Fatigue as the Chief Complaint

Maisel, Peter; Baum, Erika; Donner-Banzhoff, Norbert

doi:10.3238/arztebl.m2021.0192

Cited by 23 publications

(8 citation statements)

References 114 publications

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“…The diagnosis is typically made when fatigue is preceded by a viral illness and cannot be explained by other conditions, such as anemia, adrenal insufficiency, and cancer. 65 Similarly, there is no standardized protocol for the treatment of post-viral fatigue. Management depends on the individual patient’s illness experience and is typically focused on energy conservation.…”

Section: Post-viral Fatiguementioning

confidence: 99%

Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions

Tackey,

Slepian,

Clarke

et al. 2023

Canadian Journal of Pain

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Background Post-viral pain syndrome, also known as post-viral syndrome, is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances that can occur after an individual has recovered from a viral infection. Aims This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, and the pathophysiology, treatment, and future considerations for research and targeted therapies. Methods Medline, PubMed, and Embase databases were used to search for studies on viruses associated with post-viral syndrome. Conclusion Much remains unknown regarding the pathophysiology of post-viral syndromes, and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities. With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for an understanding of the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.

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Section: Post-viral Fatiguementioning

confidence: 99%

Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions

Tackey,

Slepian,

Clarke

et al. 2023

Canadian Journal of Pain

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“…Betroffene verwenden dabei Beschreibungen, die emotionale, kognitive, körperliche oder Verhaltensaspekte beinhalten. Müdigkeit gehört zu den Beschwerden, die im Praxisalltag Schwierigkeiten in der Diagnostik bereiten und als problematisch erlebt werden [ 2 – 5 ].…”

Section: Hintergrundunclassified

Tiredness/Fatigue—S3 guideline update

et al. 2023

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Hintergrund Müdigkeit ist ein häufiges Symptom in der Hausarztpraxis, bei dem oft diagnostische Unsicherheit besteht. Betroffene verwenden Beschreibungen, die emotionale, kognitive, körperliche oder Verhaltensaspekte beinhalten. Eine Vielzahl biologischer, seelischer und sozialer Ursachen ist denkbar, oft in Kombination. Die Leitlinie bezieht sich auf das Vorgehen bei primär ungeklärter Symptomatik. Suchmethoden Die beteiligten Expert:innen führten eine systematische Recherche mit den Begriffen für Müdigkeit im Kontext hausärztlicher Versorgung in PubMed, Cochrane Library und mit Handsuche durch. Bezüglich verwandter Leitlinien konnte für die myalgische Enzephalitis/chronisches Fatigue-Syndrom (ME/CFS) auf die Leitlinie des National Institute of Health and Care Excellence (NICE) zurückgegriffen werden. In einem strukturierten Konsensprozess wurde weitgehende Zustimmung zu Kernempfehlungen/Hintergrundtext der überarbeiteten Leitlinie erreicht. Wichtigste Botschaften 1) Neben den Charakteristika des Symptoms sollen u. a. Vorerkrankungen, Schlafverhalten, Zufuhr psychotroper Substanzen, psychosoziale und Umweltfaktoren erfragt werden. 2) Depression und Angst sollen als häufige Ursache anhand von Screeningfragen erfasst, zudem das Auftreten einer postexertionellen Malaise (PEM) erfragt werden. 3) Als Basisdiagnostik wird empfohlen: körperliche Untersuchung, Laboruntersuchungen (Blutglukose, großes Blutbild, BSG/CRP, Transaminasen/γ-GT, TSH). 4) Weitere Untersuchungen sind nur bei spezifischen Hinweisen indiziert. 5) Ein biopsychosozialer Ansatz ist anzustreben. 6) Verhaltenstherapie und symptomorientierte aktivierende Maßnahmen können Müdigkeit bei zugrunde liegender Erkrankung sowie bei ungeklärter Ursache verbessern. 7) Bei PEM werden weitere ME/CFS-Kriterien erfasst und Betroffene dementsprechend betreut.

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“…As a common non-specific symptom [ 2 ], fatigue can be the main patients’ complaint or the accompanying symptom of a variety diseases. Some fatigue can be relieved soon through adequate rest or treatment, while many fatigues cannot be relieved and may last for a long time, causing harm to people’s psychology and physiology, seriously interfering with people’s life [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Chinese herbal medicine for post-viral fatigue: A systematic review of randomized controlled trials

Hu,

Cai,

et al. 2024

PLoS ONE

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Background Fatigue is a common symptom after viral infection. Chinese herbal medicine (CHM) is thought to be a potential effective intervention in relieving fatigue. Purpose To assess the effectiveness and safety of CHM for the treatment of post-viral fatigue. Study design Systematic review and meta-analysis of randomized controlled trials (RCTs). Methods The protocol of this systematic review was registered on PROSPERO (CRD42022380356). Trials reported changes of fatigue symptom, which compared CHM to no treatment, placebo or drugs, were included. Six electronic databases and three clinical trial registration platforms were searched from inception to November 2023. Literature screening, data extraction, and risk bias assessment were independently carried out by two reviewers. Quality of the included trials was evaluated using Cochrane risk of bias tool, and the certainty of the evidence was evaluated using GRADE. The meta-analysis was performed using Review Manager 5.4, mean difference (MD) and its 95% confidence interval (CI) was used for estimate effect of continuous data. Heterogeneity among trials was assessed through I2 value. Results Overall, nineteen studies with 1921 patients were included. Results of individual trial or meta-analysis showed that CHM was better than no treatment (MD = -0.80 scores, 95%CI -1.43 to -0.17 scores, P = 0.01, 60 participants, 1 trial), placebo (MD = -1.90 scores, 95%CI -2.38 to -1.42 scores, P<0.00001, 184 participants, 1 trial), placebo on basis of rehabilitation therapy (MD = -14.90 scores, 95%CI -24.53 to -5.27 scores, P = 0.02, 118 participants, 1 trial) or drugs (MD = -0.38 scores, 95%CI -0.48 to -0.27 scores, I2 = 0%, P<0.00001, 498 participants, 4 trials) on relieving fatigue symptoms assessing by Traditional Chinese Medicine fatigue scores. Trials compared CHM plus drugs to drugs alone also showed better effect of combination therapy (average MD = -0.56 scores). In addition, CHM may improve the percentage of CD4 T lymphocytes and reduce the level of serum IL-6 (MD = -14.64 scores, 95%CI 18.36 to -10.91 scores, I2 = 0%, P<0.00001, 146 participants, 2 trials). Conclusion Current systematic review found that the participation of CHM can improve the symptoms of post-viral fatigue and some immune indicators. However, the safety of CHM remains unknown and large sample, high quality multicenter RCTs are still needed in the future.

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Fatigue as the Chief Complaint

Cited by 23 publications

References 114 publications

Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions

Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions

Tiredness/Fatigue—S3 guideline update

Chinese herbal medicine for post-viral fatigue: A systematic review of randomized controlled trials

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