Nav: Home

Study shows high prevalence of fatigue following SARS-CoV-2 infection independent of COVID-19 disease severity

September 17, 2020

Research being presented at the 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. The study is by Dr Liam Townsend, St James's Hospital and Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland, and colleagues.

As the global COVID-19 pandemic continues to grow worldwide, the number of patients recovering, and also experiencing post-infection problems, is also growing. "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," explains Dr Townsend.

"In particular, concern has been raised that SARS-CoV-2 has the potential to cause persistent fatigue, even after those infected have recovered from COVID-19. In our study, we investigated whether patients recovering from SARS-CoV-2 infection remained fatigued after their physical recovery, and to see whether there was a relationship between severe fatigue and a variety of clinical parameters. We also examined persistence of markers of disease beyond clinical resolution of infection."

The authors 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), and also their pre-existing conditions including depression. They also looked at 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.

The researchers offered an outpatient appointment to anyone who had a COVID-19 positive swab test in their laboratory at St James Hospital. This included all admitted patients as well as any hospital staff (including cleaning staff, caterers, etc) since the service was also offered to staff that thought they had COVID-19 symptoms. The majority of those in the non-admitted group had a mild illness but had a swab test performed at St James's Hospital rather than at a community testing facility, as they were employed by St James's Hospital.

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," explains 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. And while only 1 person of the 61 (1.6%) without fatigue had a history of anxiety or depression, this proportion was 13.4% (9/67) in those with persistent fatigue.

The authors conclude: "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. It also supports the use of non-pharmacological interventions for fatigue management. These interventions will need to be tailored to the individual needs of the patients, and may include lifestyle modification, cognitive behavioural therapy and self-pacing exercise, where tolerated."
-end-


European Society of Clinical Microbiology and Infectious Diseases

Related Infection Articles:

Halving the risk of infection following surgery
New analysis by the University of Leeds and the University of Bern of more than 14,000 operations has found that using alcoholic chlorhexidine gluconate (CHG) halves the risk of infection in certain types of surgery when compared to the more commonly used povidone-iodine (PVI).
How plants shut the door on infection
A new study by an international team including University of Maryland scientists has discovered the key calcium channel responsible for closing plant pores as an immune response to pathogen exposure.
Sensing infection, suppressing regeneration
UIC researchers describe an enzyme that blocks the ability of blood vessel cells to self-heal.
Boost to lung immunity following infection
The strength of the immune system in response to respiratory infections is constantly changing, depending on the history of previous, unrelated infections, according to new research from the Crick.
Is infection after surgery associated with increased long-term risk of infection, death?
Whether experiencing an infection within the first 30 days after surgery is associated with an increased risk of another infection and death within one year was the focus of this observational study that included about 660,000 veterans who underwent major surgery.
Revealed: How E. coli knows how to cause the worst possible infection
The discovery could one day let doctors prevent the infection by allowing E. coli to pass harmlessly through the body.
UK study shows most patients with suspected urinary tract infection and treated with antibiotics actually lack evidence of this infection
New research presented at this week's European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands (April 13-16, 2019) shows that only one third of patients that enter the emergency department with suspected urinary tract infection (UTI) actually have evidence of this infection, yet almost all are treated with antibiotics, unnecessarily driving the emergence of antimicrobial resistance.
Bacteria in urine doesn't always indicate infection
Doctors should think carefully before testing patients for a urinary tract infection (UTI) to avoid over-diagnosis and unnecessary antibiotic treatment, according to updated asymptomatic bacteriuria (ASB) guidelines released by the Infectious Diseases Society of America (IDSA) and published in Clinical Infectious Diseases.
Subsidies for infection control to healthcare institutions help reduce infection levels
Researchers compared three types of infection control subsidies and found that under a limited budget, a dollar-for-dollar matching subsidy, in which policymakers match hospital spending for infection control measures, was the most effective at reducing the number of hospital-acquired infections.
Dengue virus infection may cause severe outcomes following Zika virus infection during pregnancy
This study is the first to report a possible mechanism for the enhancement of Zika virus progression during pregnancy in an animal model.
More Infection News and Infection Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.