Research presented at the 2020 ESCMID Conference on Coronavirus Disease (ECCVID), held online from 23-25 September, shows that persistent fatigue occurs in more than half of patients recovered from COVID-19, regardless of the seriousness of their infection.
“Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. Whilst the presenting features of SARS-CoV-2 infection have been well-characterised, the medium and long-term consequences of infection remain unexplored,” explained study lead author Dr Liam Townsend, St James’s Hospital and Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland.
The study used a commonly-used scale to determine fatigue in recovered patients, called the Chalder Fatigue Score (CFQ-11). They also looked at the severity of the patient’s initial infection (need for admission, and critical/intensive care), their pre-existing conditions including depression, and various markers of immune activation (white cell counts, C-reactive protein, Interluekin-6, and sCD25).
The study included 128 participants (mean age 50 years; 54% female) who were recruited consecutively at a median of 10 weeks following clinical recovery from SARS-CoV-2 infection. More than half reported persistent fatigue (52.3%; 67/128) at this point.
Of the patients assessed in this study, 71/128 (55.5%) were admitted to hospital and 57/128 (44.5%) were not admitted. “Fatigue was found to occur independent of admission to hospital, affecting both groups equally,” explained Dr Townsend.
There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation and cell turnover (white blood cell counts or ratios, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue post COVID-19.
Female gender and those with a pre-existing diagnosis of depression/anxiety were over-represented in those with fatigue. Although women represented just over half of the patients in the study (54%), two-thirds of those with persistent fatigue (67%) were women.