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Persistent fatigue after COVID-19 common and independent of disease severity

Tiredness or fatigue has become a recognised symptom among patients infected with COVID-19, reportedly affecting between 44% and 69% of individuals. Although in the past, chronic fatigue has been documented among patients affected by other coronaviruses, little is known about whether this symptom persists in those who have recovered from COVID-19.

Researchers from the Department of Infectious Diseases, St James’s Hospital, Dublin, Ireland, have examined the prevalence of fatigue using the Chalder Fatigue Scale (CFQ-11) in patients who had recovered from the acute phase of a COVID-19 infection. The CFQ-11 scale asks about symptoms over the past month and assesses both physical and psychological fatigue with a total score greater than 4 meeting the criteria for fatigue. The researchers also measured white blood cell counts, CRP and interleukin-6 and sCD25 to assess if there was a correlation between these markers and fatigue.

A total of 128 patients with a mean age of 49.5 years (53.9% female) were included in the final analysis and 55.5% of these had been admitted to hospital because of COVID-19 with the remainder seen at an outpatient clinic. The mean baseline CFQ-11 score was 15.8 across the study population with a mean physical score of 11.38 and a mean psychological score of 4.72. Overall, 52.3% of participants met the criteria for persistent fatigue, with a mean CFQ-11 score of 20 at a median 10 weeks after the initial COVID-19 infection. Interestingly, there was no association between the severity of COVID-19 infection and fatigue scores and an analysis of the blood tests did not reveal any association between fatigue scores and IL-6 levels or sCD25. Furthermore, the impact of fatigue had led to almost a third (31%) of participants not having returned to work after 10 weeks.

The authors concluded that their study suggests that COVID-19 creates a huge burden of fatigue which is likely to impair quality of life necessitating management strategies for convalescing patients.

Townsend L et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS ONE 2020 e0240784. 10.1371/journal.pone.0240784