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More than half of people who recover from COVID-19 still report fatigue 10 weeks later, regardless of the severity of their initial infection, an observational study published Nov.9 in PLOS One he found.
Led by researchers from Trinity College Dublin, the study involved taking blood samples and administering the Chalder Fatigue Scale (CFQ-11) assessment to 128 patients visiting a coronavirus outpatient clinic at St. James’s Hospital in Dublin. CFQ-11 rates fatigue on a scale of 9 to 63 based on a nine-item questionnaire, with a higher score indicating greater fatigue.
Sixty-seven of the 128 participants (52.3%) reported fatigue, a common symptom of acute COVID-19 infection, a median of 10 weeks after recovery, while 54 (42.2%) said they recovered their full health.
According to the CFQ-11 case definition, 67 of the 128 participants (52.3%) met the criteria for fatigue, with an average score of 20. While the participants’ physical and psychological fatigue levels after COVID-19 were higher compared to those in the general population, they were below the scores indicating chronic fatigue syndrome, a complex disease causing extreme fatigue for at least 6 months not related to any underlying disease.
Almost a third had not returned to work
Prior to the illness, 105 participants (82%) had worked outside the home, but 33 (31%) of them had not yet returned to work at the time of participation in the study. ‘This is of particular concern, as post-viral infection is recommended to return to function after four weeks to prevent deconditioning,’ the researchers wrote.
Seventy-one of the 128 patients (55%) were hospitalized for COVID-19 treatment, 35 (49%) of them received the antimalarial drug hydroxychloroquine, and 6 (8.5%) of that subgroup also received the corticosteroid prednisolone.
There was no link between persistent fatigue and the need for hospitalization, supplemental oxygen or intensive care, or laboratory biomarker concentrations of inflammation or cell turnover. However, women and those previously diagnosed as suffering from depression or anxiety or who reported using antidepressant drugs made up a disproportionate number of those suffering from persistent fatigue.
Of the 128 patients, 66 (51.6%) were health care workers, but there was no association between occupation and lasting fatigue. “The large number of health care workers in our cohort reflects the general demographics of Irish data and our institution, where 50% of positive SARS-CoV-2 cases involved health workers,” the authors said. “The high percentage of healthcare workers infected with COVID-19, not just in our cohort but internationally, means this will have a significant impact on healthcare systems.”
The average age of the participants was 49.5 years; the results of the study were independent of age.
Reduced quality of life, health system functionality
The authors noted that persistent fatigue rates in the study were much higher than those reported in a 2006 study of patients after recovering from Epstein-Barr virus, Q fever, or Ross River virus, but that a 2009 study reported that 40% of patients had fatigue 1 year after recovering from infection with the coronavirus that causes severe acute respiratory syndrome (SARS).
“A long post-infection fatigue burden will compromise quality of life and significantly impact individuals, employers and health systems,” the authors said. “This study highlights the importance of evaluating those recovering from COVID-19 for symptoms of severe fatigue, regardless of the severity of the initial disease, and can identify a group worthy of further study and early intervention.”
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