Journal Article

Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection

Conlon, Niall, Martin-Loeches, Ignacio, Dowds, Joanne, Sugrue, Jamie A., Gaffney, Fiona, McLaughlin, Anne Marie, Bannan, Ciaran, Bourke, Nollaig M., Ni Cheallaigh, Cliona, Jones, Karen, Leavy, Deirdre, Townsend, Liam, Hopkins, David, O'Connor, Laura, Dunne, Jean, Mooney, Aoife, Nadarajan, Parthiban, Bergin, Colm, O'Farrelly, Cliona, Dyer, Adam H., O'Brien, Kate

2020

Overview

Fatigue is a common symptom in those presenting with symptomatic COVID-19 infection. However, it is unknown if COVID-19 results in persistent fatigue in those recovered from acute infection. We examined the prevalence of fatigue in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue Score (CFQ-11). We further examined potential predictors of fatigue following COVID-19 infection, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 ± 15 years; 54% female), more than half reported persistent fatigue (67/128; 52.3%) at median of 10 weeks after initial COVID-19 symptoms. 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 (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, 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. Our findings demonstrate a significant burden of post-viral fatigue in individuals with previous SARS-CoV-2 infection after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Bacterial infections / Betacoronavirus - isolation & purification / Biochemistry / Biology and life sciences / C-reactive protein / Chronic fatigue syndrome / Clinical medicine / Complications and side effects / Coronavirus Infections - complications / Coronavirus Infections - pathology / Coronavirus Infections - virology / Coronaviruses / COVID-19 / Cytokines / Epidemics / Fatigue / Fatigue - epidemiology / Fatigue - etiology / Female / Gerontology / Hospitals / Humans / Illnesses / Immune response / Immune system / Immunology / Infections / Infectious diseases / Inflammation / Interleukin 6 / Interleukin-2 Receptor alpha Subunit - blood / Interleukin-6 - blood / L-Lactate dehydrogenase / Lactate dehydrogenase / Lactic acid / Leukocytes / Lymphocytes / Male / Markers / Medicine / Medicine and Health Sciences / Middle Aged / Outpatient care facilities / Oxygen / Pandemics / Pneumonia, Viral - complications / Pneumonia, Viral - pathology / Pneumonia, Viral - virology / Prevalence / Risk factors / SARS-CoV-2 / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Supervision / Townsend, Adam / Viral diseases