New study highlights the burden of post-COVID fatigue

Reviewed by Emily Henderson, B.Sc.Nov 11 2020

More than half of people with acute COVID-19 infection continue to have persistent fatigue 10 weeks after their initial illness, according to a new study published November 9 in the open-access journal PLOS ONE by Liam Townsend of Trinity College Dublin, Ireland and colleagues.

Fatigue is one of the most common initial presenting complaints of people infected with SARS-CoV-2, the virus that causes COVID-19. The long-term consequences of COVID-19 have not been well-studied and concern has been raised that the virus has the potential to trigger a post-viral fatigue syndrome.

In the new study, researchers tracked fatigue, as well as patient characteristics including COVID-19 severity, laboratory markers, levels of inflammatory markers and pre-existing conditions, in 128 study participants who had previously been infected with SARS-CoV-2. The participants, all recruited from a post-COVID-19 outpatient clinic at St. James Hospital in Dublin, Ireland, were 54% female and averaged 49.5 years old (standard deviation ±15 years). 55.5% of the participants had been admitted to the hospital for their COVID-19 treatment while the remainder were treated as outpatients. On average, they were assessed for the study 72 days after discharge from a hospital or, if managed as an outpatient, after a timepoint 14 days following diagnosis.

Based on their score on the Chalder Fatigue Scale (CFQ-11), 52.3% (67/128) of study participants met the criteria for fatigue at the assessment point at least 6 weeks following COVID-19 infection. Only 42.2% of the patients (54/128) reported feeling back to their full health. Importantly, there was no association between COVID-19 severity, need for hospital admission, or routine laboratory markers of inflammation with the likelihood of experiencing persistent fatigue after infection.

Though the study is limited in that the population cohort was predominantly white and Irish, and patients were only assessed at a single timepoint with no follow-up, the authors also found that female gender and a history of anxiety or depression was more common in the severe fatigue group (X2=9.95, p=0.002 for female; X2=5.18, p=0.02 for depression history).

The authors add: "This study highlights the burden of post-COVID fatigue. It also demonstrates that post-COVID fatigue is unrelated to severity of initial infection, so predicting its development is not easy."