tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Apr 10;9(5)
fac127.
doi: 10.1093/ofid/ofac127. eCollection 2022 May.
Severe Fatigue in the First Year Following SARS-CoV-2 Infection: A Prospective Cohort Study
Anouk Verveen[SUP] 1 [/SUP], Elke Wynberg[SUP] 2 3 [/SUP], Hugo D G van Willigen[SUP] 3 4 [/SUP], Anders Boyd[SUP] 2 5 [/SUP], Menno D de Jong[SUP] 4 [/SUP], Godelieve de Bree[SUP] 3 [/SUP], Udi Davidovich[SUP] 2 6 [/SUP], Anja Lok[SUP] 7 [/SUP], Eric P Moll van Charante[SUP] 8 9 [/SUP], Hans Knoop[SUP] 1 [/SUP], Maria Prins[SUP] 2 3 [/SUP], Pythia Nieuwkerk[SUP] 1 [/SUP], RECoVERED Study Group
Collaborators, Affiliations
Abstract
Background: Severe fatigue can persist for months after coronavirus disease 2019 (COVID-19) onset. This longitudinal study describes fatigue severity and its determinants up to 12 months after illness onset across the full spectrum of COVID-19 severity.
Methods: RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged ≥16 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Fatigue was measured using the validated Short Fatigue Questionnaire (SFQ; range 4-28) at months 1, 3, 6, 9, and 12 of follow-up. Fatigue severity was modeled over time using mixed-effects linear regression. Determinants of severe fatigue (SFQ ≥18) at 6 months since illness onset (ie, persistent fatigue) were identified using logistic regression.
Results: Between May 2020 and July 2021, 303 participants completed at least 1 fatigue questionnaire. Twelve months after illness onset, 17.4% (95% CI, 6.7% to 38.3%), 21.6% (95% CI, 11.2% to 37.7%), and 44.8% (95% CI, 28.0% to 62.9%) of participants with mild, moderate, and severe/critical COVID-19 (World Health Organization definition), respectively, experienced severe fatigue. When adjusting for age and sex, having ≥3 comorbidities (P = .007), severe/critical COVID-19 (P = .002), low mood (P < .001), and dyspnea in the first 2 weeks of illness (P = .001) were associated with more severe fatigue over time. Severe/critical COVID-19 (adjusted odds ratio [aOR], 3.37; 95% CI, 1.28 to 8.93) and low mood at enrollment (aOR, 2.43; 95% CI, 1.11 to 5.29) were associated with persistent fatigue. Recovery rarely occurred beyond 6 months after illness onset, regardless of COVID-19 severity.
Conclusions: The occurrence of severe fatigue in our cohort was high, especially among those with initially severe/critical COVID-19, with little recovery beyond 6 months after illness onset. Our findings highlight an urgent need for improved understanding of persistent severe fatigue following COVID-19 to help inform prevention and intervention.
Keywords: COVID-19; fatigue; infection; persistence; predictors.
. 2022 Apr 10;9(5)
fac127.doi: 10.1093/ofid/ofac127. eCollection 2022 May.
Severe Fatigue in the First Year Following SARS-CoV-2 Infection: A Prospective Cohort Study
Anouk Verveen[SUP] 1 [/SUP], Elke Wynberg[SUP] 2 3 [/SUP], Hugo D G van Willigen[SUP] 3 4 [/SUP], Anders Boyd[SUP] 2 5 [/SUP], Menno D de Jong[SUP] 4 [/SUP], Godelieve de Bree[SUP] 3 [/SUP], Udi Davidovich[SUP] 2 6 [/SUP], Anja Lok[SUP] 7 [/SUP], Eric P Moll van Charante[SUP] 8 9 [/SUP], Hans Knoop[SUP] 1 [/SUP], Maria Prins[SUP] 2 3 [/SUP], Pythia Nieuwkerk[SUP] 1 [/SUP], RECoVERED Study Group
Collaborators, Affiliations
- PMID: 35415196
- PMCID: PMC8995073
- DOI: 10.1093/ofid/ofac127
Abstract
Background: Severe fatigue can persist for months after coronavirus disease 2019 (COVID-19) onset. This longitudinal study describes fatigue severity and its determinants up to 12 months after illness onset across the full spectrum of COVID-19 severity.
Methods: RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged ≥16 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Fatigue was measured using the validated Short Fatigue Questionnaire (SFQ; range 4-28) at months 1, 3, 6, 9, and 12 of follow-up. Fatigue severity was modeled over time using mixed-effects linear regression. Determinants of severe fatigue (SFQ ≥18) at 6 months since illness onset (ie, persistent fatigue) were identified using logistic regression.
Results: Between May 2020 and July 2021, 303 participants completed at least 1 fatigue questionnaire. Twelve months after illness onset, 17.4% (95% CI, 6.7% to 38.3%), 21.6% (95% CI, 11.2% to 37.7%), and 44.8% (95% CI, 28.0% to 62.9%) of participants with mild, moderate, and severe/critical COVID-19 (World Health Organization definition), respectively, experienced severe fatigue. When adjusting for age and sex, having ≥3 comorbidities (P = .007), severe/critical COVID-19 (P = .002), low mood (P < .001), and dyspnea in the first 2 weeks of illness (P = .001) were associated with more severe fatigue over time. Severe/critical COVID-19 (adjusted odds ratio [aOR], 3.37; 95% CI, 1.28 to 8.93) and low mood at enrollment (aOR, 2.43; 95% CI, 1.11 to 5.29) were associated with persistent fatigue. Recovery rarely occurred beyond 6 months after illness onset, regardless of COVID-19 severity.
Conclusions: The occurrence of severe fatigue in our cohort was high, especially among those with initially severe/critical COVID-19, with little recovery beyond 6 months after illness onset. Our findings highlight an urgent need for improved understanding of persistent severe fatigue following COVID-19 to help inform prevention and intervention.
Keywords: COVID-19; fatigue; infection; persistence; predictors.