimed.2010.10.026
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