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Post-Coronavirus: the annoying symptom that remains in half of patients

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High prevalence of chronic fatigue after coronavirus infection and regardless of the severity of COVID-19 disease show new evidence brought to light by a recent scientific study

The research papers presented at the ESCMID (European Society of Clinical Microbiology and Infectious Diseases) conference on Covid-19 disease shows that chronic fatigue occurs in more than half of patients recovering from COVID-19, regardless of the severity of their infection.

“Fatigue is a common symptom in those with symptomatic COVID-19 infection. Although current data on SARS-CoV-2 infection have been adequately characterized, the medium and long-term effects of the infection remain unexplored,” Liam Townsend from Trinity College Dublin who conducted the research.

“In particular, concerns are being raised about the fact that SARS-CoV-2 has the potential to cause chronic fatigue, even after patients recover. In our study, we investigated whether patients who recovered from a coronavirus infection experienced fatigue after physical recovery and whether there was a relationship between severe fatigue and various other clinical parameters. We also looked at the values ​​of disease indicators after the end of the infection,” he added.

The authors used a widely used scale (CFQ-11) to determine fatigue in patients who recovered and assessed the severity of patients’ initial infection (need to be admitted to hospital and ICU) as well as pre-existing conditions, including depression. They also examined various immune defense markers (white blood cells, C-reactive protein, interleukin-6 and sCD25).

The study included 128 participants (average age 50 years, 54% women) enrolled approximately 10 weeks after clinical recovery from infection, half of whom reported persistent fatigue (52.3%, 67/128) at that time.

As the data showed, there was no correlation between the severity of COVID-19 (need for hospitalization, respiratory support or ICU) and subsequent fatigue, nor between the classic laboratory markers of inflammation, cell rotation (number or white blood cell ratio, lactic dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and post-disease fatigue.

The fact is that the women and people with a pre-existing diagnosis of depression/anxiety were overrepresented to those with fatigue. Also, although women accounted for more than half of the patients in the study (54%), two-thirds of those with chronic fatigue (67%) were women. And while only one of the 61 people (1.6%) without fatigue had a history of anxiety or depression, the ratio reached 13.4% (9/67) in those with chronic fatigue.

The authors conclude: “Our findings show a significant burden of post-fatigue in individuals with previous SARS-CoV-2 infection, after the intense phase of COVID-19 disease. The study emphasizes the importance of evaluating those recovering from COVID-19 with symptoms of severe fatigue, regardless of the severity of the initial disease, and may be able to identify a significant group of patients for further studies and early intervention. It also supports the use of non-drug interventions to manage fatigue, which should be individualized to the needs of patients and may include lifestyle modifications, cognitive behavioral therapy and exercise where and when possible.”

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