COVID-19 and chronic fatigue syndrome: Is the worst yet to come?

Wostyn, Peter

doi:10.1016/j.mehy.2020.110469

Cited by 163 publications

(128 citation statements)

References 39 publications

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“…Considering dyspnoea, infection with COVID-19 could result in severe outcomes and death from pneumonia with severe symptoms [82][83][84]. Fatigue could even be found in the post-COVID-19 period [85,86].…”

Section: Discussionmentioning

confidence: 99%

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

et al. 2021

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To analyse the prevalence of severe and critical COVID-19 cases and its determinants, a systematic review and meta-analysis were conducted using Review Manager. Four English and two Chinese databases were used to identify and explore the relationships between the severity of COVID-19 and its determinants, with no restrictions on publication date. The odds ratio and 95% CI were combined to assess the influencing level of all factors. Twenty-three articles containing a total of 15,828 cases of COVID-19 were included in this systematic review. The prevalence of severe and critical COVID-19 cases was 17.84% and 4.9%, respectively. A total of 148 factors were identified, which included behavioural, symptom, comorbidity, laboratory, radiographic, exposure, and other factors. Among them, 35 factors could be included in the meta-analysis. Specifically, for example, the male (OR 1.55, 95% CI 1.42–1.69) and elderly (OR 1.06, 95% CI 1.03–1.10) populations tended to experience severe and critical illness. Patients with cough, dyspnea, fatigue, fever, and gastrointestinal symptoms could have severe and critical diseases. Regarding laboratory results, albumin, aspartate aminotransferase, creatinine, D-dimer, fibrinogen, neutrophils, procalcitonin, platelets, and respiratory rate were potential factors that could be used to predict the severity of COVID.

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Section: Discussionmentioning

confidence: 99%

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

et al. 2021

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“…The hippocampus appears to be particularly vulnerable to infection, which may also contribute to post-infection memory deficit [ 58 ]. Wostyn proposed the hypothesis that post-COVID fatigue syndrome may result from damage to olfactory sensory neurons, causing a reduced outflow of cerebrospinal fluid (CSF) through the cribriform plate, and leading to congestion of the lymphatic system with subsequent toxic build-up within the CNS [ 59 ]. In addition, direct SARS-CoV-2 neuroinvasion has been proposed as a mechanism that may lead to persistent neurophychiatric complications [ 22 ], but it appears less likely on the basis of time that elapsed from initial infection.…”

Section: Pathogenesis Of Post-covid Syndromementioning

confidence: 99%

Post-COVID Syndrome: An Insight on Its Pathogenesis

2021

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Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome.

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“…18 Some studies have suggested that post-COVID-19 symptoms resemble fibromyalgia, post-viral fatigue syndrome, or chronic fatigue viral syndrome. [24][25][26] However, these associations are speculative, and further research is needed to clarify the underlying pathophysiology of long COVID-19 and whether applying similar clinical management strategies would be beneficial. This study's main limitation was that many patients were lost to follow-up by the end of the observation period.…”

Section: Discussionmentioning

confidence: 99%

Symptom Cluster Analysis of long COVID-19 in Patients Discharged from the Temporary COVID-19 Hospital in Mexico City: A Longitudinal Study

Rm¹,

Exr²,

Car³

et al. 2021

Preprint

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Recently, several reports have emerged describing the long-term consequences of COVID-19 that may affect multiple systems, suggesting its chronicity. As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients discharged from the TCH, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p<0·00001). Women were more prone than men to develop long-term symptoms and invasive mechanical ventilation also increased the frequency of symptoms at 30-days post-discharge. Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19.

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COVID-19 and chronic fatigue syndrome: Is the worst yet to come?

Cited by 163 publications

References 39 publications

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

The Severity of COVID-19 and Its Determinants: A Systematic Review and Meta-Analysis in China

Post-COVID Syndrome: An Insight on Its Pathogenesis

Symptom Cluster Analysis of long COVID-19 in Patients Discharged from the Temporary COVID-19 Hospital in Mexico City: A Longitudinal Study

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