Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study

Pedersen, Maria; Asprusten, Tarjei Tørre; Godang, Kristin; Leegaard, Truls Michael; Osnes, Liv; Skovlund, Eva; Tjade, Trygve; Øie, Merete Glenne; Wyller, Vegard Bruun

doi:10.1016/j.bbi.2018.09.023

Cited by 64 publications

(77 citation statements)

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“…This study is a part of the CEBA‐project (Chronic Fatigue following acute EBV Infection in Adolescents; ClinicalTrial ID: NCT02335437), embracing a prospective, cross‐sectional and randomized controlled design with a total follow‐up time of 21 months. A detailed description has been provided elsewhere . Here, only prospective results from the first six months are reported.…”

Section: Methodsmentioning

confidence: 99%

“…Inclusion of participants lasted from March 2015 until November 2016. During this period, EBV‐infected individuals fulfilling the following criteria were assessed for eligibility : (i) A serological pattern indicating acute EBV infection (Table ); (ii) Age between 12 and 20 years; and (iii) Living in one of the Norwegian counties Oslo, Akershus or Buskerud. Exclusion criteria were (i) More than six weeks since debut of symptoms suggesting acute EBV infection; (ii) Any chronic disease that needed regular use of medication; and (iii) Pregnancy.…”

Section: Methodsmentioning

confidence: 99%

“…The investigational programme was carried out in a fixed sequence for all participants by two researchers only (MP and TTA), and included a clinical examination, ultrasound of the spleen, blood and throat swab sampling, autonomic cardiovascular control assessment, pressure pain threshold assessment, cognitive testing and questionnaire charting . Blood samples were obtained in a fixed sequence from antecubital venous puncture and assayed for neuroendocrinological, immunological, microbiological and routine clinical markers.…”

Section: Methodsmentioning

confidence: 99%

“…Predictors of chronic fatigue development include female sex, previous negative life events, symptom intensity and C‐reactive protein (CRP) level during the initial stages of EBV infection . However, in a recent study, virus load and other infectious markers had no predictive power .…”

Section: Introductionmentioning

confidence: 99%

“…Infectious mononucleosis is often complicated by prolonged fatigue, and as many as 12–13% of EBV‐infected individuals fulfil case definition of chronic fatigue syndrome (CFS) six months after the acute infection . Predictors of chronic fatigue development include female sex, previous negative life events, symptom intensity and C‐reactive protein (CRP) level during the initial stages of EBV infection . However, in a recent study, virus load and other infectious markers had no predictive power .…”

Section: Introductionmentioning

confidence: 99%

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Lifestyle factors during acute Epstein–Barr virus infection in adolescents predict physical activity six months later

et al. 2019

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Aim: Acute Epstein-Barr virus (EBV) infection is a trigger of prolonged fatigue. This study investigated baseline predictors of physical activity six months after an acute EBV infection.Methods: A total of 200 adolescents (12-20 years old) with acute EBV infection were assessed for 149 possible baseline predictors and followed prospectively. In this exploratory study, we performed linear regression analysis to assess possible associations between baseline predictors and steps per day at six months.Results: In the final multiple linear regression model, physical activity six months after acute EBV infection was significantly and independently predicted by baseline physical activity (steps per day), substance use (alcohol and illicit drugs) and human growth hormone (adjusted R 2 = 0.20).Conclusion: Baseline physical activity, substance use and plasma growth hormone are independent predictors of physical activity six months after an acute EBV infection in adolescents, whereas markers of the infection and associated immune response do not seem to be associated with physical activity six months later.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lifestyle factors during acute Epstein–Barr virus infection in adolescents predict physical activity six months later

et al. 2019

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Prevalence and Characteristics Associated With Post–COVID-19 Condition Among Nonhospitalized Adolescents and Young Adults

et al. 2023

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ImportanceThe prevalence and baseline risk factors of post–COVID-19 condition (PCC) remain unresolved among the large number of young people who experienced mild COVID-19.ObjectivesTo determine the point prevalence of PCC 6 months after the acute infection, to determine the risk of development of PCC adjusted for possible confounders, and to explore a broad range of potential risk factors.Design, Setting, and ParticipantsThis cohort study included nonhospitalized individuals from 2 counties in Norway between ages 12 and 25 years who underwent reverse transcription–polymerase chain reaction (RT-PCR) testing. At the early convalescent stage and at 6-month follow-up, participants underwent a clinical examination; pulmonary, cardiac, and cognitive functional testing; immunological and organ injury biomarker analyses; and completion of a questionnaire. Participants were classified according to the World Health Organization case definition of PCC at follow-up. Association analyses of 78 potential risk factors were performed.ExposuresSARS-CoV-2 infection.Main Outcomes and MeasuresThe point prevalence of PCC 6 months after RT-PCR testing in the SARS-CoV-2–positive and SARS-CoV-2–negative groups, and the risk difference with corresponding 95% CIs.ResultsA total of 404 individuals testing positive for SARS-CoV-2 and 105 individuals testing negative were enrolled (194 male [38.1%]; 102 non-European [20.0%] ethnicity). A total of 22 of the SARS-CoV-2–positive and 4 of the SARS-CoV-2–negative individuals were lost to follow-up, and 16 SARS-CoV-2–negative individuals were excluded due to SARS-CoV-2 infection in the observational period. Hence, 382 SARS-CoV-2–positive participants (mean [SD] age, 18.0 [3.7] years; 152 male [39.8%]) and 85 SARS-CoV-2–negative participants (mean [SD] age, 17.7 [3.2] years; 31 male [36.5%]) could be evaluated. The point prevalence of PCC at 6 months was 48.5% in the SARS-CoV-2–positive group and 47.1% in the control group (risk difference, 1.5%; 95% CI, −10.2% to 13.1%). SARS-CoV-2 positivity was not associated with the development of PCC (relative risk [RR], 1.06; 95% CI, 0.83 to 1.37; final multivariable model utilizing modified Poisson regression). The main risk factor for PCC was symptom severity at baseline (RR, 1.41; 95% CI, 1.27-1.56). Low physical activity (RR, 0.96; 95% CI, 0.92-1.00) and loneliness (RR, 1.01; 95% CI, 1.00-1.02) were also associated, while biological markers were not. Symptom severity correlated with personality traits.Conclusions and RelevanceThe persistent symptoms and disability that characterize PCC are associated with factors other than SARS-CoV-2 infection, including psychosocial factors. This finding raises questions about the utility of the World Health Organization case definition and has implications for the planning of health care services as well as for further research on PCC.

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Therapeutic Implications of the Microbial Hypothesis of Mental Illness

Savitz

Yolken²

2022

Current Topics in Behavioral Neurosciences

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Predictors of chronic fatigue in adolescents six months after acute Epstein-Barr virus infection: A prospective cohort study

Cited by 64 publications

References 35 publications

Lifestyle factors during acute Epstein–Barr virus infection in adolescents predict physical activity six months later

Lifestyle factors during acute Epstein–Barr virus infection in adolescents predict physical activity six months later

Prevalence and Characteristics Associated With Post–COVID-19 Condition Among Nonhospitalized Adolescents and Young Adults

Therapeutic Implications of the Microbial Hypothesis of Mental Illness

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