tetano
Editor, Senior Moderator
BMJ Open
. 2023 Apr 26;13(4):e063969.
doi: 10.1136/bmjopen-2022-063969. Fatigue outcomes following COVID-19: a systematic review and meta-analysis
Kim Poole-Wright[SUP] 1 [/SUP], Ismail Guennouni[SUP] 2 [/SUP], Olivia Sterry[SUP] 1 [/SUP], Rachael A Evans[SUP] 3 [/SUP], Fiona Gaughran[SUP] 4 5 [/SUP], Trudie Chalder[SUP] 6 [/SUP]
Affiliations
Objectives: Fatigue is a pervasive clinical symptom in coronaviruses and may continue beyond the acute phase, lasting for several months or years. This systematic review and meta-analysis aimed to incorporate the current evidence for postinfection fatigue among survivors of SARS-CoV-2 and investigate associated factors.
Methods: Embase, PsyINFO, Medline, CINAHL, CDSR, Open Grey, BioRxiv and MedRxiv were systematically searched from January 2019 to December 2021. Eligible records included all study designs in English. Outcomes were fatigue or vitality in adults with a confirmed diagnosis of SARS-CoV-2 measured at >30 days post infection. Non-confirmed cases were excluded. JBI risk of bias was assessed by three reviewers. Random effects model was used for the pooled proportion with 95% CIs. A mixed effects meta-regression of 35 prospective articles calculated change in fatigue overtime. Subgroup analyses explored specific group characteristics of study methodology. Heterogeneity was assessed using Cochran's Q and I[SUP]2[/SUP] statistic. Egger's tests for publication bias.
Results: Database searches returned 14 262 records. Following deduplication and screening, 178 records were identified. 147 (n=48 466 participants) were included for the meta-analyses. Pooled prevalence was 41% (95% CI: 37% to 45%, k=147, I[SUP]2[/SUP]=98%). Fatigue significantly reduced over time (-0.057, 95% CI: -107 to -0.008, k=35, I[SUP]2[/SUP]=99.3%, p=0.05). A higher proportion of fatigue was found in studies using a valid scale (51%, 95% CI: 43% to 58%, k=36, I[SUP]2[/SUP]=96.2%, p=0.004). No significant difference was found for fatigue by study design (p=0.272). Egger's test indicated publication bias for all analyses except valid scales. Quality assessments indicated 4% at low risk of bias, 78% at moderate risk and 18% at high risk. Frequently reported associations were female gender, age, physical functioning, breathlessness and psychological distress.
Conclusion: This study revealed that a significant proportion of survivors experienced fatigue following SARS-CoV-2 and their fatigue reduced overtime. Non-modifiable factors and psychological morbidity may contribute to ongoing fatigue and impede recovery.
Prospero registration number: CRD42020201247.
Keywords: COVID-19; EPIDEMIOLOGY; Respiratory infections.
. 2023 Apr 26;13(4):e063969.
doi: 10.1136/bmjopen-2022-063969. Fatigue outcomes following COVID-19: a systematic review and meta-analysis
Kim Poole-Wright[SUP] 1 [/SUP], Ismail Guennouni[SUP] 2 [/SUP], Olivia Sterry[SUP] 1 [/SUP], Rachael A Evans[SUP] 3 [/SUP], Fiona Gaughran[SUP] 4 5 [/SUP], Trudie Chalder[SUP] 6 [/SUP]
Affiliations
- PMID: 37185637
- DOI: 10.1136/bmjopen-2022-063969
Objectives: Fatigue is a pervasive clinical symptom in coronaviruses and may continue beyond the acute phase, lasting for several months or years. This systematic review and meta-analysis aimed to incorporate the current evidence for postinfection fatigue among survivors of SARS-CoV-2 and investigate associated factors.
Methods: Embase, PsyINFO, Medline, CINAHL, CDSR, Open Grey, BioRxiv and MedRxiv were systematically searched from January 2019 to December 2021. Eligible records included all study designs in English. Outcomes were fatigue or vitality in adults with a confirmed diagnosis of SARS-CoV-2 measured at >30 days post infection. Non-confirmed cases were excluded. JBI risk of bias was assessed by three reviewers. Random effects model was used for the pooled proportion with 95% CIs. A mixed effects meta-regression of 35 prospective articles calculated change in fatigue overtime. Subgroup analyses explored specific group characteristics of study methodology. Heterogeneity was assessed using Cochran's Q and I[SUP]2[/SUP] statistic. Egger's tests for publication bias.
Results: Database searches returned 14 262 records. Following deduplication and screening, 178 records were identified. 147 (n=48 466 participants) were included for the meta-analyses. Pooled prevalence was 41% (95% CI: 37% to 45%, k=147, I[SUP]2[/SUP]=98%). Fatigue significantly reduced over time (-0.057, 95% CI: -107 to -0.008, k=35, I[SUP]2[/SUP]=99.3%, p=0.05). A higher proportion of fatigue was found in studies using a valid scale (51%, 95% CI: 43% to 58%, k=36, I[SUP]2[/SUP]=96.2%, p=0.004). No significant difference was found for fatigue by study design (p=0.272). Egger's test indicated publication bias for all analyses except valid scales. Quality assessments indicated 4% at low risk of bias, 78% at moderate risk and 18% at high risk. Frequently reported associations were female gender, age, physical functioning, breathlessness and psychological distress.
Conclusion: This study revealed that a significant proportion of survivors experienced fatigue following SARS-CoV-2 and their fatigue reduced overtime. Non-modifiable factors and psychological morbidity may contribute to ongoing fatigue and impede recovery.
Prospero registration number: CRD42020201247.
Keywords: COVID-19; EPIDEMIOLOGY; Respiratory infections.